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Published ahead of print on May 25, 2006, doi:10.1164/rccm.200512-1886OC
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American Journal of Respiratory and Critical Care Medicine Vol 174. pp. 461-470, (2006)
© 2006 American Thoracic Society
doi: 10.1164/rccm.200512-1886OC


Original Article

IL-12 p80 Is an Innate Epithelial Cell Effector That Mediates Chronic Allograft Dysfunction

Cassandra L. Mikols*, Le Yan*, Jin Y. Norris, Tonya D. Russell, Anthony P. Khalifah, Ramsey R. Hachem, Murali M. Chakinala, Roger D. Yusen, Mario Castro, Elbert Kuo, G. Alexander Patterson, Thalachallour Mohanakumar, Elbert P. Trulock and Michael J. Walter

Divisions of Pulmonary and Critical Care and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri

Correspondence and requests for reprints should be addressed to Michael J. Walter, M.D., Division of Pulmonary and Critical Care Medicine, Campus Box 8052, 660 South Euclid Avenue, St. Louis, MO 63110. E-mail: mwalter{at}im.wustl.edu

Rationale: Bronchiolitis obliterans syndrome is the leading cause of chronic lung allograft dysfunction. We have demonstrated that respiratory viral infection is a bronchiolitis obliterans syndrome risk factor and virus-dependent injury induces expression of innate airway epithelial genes belonging to the interleukin (IL)-12 family. Thus, we hypothesized that epithelial cell IL-12 family members could mediate lung allograft dysfunction.

Objectives: We used mouse and human allograft specimens to evaluate the role of epithelial cell IL-12 family members in allograft dysfunction associated with and without viral infection.

Methods: Murine and human IL-12 family members were characterized and manipulated in allografts and then correlated with epithelial cell injury, immune cell accumulation, and collagen deposition.

Results: In a mouse model of lung transplantation, concurrent viral infection and allogeneic transplantation increased epithelial injury and this was followed by exaggerated accumulation of macrophages and collagen deposition. This virus-driven allograft dysfunction was associated with an epithelial innate response manifested by a synergistic increase in the production of the macrophage chemoattractant IL-12 p80 (p80), but not IL-12 or IL-23. Blockade or overexpression of donor epithelial p80 resulted in a corresponding abrogation or enhancement of macrophage accumulation and allograft dysfunction. We extended these findings to human recipients with viral infection and transplant bronchitis and again observed excessive epithelial p80 expression that correlated with increased macrophage accumulation.

Conclusions: These experiments support a role for an enhanced epithelial innate response as a central process in allograft dysfunction and identify the macrophage chemoattractant p80 as an innate epithelial effector of disease progression.

Key Words: graft rejection • innate immunity • lung transplantation • macrophage • virus




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