Peyster Eliot G, Wang Chichung, Ishola Felicia, Remeniuk Bethany, Hoyt Clifford, Feldman Michael D, Margulies Kenneth B
Cardiovascular Research Institute, University of Pennsylvania, Philadelphia, Pennsylvania.
Akoya Biosciences, Hopkinton, Massachusetts.
JACC Basic Transl Sci. 2020 Apr 1;5(4):328-340. doi: 10.1016/j.jacbts.2020.01.015. eCollection 2020 Apr.
Recognizing that guideline-directed histologic grading of endomyocardial biopsy tissue samples for rejection surveillance has limited diagnostic accuracy, quantitative, in situ characterization was performed of several important immune cell types in a retrospective cohort of clinical endomyocardial tissue samples. Differences between cases were identified and were grouped by histologic grade versus clinical rejection trajectory, with significantly increased programmed death ligand 1+, forkhead box P3+, and cluster of differentiation 68+ cells suppressed in clinically evident rejections, especially cases with marked clinical-histologic discordance. Programmed death ligand 1+, forkhead box P3+, and cluster of differentiation 68+ cell proportions are also significantly higher in "never-rejection" when compared with "future-rejection." These findings suggest that in situ immune modulators regulate the severity of cardiac allograft rejection.
认识到用于排斥反应监测的心内膜心肌活检组织样本的指南指导组织学分级诊断准确性有限，对一组临床心内膜心肌组织样本的回顾性队列中的几种重要免疫细胞类型进行了定量原位表征。确定了病例之间的差异，并按组织学分级与临床排斥反应轨迹进行分组，在临床明显的排斥反应中，尤其是临床组织学明显不一致的病例中，程序性死亡配体1+、叉头框P3+和分化簇68+细胞明显增加且受到抑制。与“未来排斥反应”相比，“从未发生排斥反应”中的程序性死亡配体1+、叉头框P3+和分化簇68+细胞比例也显著更高。这些发现表明原位免疫调节剂调节心脏同种异体移植排斥反应的严重程度。
