Key Points
- To examine the expression of cytokine genes in sequential endomyocardial biopsies to clarify their role in acute allograft rejection following heart transplantation.
- Analyzed 44 endomyocardial biopsies (EMBs) from 11 heart transplant recipients, comprising 21 EMBs taken before or during acute rejection and 23 EMBs without histological rejection.
- Used reverse transcriptase-polymerase chain reaction (RT-PCR) to evaluate mRNA transcripts for IL-2, IL-4, IL-6, IL-10, and the T-cell receptor beta-chain constant region (C beta) in pre- and post-transplant tissue.
- IL-2 gene expression strongly correlated with histologically proven acute rejection, occurring in 16 of 21 rejection biopsies versus 1 of 23 non-rejection biopsies (P < 0.001, chi-squared test).
- Transcripts for IL-4 and IL-6 were more frequently detected in rejection compared with non-rejection biopsies (62% vs 35% for IL-4; 81% vs 39% for IL-6).
- IL-10 transcripts showed no relationship with rejection or quiescence; IL-10 and IL-6 were present in 9 of 10 pre-transplant donor hearts, whereas IL-2 and IL-4 were absent.
Structured PICO
PPopulation11 human heart transplant recipients providing 44 sequentially taken endomyocardial biopsies (21 before/during rejection, 23 without histological evidence of acute rejection) and 10 donor heart tissues before transplantation.
IInterventionAnalysis of cytokine gene expression (IL-2, IL-4, IL-6, IL-10) using reverse transcriptase-polymerase chain reaction (RT-PCR).
CComparatorEndomyocardial biopsies without histological evidence of acute rejection.
OOutcomeCorrelation of cytokine gene expression with histologically proven acute rejection.surrogate
IL-2, IL-4, and IL-6 mRNA expression in endomyocardial biopsies correlates with acute rejection in human heart transplant recipients, suggesting their role as local immunoregulators.