Bioprosthetic Tissue Degeneration Inflammatory and Immune Processes: The Neglected Villain of Bioprosthetic Degeneration?

Human, Paul; Zilla, Peter

doi:10.1615/jlongtermeffmedimplants.v11.i34.80

Cited by 54 publications

(49 citation statements)

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“…Abundant evidence demonstrates that both glutaraldehyde-fixed and unfixed BP xenografts elicit an immune response [1][2][3][4][5][6][7][8][27][28][29][30][31]. However, little is known about the nature and identity of BP proteins eliciting the immune response.…”

Section: Discussionmentioning

confidence: 99%

“…Fixation with glutaraldehyde was once thought to largely mitigate the immune response to connective tissue xenografts by irreversibly cross-linking graft matrix proteins [1]. It is now clear that both humoral and cell-mediated immune responses to glutaraldehyde-fixed xenografts occur [1][2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…It is now clear that both humoral and cell-mediated immune responses to glutaraldehyde-fixed xenografts occur [1][2][3][4][5][6][7]. Mounting evidence implicates chronic antibody formation and immune rejection in bioprosthetic heart valve degeneration and calcification [2,3,6,7].…”

Section: Introductionmentioning

confidence: 99%

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Immunoproteomic identification of bovine pericardium xenoantigens

et al. 2008

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Bovine pericardium is an important biomaterial with current application in glutaraldehyde-fixed bioprosthetic heart valves and possible future application as an unfixed biological scaffold for tissue engineering. The importance of both humoral and cell-mediated rejection responses toward fixed and unfixed xenogeneic tissues has become increasingly apparent. However, the full scope and specific identities of bovine pericardium proteins that can elicit an immune response remain largely unknown. In this study, an immunoproteomic approach was used to survey bovine pericardium proteins for their ability to elicit a humoral immune response in rabbits. A two-stage protein extraction protocol was used to separate bovine pericardium proteins into water-and lipid-soluble fractions. Two-dimensional gel electrophoresis was performed to separate the proteins from each fraction. Western blots were generated from two-dimensional gels of both bovine pericardium protein fractions. These blots were probed with serum from rabbits immunized with bovine pericardium and a secondary antibody was used to assess for IgG positivity. Western blots were compared to duplicate two-dimensional gels and proteins in matched spots were identified by tandem mass spectrometry. Thirty-one putative protein antigens were identified, eight of which are known to be antigenic from previous studies. All of the putative antigens demonstrated progressive staining intensity with increasing days of post-exposure serum. Identified antigenic proteins represented a variety of functional and structural protein types, and included both cellular and matrix proteins. The results of this study have implications for the use of bovine pericardium as a biomaterial in bioprostheses and tissue engineering applications, as well as xenotransplantation in general.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Immunoproteomic identification of bovine pericardium xenoantigens

et al. 2008

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“…24,25 Inflammatory and immune responses have been implicated in the calcification and degenerative process of bioprosthesis as the most frequent mechanism of the contemporary glutaraldehyde pretreated porcine aortic valve degeneration. 26,27 The FSB is a porcine aortic root pretreated with ␣-amino oleic acid, an anticalcification agent shown to abolish porcine leaflet calcification in animal models. 28 The current data support the notion of a heightened anticalcification feature of the FSB valve because only 6 explanted valves showed significant macroscopic calcium deposition.…”

