Human Paul, Zilla Peter
Department of Cardiothoracic Surgery, Cape Heart Centre, University of Cape Town Medical School, Cape Town, South Africa.
Department of Cardiothoracic Surgery, University of Cape Town, Cape Town, 7925, South Africa.
J Long Term Eff Med Implants. 2017;27(2-4):159-180. doi: 10.1615/JLongTermEffMedImplants.v27.i2-4.50.
In an attempt to avoid the destructive process of bioprosthetic heart-valve calcification associated with the use of glutaraldehyde, valves are today prepared using low concentrations of the crosslinking reagent. In this review, we summarize our findings and those of others that confirm that the immunogenicity of such tissue is not sufficiently masked and that a defined humoral response is indeed mounted against a repertoire of antigens unrelated to those associated with vascularized and noncross-linked xenograft organs. We demonstrate the need for increased cross-linking of tissue to satisfactorily mitigate that response; furthermore, we examine the impact of increased cross-link density on the macrophage as antigen presenting cell with respect to its involvement in both tissue erosion and pannus overgrowth. Finally we present evidence for a role of circulating antibodies in bioprosthesis calcification.
为了避免与使用戊二醛相关的生物人工心脏瓣膜钙化的破坏过程，如今制备瓣膜时使用低浓度的交联剂。在本综述中，我们总结了我们自己以及其他人的研究结果，这些结果证实此类组织的免疫原性并未得到充分掩盖，并且确实针对一系列与血管化和未交联的异种移植器官无关的抗原产生了明确的体液反应。我们证明需要增加组织的交联以令人满意地减轻这种反应；此外，我们研究了增加交联密度对作为抗原呈递细胞的巨噬细胞在组织侵蚀和血管翳过度生长中的影响。最后，我们提供了循环抗体在生物假体钙化中作用的证据。
