CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 1, 1996, No 1

Association of Arterial Intercellular Adhesion Molecule-1 (ICAM-1 or CD54) with Development of Coronary Artery Disease in Transplanted Human Hearts

C. A. Labarrere, D. Pitts, D. R. Nelson, W. P. Faulk

Abstract:
Background: This prospective longitudinal study was designed to examine the relationship between the appearance of endothelial activation and the development of coronary artery disease (CAD) in transplanted human hearts. Methods: The study population was 81 allograft recipients who received the same immunosuppressive therapy. The mean study time was 33.9 + 2.2 months per patient, and annual angiograms on each graft were evaluated for the development and/or progression of CAD. A total of 1147 biopsies were obtained (14.2 + 0.5 biopsies per patient), and all biopsies were evaluated for cellular infiltrates and endothelial activation by using light microscopy and monoclonal antibody to intercellular adhesion molecule-1 (ICAM-1 or CD54), respectively. The activation marker was studied only on arterial and arteriolar endothelium, because it is negative at these sites in time-zero (i.e., pretransplantation) biopsies. Results: The immunocytochemical data revealed that 19 of the allografts did not develop ICAM-1 on arterial/arteriolar endothelium. The angiographic data revealed only 2 diagnoses of CAD in the 19 grafts that failed to develop arterial/arteriolar ICAM-1, while 39 diagnoses of CAD were made in the 62 grafts that developed arterial/arteriolar ICAM-1, yielding a high level of significance (p=0.0001). Kaplan-Meier calculations also revealed a striking association between the development of CAD and the per cent of grafts with ICAM-1 reactivity of arterial/arteriolar endothelium. Grafts without arterial/arteriolar ICAM-1 were free of CAD for significantly longer periods of time (p=0.0005) compared with grafts that developed ICAM-1 reactivity of arterial/arteriolar endothelium. There was no significant association (p=0.21) between ICAM-1 reactivity of arterial/arteriolar endothelium and the number of histologically identified episodes of cellular infiltrates. Conclusion: The results of this prospective study thus reveal significant qualitative and quantitative associations between the appearance of ICAM-1 (CD54) on arterial/arteriolar endothelium and the subsequent development of CAD in transplanted human hearts. This raises a question of whether endothelial activation is a predisposing characteristic of spontaneous as well as transplant-induced arteriopathies.

Keywords:
heart transplantation, arterial intercellular adhesion molecule-1, coronary artery disease

Address for Correspondence:

[Pabst Science Publishers] [CVE Homepage] [Contents] [Editorials] [Masthead] [Search] [Orders]

PABST SCIENCE PUBLISHERS
Lengerich, Berlin, Düsseldorf,
Leipzig, Riga, Scottsdale AZ (USA),
Wien, Zagreb