CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 2, 1997, No 3

Cytomegalovirus Infection Enhances the Perivascular Inflammatory Reaction in Transplanted Aortic Allografts

F. Li, G. Grauls, J. G. van Dam, M. Yin, C. A. Bruggeman

Abstract:
Background: Infections with cytomegalovirus (CMV) occur frequently in solid organ transplant recipients. Previous studies have demonstrated an association between CMV infection and chronic rejection, known to be a major cause of graft failure on the long term. Chronic rejection is characterized by a persistent perivascular inflammatory reaction and intimal proliferation. We hypothesized that the inflammatory influx of cells, especially of the monocytes/macrophages, is important for the pathophysiology of the intimal proliferation. Material and methods: For the study of virus induced effects on chronic rejection rat aortic allografts were analysed at different time intervals. The animals were infected with rat CMV (RCMV) at the day of transplantation. The appearance of inflammation in the grafts and the development of a neointima in the allografts was investigated using histology and immunohistochemical stainings. Results: The data obtained in this study demonstrate that in the allograft a persistent inflammatory reaction was found, especially in the perivascular area, leading to the formation of a neointima. In the RCMV infected rats significant more T-lymphocytes were present in the perivascular area, compared to the noninfected rats. CMV infection also leads to more IL-2 receptor positive cells and to more MHC-class II antigen expression in the perivascular area. The virus-induced effect was not found when UV-inactivated virus was used. Conclusion: Aortic allograft transplantation is associated with a perivascular inflammation and a neo-intima formation. Infectious CMV leads to an enhanced influx of T-lymphocytes and activation of inflammatory cells in the perivascular area. These changes provide the substrate for virus-induced enhancement of chronic rejection.

Keywords:
Chronic rejection, cytomegalovirus, transplantation, perivascular inflammation

Address for Correspondence:

Reference:
(CVE. 1997; 2 (3): 207-214)

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