Cell Adhesion Molecules in Human Transplantation (Medical Intelligence Unit)

228 Pages·1998·3.19 MB·English

by  Gustav Steinhoff

1
MEDICAL INTELLIGENCE UNIT
Gustav Steinhoff, M.D., Ph.D.
Cell Adhesion Molecules
in Organ Transplantation
Second Edition
R.G. LANDES
C O M P A N Y
M
EDICAL
I
NTELLIGENCE
U 1
NIT
Cell Adhesion Molecules
in Organ Transplantation
Second Edition
Gustav Steinhoff, M.D., Ph.D.
Medical School Hannover
Hannover, Germany
R.G. LANDES
COMPANY
AUSTIN, TEXAS
U.S.A.
M I U 1
EDICAL NTELLIGENCE NIT
Cell Adhesion Molecules in Organ Transplantation, Second Edition
R.G. LANDES COMPANY
Austin, Texas, U.S.A.
U.S. and Canada Copyright © 1998 R.G. Landes Company and Chapman & Hall
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Library of Congress Cataloging-in-Publication Data
Steinhoff, Gustav, 1958–
Cell adhesion molecules in human organ transplantation / Gustav Steinhoff
—2nd ed.
p. cm. — (Medical intelligence unit)
Includes bibliographical references and index.
ISBN 1-57059-517-8 (alk. paper)
1. Transplantation immunology. 2. Cell adhesion molecules. I. Steinhoff, Gustav,
1958- Cell adhesion molecules in human organ transplants. II. Title. III. Series.
[DNLM: 1. Transplantation Immunology. 2. Cell Adhesion Molecules—
immunology. 3. Major Histocompatibility Complex—immunology. 4. Organ
Transplantation. WO 680 S822c 1998]
QR188.8.S74 1998
617.9'5—dc21
DNLM/DLC
for Library of Congress 98-10904
CIP
M
EDICAL
I
NTELLIGENCE
U 1
NIT
P ’ N
UBLISHER S OTE
Cell Adhesion Molecules
R. G. Landes Company produces books in six Intelligence Unit se-
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Gustav Steinhoff, M.D., Ph.D.
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EDICATION
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CONTENTS
Part 1: Cellular Adhesion Molecules, Major Histocompatibility
Complex Antigens (MHC) and Immune Reactivity
1. Mechanisms of Interaction Between Immune Cells
and Organ Transplants............................................................... 3
Gustav Steinhoff
Organ Specific Manifestation of the Immune Reaction ...........6
Considerations on Somatic Differences in the Susceptibility
to Allogenic Immune Processes..............................................8
Considerations About the Genetical Modification
of Immunological Reactivity in Organ Transplantation.......9
2. Molecular Basis of Transplant Infiltration and Rejection......11
Gustav Steinhoff
Endothelial Adhesion Molecules and Leukocyte Adhesion
Receptors in Transplant Inflammation................................14
Initial Phase of Transplant Inflammation ...............................15
The Intermediate Phase of Transplant Inflammation ............17
The Late Phase of Transplant Inflammation...........................18
The Infiltration Phase of Transplant Inflammation................21
3. Structure and Function of MHC and Adhesion Molecules....25
Gustav Steinhoff
Major Histocompatibility Complex Molecules (MHC).........25
Intercellular Adhesion Molecules.............................................27
Part 2: MHC and Adhesion Molecules
in Clinical Organ Transplantation
4. Major Histocompatibility Complex Antigen and Cell
Adhesion Molecule Expression in Clinical Renal
Transplantation.........................................................................37
Susan V. Fuggle
Introduction..............................................................................37
Major Histocompatibility Antigen Expression........................38
Clinical Correlations and Diagnostic Potential
of Upregulated Class II Antigens..........................................39
Adhesion Molecules..................................................................41
Discussion..................................................................................52
5. MHC and Cell Adhesion Molecules in Clinical Heart
Transplantation.........................................................................57
Gustav Steinhoff and Matthias Wilhelmi
Expression of Major Histocompatibility Complex (MHC)
Molecules in Human Heart Transplants..............................57
Expression of Adhesion Molecules in Human Heart
Transplants ............................................................................64
6. Cell Adhesion Molecules in Clinical Lung Transplantation...77
Gustav Steinhoff
Introduction..............................................................................77
Patients and Methods ...............................................................77
Results........................................................................................78
7. MHC and Cell Adhesion Molecules in Clinical Liver
Transplantation.........................................................................89
Gustav Steinhoff
Major Histocompatibility Complex (MHC) Molecules
in Human Liver Transplants.................................................89
Intercellular Adhesion Molecules in Human Liver
