title: Invariant natural killer T cells infiltrate intestinal allografts undergoing acute cellular rejection.
abstract: Immunological responses in human intestinal allografts are poorly understood and accurate diagnosis of acute cellular rejection remains difficult. Here, human intestinal allografts were analyzed by multi-color quantitative fluorescent immunohistochemical morphometry in order to monitor the clinical course of rejection. Morphometry gave two-dimensional plots based on size and circularity, and identified phenotypes of individual cells infiltrating the allograft by fluorescent staining. Using this method, invariant TCRVα24(+) NKT (iNKT) cells were observed in the intestinal allograft during rejection. Because these were not identified in the normal donor intestine before surgery, this finding was considered to be a signature of acute cellular rejection of the intestinal allograft. Infiltrating iNKT cells released IL-4 and IL-5, Th2-related cytokines that antagonize the Th1 responses that induce acute cellular rejection. Histological observation suggested eosinophilic enteritis in the mucosa with elevation of IL-4 and IL-5. In conclusion, iNKT cells were recruited to the intestine; however, because higher levels of IL-4 and IL-5 may contribute to eosinophilic enteritis, timely steroid administration is recommended for allograft injury due to enteritis, as well as acute cellular rejection.
authors.affiliation: Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University Hospital, Kyoto, Japan. tsuruyam@kuhp.kyoto-u.ac.jp
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Tsuruyama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Yonekawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Miyao
authors.forename: Hisashi
authors.initials: H
authors.lastname: Onodera
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Hironori
authors.initials: H
authors.lastname: Haga
mesh_terms: D000208:Acute Disease; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology; D006801:Humans; D007223:Infant; D015847:Interleukin-4 / Q000096:biosynthesis; D015848:Interleukin-5 / Q000096:biosynthesis; D007413:Intestinal Mucosa / Q000276:immunology / Q000473:pathology; D007421:Intestine, Small / Q000276:immunology / Q000473:pathology / Q000637:transplantation*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D055611:Natural Killer T-Cells / Q000276:immunology* / Q000473:pathology*; D055815:Young Adult
chemical_list: C508598:IL4 protein, human; C508599:IL5 protein, human; D015848:Interleukin-5; D015847:Interleukin-4