title: Post-transplant increase in soluble human leukocyte antigen-G associated with non-severe cardiac allograft vasculopathy.
abstract: Cardiac allograft vasculopathy (CAV) is the single most important long-term limitation to heart transplantation. This study aimed to assess the value of monitoring soluble human leukocyte antigen-G (sHLA-G) during the first year post-transplantation to predict the severity of CAV, in 21 out of 77 heart recipients assessed by intravascular ultrasound (IVUS). Serum sHLA-G concentration increased after transplant in recipients free of severe CAV, but decreased in recipients suffering from severe CAV, significant differences between these two groups were found 6 to 12 months post-transplantation. The optimal value of the change in post-transplant sHLA-G for identifying severe CAV was ≥0.062%, which maximized sensitivity (80%) and specificity (100%). Importantly, increases in post-transplant sHLA-G were inversely associated with severe CAV, but directly associated with human cytomegalovirus reactivation. In addition, recipients presenting non-severe CAV or an increased sHLA-G post-transplantation, showed higher numbers of CD8(+)CD28(-) T cells and a down-modulation of CD28 on CD4(+) lymphocytes, which typically identifies CD8(+) regulatory T cells and anergic/tolerogenic T helper cells, respectively. In conclusion, quantification of sHLA-G might offer a complementary non-invasive method for identifying recipients at risk of more severe CAV and who might benefit from earlier preventive therapies, although these results need to be confirmed in larger series.
authors.affiliation: Immunology University Hospital Virgen de la Arrixaca, El Palmar 30120 Murcia, Spain.
authors.forename: R M
authors.initials: RM
authors.lastname: Blanco-García
authors.forename: M R
authors.initials: MR
authors.lastname: López-Álvarez
authors.forename: I P
authors.initials: IP
authors.lastname: Garrido
authors.forename: G
authors.initials: G
authors.lastname: Salgado-Cecilia
authors.forename: J A
authors.initials: JA
authors.lastname: Campillo
authors.forename: J M
authors.initials: JM
authors.lastname: Bolarín
authors.forename: L
authors.initials: L
authors.lastname: Gimeno
authors.forename: M
authors.initials: M
authors.lastname: Muro
authors.forename: A M
authors.initials: AM
authors.lastname: García-Alonso
authors.forename: M V
authors.initials: MV
authors.lastname: Martínez-Sánchez
authors.forename: M V
authors.initials: MV
authors.lastname: Bernardo Pisa
authors.forename: S
authors.initials: S
authors.lastname: Soriano-Díaz
authors.forename: D A
authors.initials: DA
authors.lastname: Pascual-Figal
authors.forename: M R
authors.initials: MR
authors.lastname: Alvarez-López
authors.forename: A
authors.initials: A
authors.lastname: Minguela
mesh_terms: D000328:Adult; D000368:Aged; D018106:CD28 Antigens / Q000276:immunology / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000276:immunology / Q000821:virology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D059951:HLA-G Antigens / Q000097:blood / Q000276:immunology* / Q000378:metabolism; D016027:Heart Transplantation / Q000009:adverse effects / Q000276:immunology* / Q000379:methods; D006801:Humans; D006965:Hyperplasia / Q000097:blood / Q000209:etiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012720:Severity of Illness Index; D012995:Solubility; D013997:Time Factors; D014184:Transplantation, Homologous; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D018084:Ultrasonography, Interventional; D014775:Virus Activation / Q000276:immunology
chemical_list: D018106:CD28 Antigens; D059951:HLA-G Antigens