Post-transplant increase in soluble human leukocyte antigen-G associated with non-severe cardiac allograft...

Area of Science:

• Immunology
• Transplantation Medicine
• Cardiology

Background:

• Cardiac allograft vasculopathy (CAV) is a primary long-term complication following heart transplantation.
• Early detection and prediction of CAV severity are crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the utility of soluble human leukocyte antigen-G (sHLA-G) monitoring in the first year post-transplantation for predicting CAV severity.
• To correlate sHLA-G levels with CAV development and immune cell profiles.

Main Methods:

• Serum sHLA-G levels were measured in 77 heart transplant recipients within the first year post-transplantation.
• Intravascular ultrasound (IVUS) was used to assess CAV severity in 21 recipients.
• Changes in sHLA-G concentrations were analyzed in relation to CAV status and immune cell populations (CD8(+)CD28(-), CD4(+)CD28(-)).

Main Results:

• Serum sHLA-G levels increased in recipients without severe CAV but decreased in those with severe CAV (significant difference at 6-12 months).
• An optimal sHLA-G increase of ≥0.062% predicted severe CAV with 80% sensitivity and 100% specificity.
• Increased sHLA-G was inversely linked to severe CAV but directly associated with human cytomegalovirus reactivation.
• Non-severe CAV or increased sHLA-G correlated with higher CD8(+)CD28(-) T cells and down-modulated CD4(+)CD28(+) cells.

Conclusions:

• sHLA-G quantification may serve as a non-invasive marker to identify heart transplant recipients at risk of severe CAV.
• This monitoring could facilitate earlier preventive strategies for high-risk individuals.
• Further validation in larger patient cohorts is warranted to confirm these findings.