THE ROLE OF HUMAN LEUKOCYTE ANTIGEN-G IN

Human leukocyte antigen-G (HLA-G), a protein expressed primarily by fetal trophoblasts, plays an essential role in maintaining fetal immune tolerance and has previously been detected following heart transplantation. We sought to establish the value of HLA-G in identifying freedom from moderate or severe rejection post-heart transplant, and the capability of its expression in vitro. After assessing myocardial HLA-G expression through immunohistochemistry, we demonstrated that it was significantly more prevalent in non-rejecting than rejecting heart transplant recipients. Utilizing vascular endothelial and smooth muscle cell culture models, we also determined that while HLA-G expression remains tightly regulated, its expression in vitro can be induced following progesterone treatment in a dose-dependent manner. Hence, HLA-G may reliably identify patients with a low immunological risk of developing subsequent clinically significant rejection post-heart transplant. Furthermore, HLA-G expression can be induced in cultured endothelial and smooth muscle cells, which might represent a strategy to protect against allograft rejection and vasculopathy. iii ACKNOWLEDGEMEN