Vor 50 Jahren: Erste erfolgreiche Behandlung einer akuten Herztransplantat-Abstoßungskrise

2018 ◽  
Vol 143 (25) ◽  
pp. 1864-1865
Author(s):  
Walter Land
Keyword(s):  
South Africa ◽  
Heart Transplantation ◽  
Allograft Rejection ◽  
Cardiac Transplantation ◽  
Human Heart ◽  
Immunosuppressive Agent ◽  
Clinical Use ◽  
Antilymphocyte Globulin ◽  
Acute Allograft Rejection ◽  
Success Story

AbstractThe first clinical use of the “Munich antilymphocyte globulin” (ALG) at the occasion of the first successful human heart transplantation is briefly described. The cardiac transplantation was carried out by Christiaan Barnard and his team in Cape Town, South Africa, in 1968. The patient developed an acute allograft rejection which could be successfully reversed within three weeks using the intravenous administration of ALG. This event can be regarded as the beginning of a success story of ALG in its use as a powerful immunosuppressive agent in all categories of clinical organ transplantation.

Abstract 3689: Loss of Myeloid Related Protein-8/14 Exacerbates Cardiac Allograft Rejection

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Koichi Shimizu ◽  
Peter Libby ◽  
Viviane Z Rocha ◽  
Eduardo J Folco ◽  
Rica Shubiki ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Antigen Presentation ◽  
Allograft Rejection ◽  
Cardiac Transplantation ◽  
Cardiac Allograft ◽  
Mrna Levels ◽  
Acute Allograft Rejection ◽  
Cardiac Allograft Rejection ◽  
Ifn Γ

Background: The S100 calcium-binding proteins MRP-8 (S100A8) and MRP-14 (S100A9) heterodimerize to form MRP-8/14 complexes that regulate myeloid cell function, control inflammatory responses, and serve as an early serum marker for monitoring acute allograft rejection. Despite functioning as a putative pro-inflammatory mediator, the pathophysiological role of MRP-8/14 in cardiovascular disease remains unknown. This study used murine cardiac transplantation to investigate the role of MRP-14 in cardiac allograft rejection using MRP-14-deficient mice (MRP14−/−) lacking MRP-8/14 complexes. Results: In major histocompatibility complex class II allomismatched cardiac transplantation (bm12 donor hearts and C57BL/6 recipients), allograft survival averaged 5.9 ± 2.9 weeks (n=10) in MRP14−/ −recipients compared to > 12 weeks (n = 15, p<0.0001) in wild-type (WT) recipients. At 2 week post-transplantation, allografts in MRP14−/ − recipients had significantly higher parenchymal rejection (PR) scores (2.8 ± 0.8, n=8) than WT recipients (0.8 ± 0.8, n=12, p<0.0001). MRP14−/ − recipients had significantly increased allograft accumulation of T cells and macrophages and mRNA levels of IFN-γ and IFN-γ–associated chemokines (IP-10, Mig, and I-TAC) compared to WT recipients. The MRP14−/− recipients also had significantly more lymphocytes in draining lymph nodes than WT recipients (cell number per lymph nodes: 23.7 ± 0.7 x 105 for MRP14−/− vs. 6.0 ± 0.2 x 105 for WT, p < 0.0001). MRP14−/− dendritic cells (DC) stimulated with IFN-γ expressed significantly higher levels of the co-stimulatory molecules CD86 and ICOSL, and mixed leukocyte reaction using allo-EC-primed MRP14−/− DC resulted in significantly higher antigen-presenting function than WT DC. Conclusion: Taken together, these observations indicate that MRP-8/14 complexes participate in acute allograft rejection by modulating dendritic cell antigen presentation and T cell priming. The unexpected finding that deficiency of MRP-8/14 complexes exacerbates acute allograft rejection indicates that MRP-8/14 has distinct roles in modulating immune cell functions, such as migration and antigen presentation. This research has received full or partial funding support from the American Heart Association, AHA National Center.

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