Antiproliferative effects of immunosuppressant drugs on vascular smooth muscle cells: An additional advantage for attenuating transplant vasculopathy
Antiproliferative effects of immunosuppressant drugs on vascular smooth muscle cells: An additional advantage for attenuating transplant vasculopathy
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DOI：
10.1358/dnp.2004.17.2.829044
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发表时间：
2004-03-01
影响因子：
--
通讯作者：
Autieri, MV
中科院分区：
文献类型：
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作者：
Autieri, MV
冠状动脉移植血管病变（CATV）是实体器官移植失败的主要原因。 CATV是一种血管增生性疾病，其特征是血管平滑肌细胞（VSMC）激活、闭塞性动脉闭塞。由于 CATV 的慢性和广泛性，用于治疗传统冠状动脉疾病的方法不适用于大多数 CATV 患者。标准抗排斥治疗中使用的大多数药物都是免疫抑制药物，旨在通过禁用免疫反应来抑制器官排斥。由于 VSMC 是 CATV 发展中的主要效应细胞，因此通过免疫抑制药物中断其激活和增殖是对抗 CATV 的第二道攻击线。幸运的是，许多这些药物的一个意想不到但有益的副作用是抑制 VSMC 增殖，从而减弱 CATV 的进展。这篇综述总结了更常用的免疫抑制剂对 VSMC 病理生理学的影响，并检查了一些专门用于减弱 VSMC 激活的新药物的作用。与积极的免疫抑制治疗相关的感染和恶性肿瘤的风险是开发直接和特异性影响 VSMC 对损伤反应的药物的强大动力，并且可能代表减弱 CATV 的重要替代方法甚至主要方法。 (C) 2004 年《Prous Science》。版权所有。
Coronary artery transplant vasculopathy (CATV) is the major cause of solid organ transplant failure. CATV is a vascular proliferative disease characterized by vascular smooth muscle cell (VSMC) activation obliterative arterial occlusion. Modalities used to treat conventional coronary artery disease are not applicable for most patients with CATV because of its chronic and extensive nature. The majority of drugs used in standard antirejection therapy are immunosuppressive and aim to suppress organ rejection by disabling the immune response. Since VSMCs are the major effector cells in the development of CATV, interruption of their activation and proliferation by immunosuppressive drugs represent a second line of attack with which to combat CATV. Fortunately, an unintended but advantageous side effect of many of these drugs is suppression of VSMC proliferation and consequential attenuation of the progression of CATV. This review summarizes the impact that the more commonly used immunosuppressives have on VSMC pathophysiology and examines the effects of some of the newer drugs that are specifically designed to attenuate VSMC activation. The risk of infection and malignancy associated with aggressive immunosuppressive therapy are a compelling impetus to develop drugs that directly and specifically impact the VSMC response to injury and may represent an important alternative or even a primary approach to attenuating CATV. (C) 2004 Prous Science. All rights reserved.