Published 6 issues per year
ISSN Print: 1040-8401
ISSN Online: 2162-6472
Indexed in
Chronic Allograft Rejection Associated Vasculopathy and Synthetic Biodegradable Vascular Grafts: A Lesson to Learn?
ABSTRACT
In chronic allograffs, graft vessels eventually develop so-called "transplant vascular sclerosis" or "intimal hyperplasia". A major question is whether the cells in the neointima are donor or recipient derived. The process of transplant vascular sclerosis closely resembles the remodeling of the vascular wall as seen when synthetic biodegradable small caliber vascular grafts are implanted. In this model, the cells in the newly developing neointima as well as neomedia are, by definition, recipient derived.
By using cardiac allografts as well as aortic allografts exchanged between a female donor and a male recipient (rats), the origin of the neointimal vascular smooth muscle cells could be traced by looking for the Y-chromosome in isolated (α-actin positive) intimal cells using PCR. In both models these intimal cells were found to be of recipient-origin.
It is proposed, that, basically, this remodeling process is part of a normal healing process. Whereas in biodegradable grafts this "healing process" appears to be self limiting, in allografts the process goes on beyond the needs of functional repair, eventually, in some cases, leading to total vascular occlusion. Future therapeutic protocols might try and aim at controlling this essentially normal repair process.
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Miyagawa-Hayashino Aya, Tsuruyama Tatsuaki, Haga Hironori, Oike Fimitaka, Il-Deok Kim, Egawa Hiroto, Hiai Hiroshi, Tanaka Koichi, Manabe Toshiaki, Arteriopathy in chronic allograft rejection in liver transplantation, Liver Transplantation, 10, 4, 2004. Crossref
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Roux Nicolas, Brakenhielm Ebba, Freguin-Bouillant Caroline, Lallemand Françoise, Henry Jean-Paul, Boyer Olivier, Thuillez Christian, Plissonnier Didier, Progenitor Cell Mobilizing Treatments Prevent Experimental Transplant Arteriosclerosis, Journal of Surgical Research, 176, 2, 2012. Crossref
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Hillebrands Jan-Luuk, Klatter Flip A., van den Hurk Bart M.H., Popa Eliane R., Nieuwenhuis Paul, Rozing Jan, Origin of neointimal endothelium and α-actin–positive smooth muscle cells in transplant arteriosclerosis, Journal of Clinical Investigation, 107, 11, 2001. Crossref
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Hillebrands Jan-Luuk, van den Hurk Bart M.H, Klatter Flip A, Popa Eliane R, Nieuwenhuis Paul, Rozing Jan, Recipient origin of neointimal vascular smooth muscle cells in cardiac allografts with transplant arteriosclerosis, The Journal of Heart and Lung Transplantation, 19, 12, 2000. Crossref
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Tereb Denis A., Kirkiles-Smith Nancy C., Kim Richard W., Wang Yinong, Rudic R. Daniel, Schechner Jeffrey S., Lorber Marc I., Bothwell Alfred L.M., Pober Jordan S., Tellides George, HUMAN T CELLS INFILTRATE AND INJURE PIG CORONARY ARTERY GRAFTS WITH ACTIVATED BUT NOT QUIESCENT ENDOTHELIUM IN IMMUNODEFICIENT MOUSE HOSTS1, Transplantation, 71, 11, 2001. Crossref
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Hillebrands Jan-Luuk, Onuta Geanina, Rozing Jan, Role of Progenitor Cells in Transplant Arteriosclerosis, Trends in Cardiovascular Medicine, 15, 1, 2005. Crossref
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Michel Jean-Baptiste, Plissonnier Didier, Gomes Dominique, Effecteurs humoraux et cibles cellulaires de l’allo-rejet artériel chronique, Bulletin de l'Académie Nationale de Médecine, 185, 3, 2001. Crossref
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Shimizu Hisashi, Takahashi Masafumi, Takeda Shin-ichi, Inoue Seiichiro, Fujishiro Jun, Hakamata Yoji, Kaneko Takashi, Murakami Takashi, Takeyoshi Izumi, Morishita Yasuo, Kobayashi Eiji, Conversion from cyclosporine A to mycophenolate mofetil protects recipient kidney and prevents intimal hyperplasia in rat aortic allografts, Transplant Immunology, 13, 3, 2004. Crossref