E-selectin expression in human cardiac grafts with cellular rejection.

BACKGROUND

E-selectin expression has recently been documented to occur with lymphocytic infiltration in the skin and synovium. The question of whether E-selectin is expressed in the context of cardiac graft rejection was addressed in this study.

METHODS AND RESULTS

One hundred ninety-five human posttransplant cardiac biopsy specimens were immunoreacted with antibodies to E-selectin and VCAM-1, and endothelial expression of both adhesion molecules was recorded as present or absent. Cardiac graft rejection was graded in blinded fashion. The frequency of E-selectin expression was 11% in biopsies without rejection, 36% in mild rejection, and 58% in moderate rejection, a significant correlation (P < .001). VCAM-1 expression was present in 11% of biopsies with no rejection, 37% with mild rejection, and 85% with moderate rejection, corroborating the previously reported strong correlation between VCAM-1 expression and graft rejection (P < .0001). In 71% of specimens, E-selectin expression coincided with VCAM-1 expression. In the remaining 29% of specimens in which E-selectin and VCAM-1 expression were not both present, isolated E-selectin expression was found more frequently in biopsies with early, increasing rejection, whereas isolated VCAM-1 expression was found more frequently in specimens with established moderate rejection and later, resolving rejection.

CONCLUSIONS

E-selectin is expressed in cardiac allograft rejection and may play a role in recruitment of lymphocytes into the graft. Rejection trend analysis suggests that E-selectin expression may be prominent early in the course of rejection.