Alvarez-Márquez Antonia, Aguilera Isabel, Blanco Rosa María, Pascual Domingo, Encarnación-Carrizosa Mercedes, Alvarez-López Maria Rocío, Wichmann Ingeborg, Núñez-Roldán Antonio
Servicio de Inmunología, Hospital Universitario Virgen del Rocío, Seville, Spain.
Hum Immunol. 2008 Mar;69(3):143-8. doi: 10.1016/j.humimm.2008.01.015. Epub 2008 Feb 29.
Using an indirect immunofluorescence method on human umbilical vein endothelial cells (HUVEC), we investigated the presence of antiendothelial cell antibodies (AECA) in 136 pre- and posttransplant serum samples sequentially collected from 31 patients during the first year after cardiac transplantation. A healthy control group was also included (n = 87). Colocalization studies demonstrated a positive staining pattern of different cytoskeletal components (cytoskeletal-antiendothelial cell antibodies, CSK-AECA) including antivimentin, antiactin, antitubulin, and anticytokeratin among heart transplanted patients. Frequency of CSK-AECA in the control group and at day 0 in the transplant group was 18.3 and 22.5%, respectively (p = NS). A progressive increase in the frequency of CSK-AECA was observed after cardiac transplantation: 13.3% at day 15; 22.2% at day 30; 53.8% at day 90, and 58% at day 360. Interestingly, rejection episodes within the first year after transplantation occurred in 83.3% of CSK-AECA-positive and in 30.7% of CSK-AECA-negative patients (p = 0.0045). The presence of antibodies was detected prior to the rejection event and was associated with a poor clinical outcome: rejection episodes occurred at a mean of 36.14 +/- 17 days after transplantation in patients with preexisting AECA and 174.25 +/- 51.9 days after de novo antibody appearance in patients with no antibodies at day 0 (p = 0.029). In conclusion, a progressive increase in the frequency of CSK-AECA was observed following cardiac transplantation; the presence of these antibodies is strongly associated and precedes the rejection episodes. Thus, CSK-AECA could be a good marker for acute graft rejection.
我们采用间接免疫荧光法对人脐静脉内皮细胞（HUVEC）进行检测，研究了31例心脏移植患者在术后第一年依次采集的136份移植前和移植后血清样本中抗内皮细胞抗体（AECA）的存在情况。同时纳入了一个健康对照组（n = 87）。共定位研究显示，心脏移植患者中存在针对不同细胞骨架成分的阳性染色模式（细胞骨架抗内皮细胞抗体，CSK - AECA），包括抗波形蛋白、抗肌动蛋白、抗微管蛋白和抗细胞角蛋白。对照组和移植组第0天CSK - AECA的频率分别为18.3%和22.5%（p =无显著性差异）。心脏移植后观察到CSK - AECA频率逐渐升高：第15天为13.3%；第30天为22.2%；第90天为53.8%，第360天为58%。有趣的是，移植后第一年内，83.3%的CSK - AECA阳性患者和30.7%的CSK - AECA阴性患者发生了排斥反应（p = 0.0045）。在排斥事件发生之前检测到抗体的存在，且与不良临床结局相关：移植前已有AECA的患者排斥反应平均发生在移植后36.14±17天，而第0天无抗体的患者在新生抗体出现后174.25±51.9天发生排斥反应（p = 0.029）。总之，心脏移植后观察到CSK - AECA频率逐渐升高；这些抗体的存在与排斥反应密切相关且早于排斥反应发作。因此，CSK - AECA可能是急性移植物排斥反应的良好标志物。
