ORIGINAL PRE-CLINICAL SCIENCE Interleukin-16 deficiency suppresses the development of chronic rejection in murine cardiac transplantation model Naoyuki Kimura, MD, a Satoshi Itoh, MD, a Susumu Nakae, PhD, b Robert C. Axtell, PhD, c Jeffrey B. Velotta, MD, a Ernst Jan Bos, BS, a Denis R. Merk, MD, a Yongquan Gong, MD, a Homare Okamura, MD, a Claude M. Nagamine, DVM, PhD, d Hideo Adachi, MD, PhD, e Hardy Kornfeld, MD, f Robert C. Robbins, MD, a and Michael P. Fischbein, MD, PhD a From the a Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California; the b Frontier Research Initiative, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; the c Department of Neurology and Neurological Sciences; and the d Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California; the e Department of Cardiovascular Surgery, Jichi Medical University, Saitama Medical Center, Saitama, Japan; and the f Department of Pulmonary, Allergy & Critical Care Medicine, University of Massachusetts Medical School, Worcester, Massachusetts. BACKGROUND: IL-16 promotes the recruitment of various cells expressing CD4, a receptor for IL-16. The precise role of IL-16 in transplant rejection remains unknown; therefore, the present study investigated the contribution of IL-16 to the development of chronic rejection in heart transplants. METHODS: C-H-2 bm12 KhEg (H-2 bm12 ) donor hearts were transplanted into (1) IL-16-deficient (IL- 16 -/- ) C57BL/6J or (b) wild type (WT) control recipients (MHC class II mismatch). Grafts were harvested at 52 days, parenchymal rejection was assessed by the ISHLT grading system, and CAV was examined morphometrically. Graft infiltrating cells were detected 10 and 52 days after transplantation. Intragraft cytokine and chemokine profiles were assessed. To confirm the role of IL-16 in CAV development, C-H-2 bm12 KhEg (H-2 bm12 ) donor hearts were transplanted into C57BL/6J WT recipients treated with (1) anti-IL-16-neutralization monoclonal antibody or (b) control immunoglobulin G. Grafts were harvested at 52 days, and CAV was quantified morphometrically. Graft-infiltrating cells were examined histologically. RESULTS: Parenchymal rejection and CAV was significantly attenuated in donor hearts transplanted into IL-16 -/- recipient mice compared with WT controls. Donor hearts transplanted into IL-16 -/- recipients had a significant reduction in coronary artery luminal occlusion, intima-to-media ratio, and percentage of diseased vessels. CAV was associated with decreased donor organ inflammation, as well as donor organ cytokine (IL-1and IL-6) and chemokine (MCP-1 and KC) protein expression. Intimal proliferation and inflammatory cell infiltration were significantly reduced in hearts transplanted into recipients treated with an IL-16-neutralization antibody. CONCLUSIONS: IL-16-deficiency reduced graft inflammatory cell recruitment, and allograft inflam- matory cytokine and chemokine production. Therefore, IL-16 neutralization may provide a potential target for novel therapeutic treatment for cardiac allograft rejection. J Heart Lung Transplant 2011;30:1409 –17 © 2011 International Society for Heart and Lung Transplantation. All rights reserved. KEYWORDS: chronic rejection; heart transplantation; immunology; cytokines; animal model Reprint requests: Michael P. Fischbein, MD, PhD, Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Dr, CVRB MC 5407, Stanford, CA, 94305. Telephone: 650-725-3828. Fax: 650-725-3846. E-mail address: mfischbe@stanford.edu http://www.jhltonline.org 1053-2498/$ -see front matter © 2011 International Society for Heart and Lung Transplantation. All rights reserved. doi:10.1016/j.healun.2011.08.017