Alloimmunity and nonimmunologic risk factors in cardiac allograft vasculopathy.

Détails

Ressource 1Télécharger: serval:BIB_4D701B8CF37E.P001 (132.67 [Ko])
Etat: Public
Version: de l'auteur
Licence: Non spécifiée
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ID Serval
serval:BIB_4D701B8CF37E
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Alloimmunity and nonimmunologic risk factors in cardiac allograft vasculopathy.
Périodique
European heart journal
Auteur(s)
Vassalli G., Gallino A., Weis M., von Scheidt W., Kappenberger L., von Segesser L.K., Goy J.J.
ISSN
0195-668X
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
24
Numéro
13
Pages
1180-8
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review - Publication Status: ppublish
Résumé
Graft vasculopathy is an accelerated form of coronary artery disease that occurs in transplanted hearts. Despite major advances in immunosuppression, the prevalence of the disease has remained substantially unchanged during the last two decades. According to the 'response to injury' paradigm, graft vasculopathy is the result of a continuous inflammatory response to tissue injury initiated by both alloantigen-dependent and independent stress responses. Experimental evidence suggests that these responses may become self-sustaining, as allograft re-transplantation into the donor strain at a later stage fails to prevent disease progression. Histological evidence of endothelitis and arteritis, in association with intima fibrosis and atherosclerosis, reflects the central role of alloimmunity and inflammation in the development of arterial lesions. Experimental results in gene-targeted mouse models indicate that cellular and humoral immune responses are both involved in the pathogenesis of graft vasculopathy. Circulating antibodies against donor endothelium are found in a significant number of patients, but their pathogenic role is still controversial. Alloantigen-independent factors include donor-transmitted coronary artery disease, surgical trauma, ischaemia-reperfusion injury, viral infections, hyperlipidaemia, hypertension, and glucose intolerance. Recent therapeutic advances include the use of novel immunosuppressive agents such as sirolimus (rapamycin), HMG-CoA reductase inhibitors, calcium channel blockers, and angiotensin converting enzyme inhibitors. Optimal treatment of cardiovascular risk factors remains of paramount importance.
Mots-clé
Antibody Formation, Coronary Angiography, Coronary Disease, Endothelium, Vascular, Heart Transplantation, Humans, Isoantibodies, Isoantigens, Postoperative Complications, Risk Factors, Transplantation Immunology, Transplantation Tolerance, Transplantation, Homologous
Pubmed
Web of science
Open Access
Oui
Création de la notice
15/02/2008 11:28
Dernière modification de la notice
25/09/2019 6:09
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