Gabrielli A, Marrozzini C, Candela M, Ferretti R M, Recchioni A, Binetti G F, Danieli G
Istituto di Clinica Medica, Università degli Studi, Ancona.
Cardiologia. 1994 Jul;39(7):481-6.
Endomyocardial biopsy is still considered the only reliable method for diagnosing acute rejection. However, because of its invasive nature, this procedure cannot be performed on a daily basis. Therefore, for the noninvasive monitoring of transplanted patients, we tested the sensitivity of serum levels of basement membrane antigens, type IV collagen fragment NC1 and laminin fragment P1 (LP1), of antibodies against laminin and type IV collagen, and of soluble interleukin 2 receptor (sIL2R). In 17 patients who underwent heart transplantation no correlation was found between the degree of rejection and the levels of antibodies to type IV collagen and laminin. Serum laminin P1 and sIL2-R values were found increased in all the study groups even in absence of rejection; however, sIL2R levels were higher in patients with more severe rejection. NC1 levels were found significantly higher in patients with mild or moderate rejection than in those with no rejection or in controls. These preliminary data suggest a possible predictive role of basement membrane antigens in cardiac rejection, but further studies in a larger group of transplanted patients are needed.
心内膜心肌活检仍被认为是诊断急性排斥反应的唯一可靠方法。然而，由于其具有侵入性，该操作无法每天进行。因此，为了对移植患者进行非侵入性监测，我们检测了基底膜抗原、IV型胶原片段NC1和层粘连蛋白片段P1（LP1）的血清水平、抗层粘连蛋白和IV型胶原抗体以及可溶性白细胞介素2受体（sIL2R）的敏感性。在17例接受心脏移植的患者中，未发现排斥反应程度与抗IV型胶原和层粘连蛋白抗体水平之间存在相关性。即使在没有排斥反应的情况下，所有研究组的血清层粘连蛋白P1和sIL2 - R值均升高；然而，排斥反应较严重的患者sIL2R水平更高。发现轻度或中度排斥反应患者的NC1水平显著高于无排斥反应患者或对照组。这些初步数据表明基底膜抗原在心脏排斥反应中可能具有预测作用，但需要在更大规模的移植患者群体中进行进一步研究。
