PMID: 20649510Jul 24, 2010Paper

Impact of immunosuppressive drugs on the development of cardiac allograft vasculopathy

Current Vascular Pharmacology
Michael Dandel, Roland Hetzer

Abstract

Immunosuppressive drugs (ISDs) have a major impact on the development and progression of cardiac allograft vasculopathy (CAV), the main cause of cardiac allograft loss and a leading cause of death beyond the 1st post-transplant year. The influence of ISDs on the development and progression of CAV is complex. In spite of their high potency to suppress the alloimmune response (prevention of allograft rejection) which plays an essential role in the pathogenesis of CAV, the immunosuppressive regimens which were used in the past were not able to entirely prevent the development of CAV. This can be explained by the fact that several non-alloimmune insults such as brain death, organ preservation, surgical trauma, ischemia-reperfusion, diabetes, hypertension, hyperlipidemia, cytomegalovirus infection etc. are also involved in the development or progression of CAV. Some of these insults are not affected by immunosuppression, whereas others can be even aggravated by certain ISDs, particularly by calcineurin inhibitors (CNIs), but also by glucocorticosteroids and proliferation signal inhibitors (PSIs). Certain ISDs, especially CNIs, also have direct toxic effects on vascular endothelial and smooth muscle cells inducing endothelial dysfunc...Continue Reading

Citations

Mar 9, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Marietta von Suesskind-SchwendiKarla Lehle
Nov 28, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Roland HetzerEva Maria Delmo Walter
Oct 15, 2014·Immunotherapy·Markus J Barten, Maja-Theresa Dieterlen
Sep 6, 2011·Radiologic Clinics of North America·Frederick D Grant, S Ted Treves
Apr 27, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·N P HofmannG Korosoglou
May 21, 2011·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jorge A Belardi
Apr 17, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J HesterK J Wood
Aug 2, 2011·Immunology Letters·Valeria CrudeleClaudio Napoli

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