VCAM-1 and E-selectin expression during cytomegalovirus infection in post-transplant myocardial biopsies

Adhesion molecule expression may become useful in monitoring cardiac graft rejection, but first the question of whether expression is upregulated by cytomegalovirus (CMV), a common post-transplant infection, must be answered. To study this, all cardiac biopsies (n = 201) on 12 cardiac transplant recipients were examined for rejection grade and VCAM-1, ICAM-1, and E-selectin expression over the first 6-15 months post-transplant. Adhesion molecule expression in biopsies taken during documented CMV infections were compared to those taken in the absence of infection, both overall and sorted as to rejection grade. There were 17 CMV infections in this patient group. VCAM-1 was expressed in 82% of biopsies coincident with CMV infections, compared to 43% of biopsies unrelated to CMV infection, a significant difference (p < 0.01). E-selectin was expressed in 65% of biopsies with CMV infection, compared to 30% of biopsies unrelated to CMV infection, also statistically significant (p = 0.01). Both VCAM-1 and E-selectin were expressed in 80% of biopsies without rejection taken during CMV infections, significantly greater than the 24% incidence of VCAM-1 and 14% incidence of E-selectin expression in biopsies without rejection that were not concomitant with CMV infection. In the absence of CMV infection, both VCAM-1 and E-selectin expression correlated significantly with rejection grade, but this relationship became invalid in the presence of CMV infection. ICAM-1 expression bore no relation to CMV infection. VCAM-1 and E-selectin expression in cardiac biopsies can be upregulated with CMV infection in the absence of graft rejection.