A novel noninvasive method to detect rejection after heart transplantation.
Prompt and accurate detection of rejection prior to pathological changes after organ transplantation is vital for monitoring rejections. Although biopsy remains the current gold standard for rejection diagnosis, it is an invasive method and cannot be repeated daily. Thus, noninvasive monitoring methods are needed. In this study, by introducing an IL-2 neutralizing monoclonal antibody (IL-2 N-mAb) and immunosuppressants into the culture with the presence of specific stimulators and activated lymphocytes, an activated lymphocyte-specific assay (ALSA) system was established to detect the specific activated lymphocytes. This assay demonstrated that the suppression in the ALSA test was closely related to the existence of specific activated lymphocytes. The ALSA test was applied to 47 heart graft recipients and the proliferation of activated lymphocytes from all rejection recipients proven by endomyocardial biopsies was found to be inhibited by spleen cells from the corresponding donors, suggesting that this suppression could reflect the existence of activated lymphocytes against donor antigens, and thus the rejection of a heart graft. The sensitivity of the ALSA test in these 47 heart graft recipients was 100%; however, the specificity was only 37.5%. It was also demonstrated that IL-2 N-mAb was indispensible, and the proper culture time courses and concentrations of stimulators were essential for the ALSA test. This preliminary study with 47 grafts revealed that the ALSA test was a promising noninvasive tool, which could be used in vitro to assist with the diagnosis of rejection post-heart transplantation.
Central Laboratory, Shaanxi Provincial People's Hospital, Third Affiliated Hospital of the School of Medicine, Xi'an Jiaotong University, Xi'an, China. hujun116@gmail.com
Jun
J
Hu
Xin
X
Xie
Yuan
Y
Li
Shuang
S
Wang
Qing
Q
Feng
Xin
X
Wang
Daoyan
D
Liang
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D004699:Endocardium / Q000473:pathology; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology; D016027:Heart Transplantation; D006801:Humans; D007376:Interleukin-2 / Q000032:analysis*; D008213:Lymphocyte Activation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055815:Young Adult
D007376:Interleukin-2