Abstract

Intragraft T-cell receptor (TCR) alpha and beta chain variable region gene expression was analyzed in human cardiac allograft biopsies by reverse transcription polymerase chain reaction. Rearranged TCR alpha and beta chain gene transcripts were detected in all biopsies examined (N = 23), indicating the presence of T cells bearing the alpha/beta TCR even in the absence of microscopically apparent leukocyte infiltration. In this analysis, a broad TCR alpha/beta repertoire in actively rejecting lesions was demonstrated, whereas fewer TCR alpha and beta chain gene families were detected in nonrejecting lesions. The number of expressed TCR V beta chain gene families typically was two- to sixfold higher than that of V alpha chain families in all biopsies tested. This asymmetric relation was present throughout the histologic grading spectrum of the biopsies. Based on these data, the TCR repertoire is heterogenous even in the early stages of mononuclear cell infiltration of the allograft. Also based on the data, the presence of T cells in grafts with minimal cellular infiltrates is not a specific marker of subsequent rejection episode, because T cells were identified in all allograft biopsies.

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