Expression of vascular cell adhesion molecule (VCAM-1) in liver and pancreas allograft rejection.

VCAM-1, a leukocyte adhesion molecule expressed by cytokine-activated endothelial cells in culture, may mediate mononuclear leukocyte infiltration in vessels and interstitium in solid organ allograft rejection. Using the avidin-biotin immunoperoxidase technique and two different antibodies--4B9, a murine monoclonal antibody, and rabbit polyclonal antisera to recombinant human VCAM (rVCAM Ab), which work in methacarn-fixed tissues--we studied the expression of this molecule in biopsies of transplanted liver and pancreas with and without features of rejection as well as nontransplant control tissues. The rVCAM Ab, but not 4B9, showed a population of reactive endothelial cells limited to sites of prominent subendothelial leukocytic cell infiltration in arteries and veins in rejecting allografts. VCAM-1 expression by sinusoidal endothelium in rejecting liver allografts was also observed. In addition, a population of cells (DC) with dendritic morphology was identified by rVCAM Ab within sites of lymphoid cell aggregations in both liver and pancreas allografts. Further evidence that these cells represent true DC was obtained by identification of VCAM-1 positive morphologically similar cells in both germinal centers and interfollicular areas of reactive lymph nodes; and by similar staining of these cells in allograft organs by a monoclonal antibody to nerve growth factor receptor, previously shown to recognize DC. DCs were generally not seen in normal control organs or portions of allografts uninvolved by lymphoid aggregates. This study provides evidence that 1) endothelial cell expression of VCAM-1 may be important in transplant rejection, 2) different epitopes of VCAM-1 may be preserved in tissue sections and recognized by different antibodies, and 3) there is probably a population of VCAM-1 expressing DC that participates in the cellular rejection progress.