Document Detail

Alpha-Gal specific IgG immune response after implantation of bioprostheses.
MedLine Citation:
PMID:  19670109     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We have previously shown that the alpha-Gal (Galalpha1.3-Galbeta1-4GlcNAc-R) epitope is a relevant xenoantigen present on bioprostheses utilized in cardiac surgery and elicits an alpha-Gal specific IgM immune response. We sought to investigate whether that immune response continues after valve implantation. MATERIALS AND METHODS: We collected plasma samples from patients who underwent bioprosthesis implantation (n = 19) or mechanical valve replacement (n = 8), respectively, prior to, at 10 days and at 3 months after cardiac surgery. ELISA was utilized to quantify alpha-Gal specific IgG and IgG subclasses. 3 bioprosthetic tissue samples were obtained from patients who had to undergo re-operation within 1 week (n = 1) or at 12-15 months (n = 2) after the initial operation. We utilized confocal laser scanning microscopy (CLSM) to detect the presence of alpha-Gal epitopes (IB4) and cell nuclei (DAPI). RESULTS: alpha-Gal specific IgG was significantly increased 3 months after implantation of bioprostheses compared to preoperative values (p < 0.001) and was significantly higher than alpha-Gal specific IgG levels of the control group (p < 0.05). IgG3 was the major subclass directed against alpha-Gal (p < 0.05, pre- vs. postoperative values). In CLSM analysis we demonstrated that bioprostheses explanted 1 week after implantation contained IB4/DAPI positive cells within the collagen matrix. In contrast, in patients who underwent reoperation after 12 months, porcine tissue showed a complete lack of IB4/DAPI. CONCLUSION: Our results indicate that the implantation of bioprostheses elicits a specific humoral immune response against alpha-Gal bearing cells compared to controls within 3 months after cardiac surgery. The complete absence of IB4/DAPI positive structures 12 months after implantation indicates a specific degradation of alpha-Gal bearing cells through previous exposure to the human blood circuit.
A Mangold; T Szerafin; K Hoetzenecker; S Hacker; M Lichtenauer; T Niederpold; S Nickl; M Dworschak; R Blumer; J Auer; H J Ankersmit
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-20
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  57     ISSN:  1439-1902     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  191-5     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart New York.
Department of Cardiothoracic Surgery, Medical University of Vienna, Vienna, Austria.
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MeSH Terms
Antibody Specificity
Enzyme-Linked Immunosorbent Assay
Heart Valve Prosthesis*
Heart Valves / surgery*
Immunoglobulin G / biosynthesis*,  immunology*
Middle Aged
Postoperative Period
Time Factors
alpha-Galactosidase / immunology*
Reg. No./Substance:
0/Epitopes; 0/Immunoglobulin G; EC

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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