Post-transplant increase in soluble human leukocyte antigen-G associated with non-severe cardiac allograft vasculopathy |
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Authors: | RM Blanco-García MR López-Álvarez IP Garrido G Salgado-Cecilia JA Campillo JM Bolarín L Gimeno M Muro AM García-Alonso MV Martínez-Sánchez MV Bernardo Pisa S Soriano-Díaz DA Pascual-Figal MR Álvarez-López A Minguela |
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Institution: | 1. Immunology University Hospital Virgen de la Arrixaca, El Palmar 30120 Murcia, Spain;2. Cardiology Services, University Hospital Virgen de la Arrixaca, El Palmar 30120 Murcia, Spain;3. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD o Ciberehd), Spain |
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Abstract: | Cardiac allograft vasculopathy (CAV) is the single most important long-term limitation to heart transplantation. This study aimed to assess the value of monitoring soluble human leukocyte antigen-G (sHLA-G) during the first year post-transplantation to predict the severity of CAV, in 21 out of 77 heart recipients assessed by intravascular ultrasound (IVUS). Serum sHLA-G concentration increased after transplant in recipients free of severe CAV, but decreased in recipients suffering from severe CAV, significant differences between these two groups were found 6 to 12 months post-transplantation. The optimal value of the change in post-transplant sHLA-G for identifying severe CAV was ?0.062%, which maximized sensitivity (80%) and specificity (100%). Importantly, increases in post-transplant sHLA-G were inversely associated with severe CAV, but directly associated with human cytomegalovirus reactivation. In addition, recipients presenting non-severe CAV or an increased sHLA-G post-transplantation, showed higher numbers of CD8+CD28− T cells and a down-modulation of CD28 on CD4+ lymphocytes, which typically identifies CD8+ regulatory T cells and anergic/tolerogenic T helper cells, respectively. In conclusion, quantification of sHLA-G might offer a complementary non-invasive method for identifying recipients at risk of more severe CAV and who might benefit from earlier preventive therapies, although these results need to be confirmed in larger series. |
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Keywords: | CAV cardiac allograft vasculopathy HLA-G human leukocyte antigen-G HCMV human cytomegalovirus IVUS intravascular ultrasound MFI mean fluorescence intensity |
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