matory cell infiltration and myocyteinjury. The excel- lent predictive value of the existing classification schemes, which all are based solely on histological criteria ...
Anieican journal of Pathologv, Vol. 142, Vo. 6, June 1993 Copvright © Americatn Society for Itnvestigatitve Pathology
Differential Infiltration by CD45RO and CD45RA Subsets of T Cells Associated with Human Heart Allograft Re jection
Sherif Ibrahim,* Deborah V. Dawson,t Peter Van Trigt,$ and Fred Sanfilippo**§ From the Departmenits of Pathology, * Surgery,* and Immunology,5 and the Division of Biometry,t Duke Unziversity anid VA Medical Ceiters, Durham, North Carolina
Subsets ofTceUs express different isoforms ofthe leukocyte common antigen CD45; those expressing the glycoprotein 220 isoform (CD45RA) have been characterized as naive in their response to antigens, and those expressing the glycoprotein 180 isoform (CD45RO) as memory TceUls. The association between the rejection status of human cardiac allograft recipients and the relative infiltration of the CD45 subsets of both CD8+ and CD4+ T ceUls was examined using two-color immunohistological labeling techniques on 33 heart transplant biopsies, categorized by routine histological and clinical criteria as mild (requiring no treatment) or moderate (requiring antirejection therapy) rejection. Double-labeling was performed using pairs of monoclonal antibodies to define thefollowing populations: CD4 +CD45RA +, CD4+CD45RO+, CD8+CD45RA+, and CD8+CD45RO+. The number of ceUs per high-power field (HPF) for each of these ceU subsets was counted in every biopsy. In cases with mild rejection, infiltration was predominant for CD4 +CD45RA + ceUs (median =5.0 cells/HPF) relative to CD4 +CD45RO+ (3.12 cells/HPF), CD8+CD45RA + (2.14 cells/HPF), and especially CD8+CD45RO + (1.22 ceUs/HPF) populations. In cases with moderate rejection, all four subpopulations increased but were essentially equivalent in intensity, such that in comparison to cases with mild rejection, the smaUest increase was seen for CD4 +CD45RA + ceUs (6.67 cells/HPF, P < 0.09) and the greatest for CD8+CD45RO+ ceUs (7.00 cells/HPF, P
