More precise characterization of humoral immune reactivity to cartilage tissue in patients with resorption of cartilage transplants in the area of the head and neck

The problems with repeated failure of cartilage grafting in reconstructive surgery are not yet resolved. Humoral immunoreactivity against chondrocytes as well as typical cartilage collagens type II, IX and XI was investigated in patients who showed resorptions and/or rejections of transplanted cartilage grafts. The presence of antibodies against isolated human chondrocytes was determined using an indirect immunofluorescence method, an enzyme-linked immunosorbent assay (ELISA) for chondrocytes and immunoblotting with chondrocyte cell membranes. Furthermore, an ELISA for collagens type II, IX and XI as well as immunoblotting with purified collagens type II and XI were used. The control groups consisted of patients with successful cartilage transplantation, patients suffering from rheumatoid arthritis and healthy persons. Patients with unsuccessful cartilage transplantation showed significantly elevated titres of antibodies against chondrocytes (p < 0.001) and collagens type IX and XI (p < 0.001) compared to the control groups. In one patient with unsuccessful cartilage graft, we could also find a humoral reactivity against collagen type XI by immunoblotting. In contrast, no humoral immune reactivity was demonstrable against chondrocyte cell membranes by immunoblotting. In all examined patients fifty percent of patients with repeated resorptions or rejections of transplanted grafts showed antinuclear antibodies (ANA), demonstrating a possible but not yet declared autoimmune disease. These data confirm a humoral immunoreactivity against chondrocytes as well as against collagen which could be responsible for resorptions and/or rejections observed after cartilage graft.