Immunohistochemical Quantification of Inflammatory Cells in Endomyocardial Biopsy Fragments After Heart Transplantation: A New Potential Method to Improve the Diagnosis of Rejection After Heart Transplantation
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Citações na Scopus
4
Tipo de produção
article
Data de publicação
2014
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
BRENDAO, S. M. G.
SOUZA, G.
Citação
TRANSPLANTATION PROCEEDINGS, v.46, n.5, p.1489-1496, 2014
Resumo
Inconsistencies in cardiac rejection grading systems corroborate the concept that the evaluation of inflammatory intensity and myocyte damage seems to be subjective. We studied in 36 patients the potential role of the immunohistochemical (IHC) counting of inflammatory cells in endomyocardial biopsy (EMB) as an objective tool, testing the hypothesis of correlation between the International Society for Heart and Lung Transplantation 2004 rejection and IHC counting of inflammatory cells. We observed a progressive increment in CD68+ cells/mm(2) (P = .000) and CD3+ cells/mm(2) (P = .000) with higher rejection grade. A strong correlation between the grade of cellular rejection and both CD68+ cells/mm(2) and CD3+ cells/mm(2) was obtained (P =.000). One patient with CD3+ and CD68+ cells/mm(2) above the upper limit of the 95% confidence interval for cells/mm(2) found in rejection grade 1R evolved to rejection grade 2R without treatment. In patients with 2R that did not respond to treatment the values of CD68+ or CD3+ cells were higher than the overall median values for rejection grade 2R. For diagnosis of rejection needing treatment, the CD68+ and CD3+ cells/mm(2) areas under the receiver operating characteristic curves were 0.956 and 0.934, respectively. IHC counting of mononuclear inflammatory infiltrate in EMB seems to have additive potential role in evaluation of EMB for the diagnosis and prognosis of rejection episodes.
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Referências
- Angelini A, 2011, J HEART LUNG TRANSPL, V30, P1214, DOI 10.1016/j.healun.2011.05.011
- Aretz H T, 1987, Am J Cardiovasc Pathol, V1, P3
- Auler JOC, 1996, J HEART LUNG TRANSPL, V15, P443
- Bacal F, 2005, AM J TRANSPLANT, V5, P2017, DOI 10.1111/j.1600-6143.2005.00975.x
- Bocchi EA, 2001, ANN THORAC SURG, V71, P1833, DOI 10.1016/S0003-4975(01)02587-5
- Bocchi EA, 1997, TRANSPLANT P, V29, P586, DOI 10.1016/S0041-1345(96)00315-6
- Bocchi EA, 1996, J HEART LUNG TRANSPL, V15, P736
- Bocchi EA, 2001, J HEART LUNG TRANSPL, V20, P637, DOI 10.1016/S1053-2498(00)00235-7
- Dennert R, 2008, EUR HEART J, V29, P2073, DOI 10.1093/eurheartj/ehn296
- Fiorelli AI, 2005, TRANSPLANT P, V37, P2793, DOI 10.1016/j.transproceed.2005.05.038
- Maisch B, 2000, HERZ, V25, P200, DOI 10.1007/s000590050007
- Resende Marcos Valério Coimbra, 2011, Arq Bras Cardiol, V97, P8
- Stewart S, 2005, J HEART LUNG TRANSPL, V24, P1710, DOI 10.1016/j.healun.2005.03.019
- Winters GL, 1996, J HEART LUNG TRANSPL, V15, P728
- Wood KJ, 2012, TRANSPLANTATION, V93, P1, DOI 10.1097/TP.0b013e31823cab44
- Yang HM, 2009, CARDIOVASC PATHOL, V18, P198, DOI 10.1016/j.carpath.2008.05.003