The role of anti-endothelial antibodies in the immunopathogenesis of transplant associated coronary artery disease (Review).

Transplant coronary artery disease (TxCAD) is manifest as a diffuse, concentric intimal proliferation which results in occlusion of the allograft vessel lumen, and is responsible for limiting the long-term success of cardiac transplantation. The recent discovery of high circulating levels of anti-endothelial antibodies (AEAs) in patients with TxCAD has resulted in increased clinical and experimental research interests in understanding their patho-physiological roles in TxCAD. Increasing evidence suggests that AEAs are cross-reactive towards an endothelial protein doublet of 56-58 kDa which has now been characterised and identified as the cytoskeletal protein vimentin. Despite this recent progress the immunopathogenesis of TxCAD remains unclear. In this review recent developments and mechanisms of the involvement of AEAs in the immunopathogenesis of TxCAD are discussed.