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Inflammatory Cell Infiltration, Cytokines, and Mechanisms of Myocyte Necrosis in Cardiac Transplant Rejection

  • Jay Bruce Sundstrom
  • Kimberley Cecile Jollow
  • Aftab Ahmed Ansari

Abstract

Successful engraftment or rejection of the cardiac allograft depends on the function and viability of each of the lineages of cells that comprise cardiac tissue, the major lineage being highly specialized, terminally differentiated parenchymal cardiac myocytes. The traditional approach to optimizing survival of the allograft has been to target what have been considered as immune-mediated mechanisms of rejection. However, it is now becoming increasingly clear that the rejection pathways that evolve are determined not only by the nature of the allogeneic antigenic signals which initiate the allo-response, but also by the inflammatory environment in which these responses develop. Therefore, effective clinical strategies to prevent graft rejection must address antigen-independent as well as antigen-dependent processes involved in both direct and indirect mechanisms of cardiac myocyte cell death or “drop out”. In this review we will describe how both the complex interaction of the immune response to alloantigen displayed by distinct lineages of cells that comprise donor tissues possessing different intrinsic antigen presentation capabilities and the inflammatory “response to injury” lead to the direct and/or indirect destruction of cardiac myocytes and the remodeling and reinforcement of damaged tissues within the cardiac allograft.

Keywords

Acute Rejection Cardiac Myocytes Allograft Rejection Cardiac Allograft Hyperacute Rejection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Jay Bruce Sundstrom
    • 1
  • Kimberley Cecile Jollow
    • 1
  • Aftab Ahmed Ansari
    • 1
  1. 1.Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaUSA

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