Section: Structural Valve Deteriorationmentioning

confidence: 99%

Long-Term Clinical and Echocardiographic Follow-Up of the Freestyle Stentless Aortic Bioprosthesis

et al. 2012

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Background-Stentless aortic bioprostheses were designed to provide enhanced hemodynamic performance and potentially greater longevity. The present report describes the outcomes of patients with the Freestyle stentless bioprosthesis followed for Յ18 years. Methods and Results-Between 1993 and 2011, 430 patients underwent primary aortic valve replacement with a Freestyle bioprosthesis in the subcoronary position. Mean age was 68.2Ϯ8.2 years. All of the clinical and echocardiographic data were collected prospectively. Mean overall follow-up was 9.1Ϯ4.4 years and was complete in all of the patients. In-hospital mortality was 3.5% (nϭ15). Overall, 10-and 15-year survival were 60.7% and 35.0%, respectively. Fifty-one patients required reoperation during follow-up, including 27 for structural valve deterioration (SVD). Overall, freedom from reoperation was 91.0% and 75.0% at 10 and 15 years, whereas freedom from reoperation for SVD was 95.9% and 82.3%, respectively. At 10 and 15 years, freedom from reoperation for SVD was 94.0% and 62.6% for patients Ͻ60 years of age and 96.3% and 88.4% for patients Ն60 years of age (Pϭ0.002). The median time to explant for SVD was 10.7 years. SVD presented mostly as acute, severe aortic insufficiency attributed to leaflet tear (77.8%).The independent risk factors for reoperation for SVD were age Ͻ60 years (Pϭ0.001) and dyslipidemia (Pϭ0.02). Conclusions-Aortic valve replacement with the Freestyle bioprosthesis in a subcoronary position provides good long-term clinical and echocardiographic outcomes for patients Ͼ60 years of age. Severe aortic insufficiency with leaflet tear is the major mode of SVD leading to reoperation in these patients. (Circulation. 2012;126[suppl 1]:S198 -S204.)

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“…This type of collagen is characterized by a low antigenicity and increased thrombogenicity [27]. Standard methods of processing with glutaraldehyde have to alleviate the immune response to xenografts [28], while there is an increased risk of tissue fatigue with progress of degenerative processes and calcification, which may be due to cytotoxicity and inflammatory changes [29], these phenomena being revealed in experimental use of bovine pericardium grafts.…”

Section: Color H-e;mentioning

confidence: 99%

Comparative Cellular Local Response in Abdominal Defect Plastic Surgery with Bovine Pericardium and Bovine Fascia Preserved in Formaldehyde in Experimental Rabbits

Gudemac

Babuci

Tica

et al. 2017

ARS Medica Tomitana

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In the present paper, we refer to a method of primary closure of congenital defects of the anterior abdominal wall with tensionless viscero-abdominal disproportion. The study group included 10 animals subjected to surgery of the abdominal wall defect closure with bovine pericardium graft preserved in 0.5% formaldehyde, and 5 rabbits of the same breed and weight, in which bovine fascia graft was used as implant, being preserved in 0.5% formaldehyde. The abdominal anterior wall defect was made surgically by excision of the musculo-fascial structures and peritoneum. Bovine pericardium graft and bovine fascia graft were placed and fixed posteriorly to rectus abdominals muscles, having direct contact with the intra-abdominal contents and protected by suturing skin and subcutaneous layer. The purpose of the study was to perform a comparative postoperative evaluation of local macroscopic and microscopic changes that develop after reconstruction of the major abdominal wall defects experimentally induced in rabbits, using bovine pericardium and bovine fascia grafts preserved in 0.5% formaldehyde. In cases of major fascial defects of the anterior abdominal wall, bovine pericardium graft has acceptable strength and biocompatibility, having stabilizing properties of the abdominal wall due to the development of the connective tissue layer located between the implant and

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Bioprosthetic Tissue Degeneration Inflammatory and Immune Processes: The Neglected Villain of Bioprosthetic Degeneration?

Cited by 54 publications

References 0 publications

Immunoproteomic identification of bovine pericardium xenoantigens

Immunoproteomic identification of bovine pericardium xenoantigens

Long-Term Clinical and Echocardiographic Follow-Up of the Freestyle Stentless Aortic Bioprosthesis

Comparative Cellular Local Response in Abdominal Defect Plastic Surgery with Bovine Pericardium and Bovine Fascia Preserved in Formaldehyde in Experimental Rabbits

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