Document Detail


Endothelial apoptosis and chronic transplant vasculopathy: recent results, novel mechanisms.
MedLine Citation:
PMID:  16426308     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chronic transplant vasculopathy (CTV) is a progressive form of vascular obliteration affecting the arteries, arterioles and capillaries of solid organ transplants. It is characterized by intimal accumulation of mononuclear cells, vascular smooth muscle cells (VSMC), myofibroblasts and connective tissue. Mounting evidence, based on animal models and human biopsy results, suggests that acute and persistent rejection triggering apoptosis of endothelial cells (EC) plays a pivotal role in CTV. The precise mechanisms that underlie the induction of fibroproliferative changes in association with endothelial apoptosis have yet to be clearly delineated. Recent observations in the field of apoptosis research provide some important mechanistic clues. First, endothelial apoptosis creates a state of hyperadhesiveness for mononuclear cells, thus facilitating sustained leukocyte infiltration. Second, phosphatidylserine-dependent engulfment of apoptotic cells by infiltrating mononuclear leukocytes promotes transforming growth factor-beta1 production. Third, apoptosis of EC triggers extracellular matrix (ECM) proteolysis thus initiating the production of fibroproliferative/fibrogenic ECM fragments. The relative importance of these mechanisms in the pathophysiology of CTV will need to be addressed in vivo. Yet, these recent developments provide a new mechanistic framework that will help better define the importance of immune-mediated EC apoptosis in the regulation of vascular repair.
Authors:
J-F Cailhier; P Laplante; M-J Hébert
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  6     ISSN:  1600-6135     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-23     Completed Date:  2006-03-28     Revised Date:  2007-02-14    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  247-53     Citation Subset:  IM    
Affiliation:
Renal and Transplantation Division, Research Centre CHUM (Centre Hospitalier de l'Université de Montréal), University of Montreal, 1560 Sherbrooke Est, Montreal, Quebec H2L 4M1, Canada.
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MeSH Terms
Descriptor/Qualifier:
Apoptosis
Chronic Disease
Endothelium, Vascular / pathology,  physiopathology*
Humans
Models, Cardiovascular
Postoperative Complications / pathology*,  physiopathology
Transplantation, Homologous / pathology
Vascular Diseases / pathology*,  physiopathology

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