Cells from graft recipient appear to cause scarring in chronic renal rejection

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Last Updated: 2001-07-13 18:05:24 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – In patients with chronic renal allograft rejection, circulating mesenchymal cells from the graft recipient can colonize the allograft and lead to chronic rejection, according to a report in The New England Journal of Medicine for July 12.

The standard belief has been that if an organ develops scarring, local cells and tissues are involved, Dr. Paul C. Grimm, from the University of California at San Diego, told Reuters Health. "However, we found that the cells that cause scarring in kidney transplants are not from the transplanted kidney; they are from the recipient."

"Cells from the recipient are circulating in the bloodstream, somehow find their way into the transplanted organ, and are involved in the process of chronic rejection," he said.

Dr. Grimm and colleagues studied renal allograft biopsy specimens from 14 patients experiencing chronic renal allograft rejection. Among these specimens, six were from male recipients of an allograft from a female donor and four from a female recipient of an allograft from a male donor. The remaining specimens were from two male recipients of an allograft from a male donor and two from a female recipient of an allograft a from a female donor, the researchers report.

Analysis revealed that among the six specimens from male recipients with female donors a mean of 34% of the mesenchymal cells in the neointima, 38% of the mesenchymal cells in the adventitia and 30% of the mesenchymal cells in the interstitium contained the Y-chromosomal marker.

Dr. Grimm and colleagues believe these data "provide evidence that a circulating mesenchymal cell has the potential to colonize an allograft."

"The reason this finding is so potentially interesting is that since the cells that cause scarring and healing are circulating, there are things that we might be able to do to block or alter the process," Dr. Grimm told Reuters Health.

N Engl J Med 2001;345:93-97.

-Westport Newsroom 203 319 2700

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