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From the Departments of Clinical and Experimental
Medicine,*
Clinical Immunology Branch,
Pathology,
and Thoracic
Surgery,
Padua University School of Medicine,
Padua, Italy
The attraction of T lymphocytes into the pulmonary parenchyma
represents an essential step in mechanisms ultimately leading to lung
allograft rejection. In this study we evaluated whether IP-10
(CXCL10), a chemokine that is induced by interferon-
and
stimulates the directional migration of activated T cells,
plays a role in regulating the trafficking of effector T cells during
lung allograft rejection episodes. Immunohistochemical examination
showed that areas characterized by acute cellular rejection (grades 1
to 4) and active obliterative bronchiolitis (chronic rejection,
Ca) were infiltrated by T cells expressing CXCR3, ie,
the specific receptor for CXCL10. In parallel, T cells
accumulating in the bronchoalveolar lavage of lung transplant
recipients with rejection episodes were CXCR3+ and exhibited a strong
in vitro migratory capability in response to CXCL10. In
lung biopsies, CXCL10 was abundantly expressed by
graft-infiltrating macrophages and occasionally by epithelial cells.
Alveolar macrophages expressed and secreted definite levels of CXCL10
capable of inducing chemotaxis of the CXCR3+ T-cell line 300-19; the
secretory capability of alveolar macrophages was up-regulated by
preincubation with interferon-
. Interestingly, striking
levels of CXCR3 ligands could be demonstrated in the fluid
component of the bronchoalveolar lavage in individuals with rejection
episodes. These data indicate the role of the CXCR3/CXCL10
interactions in the recruitment of lymphocytes at sites of lung
rejection and provide a rationale for the use of agents that block the
CXCR3/CXCL10 axis in the treatment of lung allograft
rejection.
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