Anti-endothelial antibodies and coronary artery disease after cardiac transplantation.

Accelerated coronary artery disease is the most serious complication after cardiac transplantation. The disease has a multifactorial aetiology, with little agreement about the relative importance of the various risk factors. We have investigated the frequency of anti-endothelial antibodies against human umbilical vein endothelial cells by one-dimensional sodium dodecyl sulphate polyacrylamide gel electrophoresis and western blotting. Peptide-specific anti-endothelial antibodies were found in 15/21 heart transplant recipients with accelerated coronary artery disease, and 1/20 transplant patients who had not developed the disease. Positive immunofluorescence of patients' serum on frozen sections of coronary vessels confirmed the endothelial specificity of antibodies. These results provide evidence of an immune aetiology for transplant-associated coronary artery disease and could have important implications for its diagnosis and therapy.