Letter to the Editor |
Department of Medicine, New York Medical College, Valhalla, NY, piero_anversa@nymc.edu
To the Editor:
The article entitled "Evidence for Cardiomyocyte Repopulation by Extracardiac Progenitors in Transplanted Human Hearts" by Laflamme et al,1 published in Circulation Research, confirms our early observations2 that cardiac chimerism occurs after transplantation of a female heart in a male patient. These results are also in agreement with the detection of chimerism in multiple organs after bone marrow transplantation.3 The authors of the study in Circulation Research are perturbed by the low frequency of chimerism in their samples compared with ours2 (as well as in a subsequent recent report3). They attribute this discrepancy to "...technical differences..." (pages 637 and 638) between the two studies. We agree completely with their assessment.
Given the resolution of the histological sections included in the article in Circulation Research, 1 we are pleasantly surprised that they could identify even this relatively low level of chimerism. Laflamme et al place special emphasis on the stringency of their criteria for scoring Y chromosomepositive myocyte nuclei and their ability to exclude inflammatory cells in the quantitation. While we commend their thoroughness, we are surprised that they seem to doubt our ability to do the same. In fact, we believe strongly that, in addition to the better quality of histological sections, our methodology for detecting Y chromosomepositive myocytes was more stringent than theirs. One of the main reasons for using confocal microscopy is precisely to be able to unambiguously assign the nuclei to their corresponding cytoplasm. Their argument that conventional microscopy " ...offers much better detection of cell
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