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Expression of cyclooxygenase‐1 and cyclooxygenase‐2 in human renal allograft rejection – a prospective study

Cyclooxygenases (COX) are known to be involved in inflammatory kidney diseases. However, there are no data available about the expression of COX‐1 and only preliminary reports about the expression of COX‐2 in biopsies of patients undergoing acute renal allograft rejection. We conducted this prospective study to analyze the expression, distribution, and cellular localization of COX‐1 and ‐2 and thus to elucidate the role of COX in human kidney transplantation. One hundred forty‐four biopsies were included from patients without rejection and unaltered morphology (n = 60), with acute interstitial rejection (n = 7), with acute vascular rejection (n = 21), with chronic allograft nephropathy (n = 16), without rejection but with various other lesions (n = 40). COX‐1 and ‐2 expression was localized in each biopsy by immunohistochemistry. We found a highly significant up‐regulation of COX‐1 in vessels and in infiltrating interstitial cells of patients with acute allograft rejection compared with biopsies with well‐preserved tissue. Also, COX‐2 expression was significantly elevated in infiltrating interstitial cells of biopsies with acute rejection. This is the first prospective study demonstrating a significant induction of both COX‐1 and ‐2 in human allograft biopsies with acute rejection after renal transplantation.