학술논문

The role of antibody responses against glycans in bioprosthetic heart valve calcification and deterioration
Document Type
article
Source
Nature Medicine. 28(2)
Subject
Biomedical and Clinical Sciences
Immunology
Heart Disease
Cardiovascular
5.3 Medical devices
Development of treatments and therapeutic interventions
Animals
Antibody Formation
Aortic Valve
Aortic Valve Stenosis
Bioprosthesis
Calcinosis
Galactose
Humans
Immunoglobulin G
Mice
Polysaccharides
Prospective Studies
Medical and Health Sciences
Biomedical and clinical sciences
Health sciences
Language
Abstract
Bioprosthetic heart valves (BHVs) are commonly used to replace severely diseased heart valves but their susceptibility to structural valve degeneration (SVD) limits their use in young patients. We hypothesized that antibodies against immunogenic glycans present on BHVs, particularly antibodies against the xenoantigens galactose-α1,3-galactose (αGal) and N-glycolylneuraminic acid (Neu5Gc), could mediate their deterioration through calcification. We established a large longitudinal prospective international cohort of patients (n = 1668, 34 ± 43 months of follow-up (0.1-182); 4,998 blood samples) to investigate the hemodynamics and immune responses associated with BHVs up to 15 years after aortic valve replacement. Early signs of SVD appeared in