Perforin expression localizing cytotoxic lymphocytes in the intimas of coronary arteries with transplant-related accelerated arteriosclerosis

William M. Fox, Arif Hameed, Grover M. Hutchins, Bruce A. Reitz, William A. Baumgartner, William E. Beschorner, Ralph H. Hruban

Research output: Contribution to journalArticle

Abstract

Accelerated arteriosclerosis is the major long-term complication of cardiac transplantation. It has been demonstrated recently that accelerated arteriosclerosis is caused, in part, by rejection-related, cell-mediated immunity. However, the role of cytotoxic T lymphocytes in this process is a subject of controversy. Perforin is a specific marker of functionally active cytotoxic lymphocytes because it is a functional component of the cytotoxic granules of these cells. We examined 11 coronary arteries from seven autopsied and four retransplanted heart transplant recipients for the presence of perforin-containing lymphocytes. Immunohistochemical stains for perforin were performed using a monoclonal antibody against human perforin. Eight of the 11 coronary arteries examined were found to contain perforin-positive cells. These perforin-positive cells were present in subendothelial spaces of the coronary arteries, and the staining seen was cytoplasmic and granular. The granules often were polarized to the endothelial surface. Furthermore, the cells identified were usually in close proximity to, or in direct contact with, coronary artery endothelial cells. These results suggest that cell-mediated endothelial injury by perforin-positive cytotoxic lymphocytes may contribute to the development of accelerated arteriosclerosis in heart transplant recipients.

Original languageEnglish (US)
Pages (from-to)477-482
Number of pages6
JournalHuman pathology
Volume24
Issue number5
DOIs
StatePublished - May 1993

Keywords

  • accelerated arteriosclerosis
  • coronary artery disease
  • cytotoxic lymphocytes
  • heart transplantation
  • perforin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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