Transplants ............................................................................94
Part 3: Pathophysiological and Clinical Aspects
8. Role of Adhesion Molecules in Reperfusion Injury
and Rejection...........................................................................117
Gustav Steinhoff
Transplant Reperfusion Reaction...........................................117
Acute and Chronic Transplant Rejection..............................118
Longterm Adaptation of Organ Transplants.........................121
9. Cytomegalovirus (CMV) Infection, Expression
of Cell Adhesion Molecules and Allogeneic Rejection..........123
Xiaomang You
Introduction............................................................................123
Manifestation of CMV Infection in Allografts......................124
Expression of MHC Molecules with CMV Infection............126
Expression of Cell Adhesion Molecules.................................128
Mechanisms of Regulation for Allogeneic Rejection
by CMV Infection................................................................130
Impact of CMV Infection on Allogeneic Grafts....................133
10. Therapeutic Options by Blocking Adhesion Molecules........137
Michael Brandt
Introduction............................................................................137
Reperfusion Injury..................................................................137
Acute Allograft Rejection........................................................139
Chronic Allograft Rejection....................................................140
Future Outlook........................................................................141
Part 4: Adhesion Molecules in Xenotransplantation
11. Adhesion Molecules in Xenotransplantation........................145
André R. Simon, Anthony N. Warrens and Megan Sykes
Introduction............................................................................145
The Immunosuppression Approach......................................146
The Genetic Approach............................................................147
The Tolerance Approach........................................................147
Specific Adhesion Molecule-Ligand Interactions..................150
Comments...............................................................................162
References..........................................................................................165
Index ..................................................................................................215
EDITORS
Gustav Steinhoff, M.D., Ph.D.
Department of Thoracic and Cardiovascular Surgery
Leibniz Research Laboratories of Biotechnology
and Artificial Organs (LEBAO)
Medical School Hannover
Hannover, Germany
Chapters 1, 2, 3, 5, 6, 7, 8
CONTRIBUTORS
Michael Brandt, M.D. Anthony N. Warrens, M.D., Ph.D.
Department of Thoracic and Transplantation Biology Research
Cardiovascular Surgery Center Surgical Service
Medical School Hannover Massachusetts General Hospital
Hannover, Germany Harvard Medical School
Chapter 10 Boston, Massachusetts, U.S.A.
Chapter 11
Susan V. Fuggle, D. Phil.
Nuffield Department of Surgery Matthias Wilhelmi
University of Oxford Department of Thoracic and
John Radcliffe Hospital Cardiovascular Surgery
Headington, Oxford, United Medical School Hannover
Kingdom Hannover, Germany
Chapter 4 Chapter 5
André R. Simon, M.D. Xiaomang You, M.D.
Transplantation Biology Research Division of Immunoloigy and
Center Surgical Service Infectious Diseases
Massachusetts General Hospital Dalhousie University
Harvard Medical School Halifax, Nova Scotia, Canada
Boston, Massachusetts, U.S.A. Chapter 9
Chapter 11
Megan Sykes, M.D.
Transplantation Biology Research
Center
Surgical Service
Massachusetts General Hospital
Harvard Medical School
Boston, Massachusetts, U.S.A.
Chapter 11
ABSTRACT
Adhesion molecules play a central role in the regulation of immune
responses after organ transplantation. This book gives a broad sur-
vey about the current knowledge of expression and induction of various
intercellular adhesion molecules in clinical kidney, liver, heart and lung
transplantation. Furthermore, the relevance of cellular adhesive inter-
actions for the developing field of discordant xenotransplantation is re-
viewed. This book gives a complete survey on the cellular expression
patterns on endothelia, resident cells and graft infiltrating cells in hu-
man transplants. The patterns of cellular expression and inducibility in
different pathological conditions of the graft are reviewed. The implica-
tions for the organ specific appearance of inflammatory reactions in
human heart, kidney, liver, and lung transplants for immunosuppres-
sive and therapeutic interventions are described. The future prospects
concerning tolerance induction, specific immunosuppression, and im-
mune escape mechanisms for allo- and xenotransplantation are dis-
cussed.