Regulation of Cardiac Allograft Rejection by T Lymphocytes

Cardiac allograft rejection is diagnosed by routine, surveillance endomyocardial biopsy (EMB). EMB is an invasive and expensive procedure that detects ongoing, rather than impending, rejection, and may be influenced by sampling error due to nonuniform distribution of myocardial lesions. T cells are the principal regulators of allograft rejection; therefore, identifying T cell functions that are associated with cardiac allograft rejection should provide insight for the development of noninvasive monitoring techniques that may augment and reduce the frequency of EMB. Experiments that define the protective and deleterious activities of Th1 and Th2 T cell subsets are clearly warranted, and will direct the potential use of cytokine manipulating therapies aimed at inducing tolerogenic T cell responses. (Trends Cardiovasc Med 1996;6:168–173).