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Antibody formation towards porcine tissue in patients implanted with crosslinked heart valves is directed to antigenic tissue proteins and αGal epitopes and is reduced in healthy vegetarian subjects

Antibody formation towards porcine tissue in patients implanted with crosslinked heart valves is... Abbreviationsga‐pVGlutaraldehyde‐fixed porcine heart valvesIntroductionMore than 250 000 heart valves have to be replaced worldwide per year due to valvular heart disease in humans. Along with mechanical valve prostheses, bioprosthetic heart valves, which are derived from porcine or bovine tissue, are frequently implanted. For more than 50 years, a method has been established that both helps to preserve the tissue and reduces the natural immunogenicity of theses valves, namely the fixation of the tissue with glutaraldehyde. Aldehydes chemically react with free amino groups and therefore crosslink tissue proteins which is assumed to destroy or mask immunogenic epitopes within the tissue. Indeed, five decades of successful implantation of ga‐fixed valves without severe rejection seem to confirm this assumption. However, ga‐fixed valves frequently undergo calcification within 10‐15 years that leads to structural valve deterioration and demands for the replacement of the bioprosthetic valve by an alternative implant. Although valve failure is multifactorial including causes like high blood pressure or endocarditis, these observations point with increasing evidence to the fact that the crosslinking procedure does not eliminate completely immunogenic structures and that a mild but ongoing immune reaction towards these residual epitopes causes sustained inflammation with final calcification. Key players in this scenario are http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Xenotransplantation Wiley

Antibody formation towards porcine tissue in patients implanted with crosslinked heart valves is directed to antigenic tissue proteins and αGal epitopes and is reduced in healthy vegetarian subjects

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References (49)

Publisher
Wiley
Copyright
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
ISSN
0908-665X
eISSN
1399-3089
DOI
10.1111/xen.12288
pmid
28101961
Publisher site
See Article on Publisher Site

Abstract

Abbreviationsga‐pVGlutaraldehyde‐fixed porcine heart valvesIntroductionMore than 250 000 heart valves have to be replaced worldwide per year due to valvular heart disease in humans. Along with mechanical valve prostheses, bioprosthetic heart valves, which are derived from porcine or bovine tissue, are frequently implanted. For more than 50 years, a method has been established that both helps to preserve the tissue and reduces the natural immunogenicity of theses valves, namely the fixation of the tissue with glutaraldehyde. Aldehydes chemically react with free amino groups and therefore crosslink tissue proteins which is assumed to destroy or mask immunogenic epitopes within the tissue. Indeed, five decades of successful implantation of ga‐fixed valves without severe rejection seem to confirm this assumption. However, ga‐fixed valves frequently undergo calcification within 10‐15 years that leads to structural valve deterioration and demands for the replacement of the bioprosthetic valve by an alternative implant. Although valve failure is multifactorial including causes like high blood pressure or endocarditis, these observations point with increasing evidence to the fact that the crosslinking procedure does not eliminate completely immunogenic structures and that a mild but ongoing immune reaction towards these residual epitopes causes sustained inflammation with final calcification. Key players in this scenario are

Journal

Xenotransplantation – Wiley

Published: Mar 1, 2017

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