Evidence that cyclosporin A prevents clinical cardiac allograft rejection by blocking both direct and indirect antigen presentation pathways

  • N. M. van Besouw
  • L. M. B. Vaessen
  • C. J. Knoop
  • W. Weimar
  • A. H. M. M. Balk
  • B. Mochtar
  • F. H. J. Claas

Abstract

Monitoring for the responses to alloantigens presented either by the direct or the indirect presentation pathway have been reported to be of clinical value after kidney transplantation. Amongst others, the level of these responses may be dependent on the immunosuppressive treatment. We studied both presentation routes in peripheral blood mononuclear cells (PBMC) of cardiac transplant patients, who experienced episodes of rejection, and related them to the in vivo cyclosporin A (CsA) levels in plasma. PBMC of the recipients were stimulated with irradiated donor cells to determine the direct presentation pathway. As a method for the activation of the immune response via the indirect pathway, PBMC were stimulated with tetanus toxoid. Both immune responses increased when CsA levels inadvertently decreased to inadequate concentrations and histological rejection was diagnosed. After clinical heart transplantation, CsA may prevent rejection by blocking both the direct and the indirect antigen presentation pathway.

Key words

Clinical transplantation Presentation pathways Cyclosporin A Rejection 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • N. M. van Besouw
    • 1
  • L. M. B. Vaessen
    • 1
  • C. J. Knoop
    • 1
  • W. Weimar
    • 1
  • A. H. M. M. Balk
    • 2
  • B. Mochtar
    • 2
  • F. H. J. Claas
    • 3
  1. 1.Department of Internal Medicine I, Room Bd299University Hospital Rotterdam-DijkzigtRotterdamThe Netherlands
  2. 2.Thorax CenterUniversity Hospital Rotterdam-DijkzigtRotterdamThe Netherlands
  3. 3.Department of Immunohematology and BloodbankUniversity Hospital LeidenLeidenThe Netherlands

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