UNASSIGNED:经导管主动脉瓣植入术(TAVI)由于其最小的侵入性和实用性,正在迅速取代心脏手术。尚未对带有半乳糖-α-1,3-半乳糖(α-Gal)的TAVI生物假体心脏瓣膜的生物相容性进行中期免疫学研究。在这项研究中,我们调查了TAVI植入后3个月,用于TAVI的生物人工心脏瓣膜是否会增强α-Gal特异性抗体依赖性和抗体非依赖性免疫反应。
UNASSIGNED:这项前瞻性观察性研究包括27例接受TAVI的严重主动脉瓣狭窄患者和10例接受经导管MitraClip治疗的严重二尖瓣反流患者(雅培实验室,雅培公园,病态)程序。在常规检查中,在治疗前和治疗后90天抽取血样。使用酶联免疫吸附测定分析血清样品。血清α-Gal特异性免疫球蛋白(Ig)G浓度,IgG亚类和IgE,补体因子3a,评估NETosis特异性瓜氨酸化H3和系统性炎症标志物可溶性肿瘤形成抑制和白介素33。
未经批准:TAVI后三个月,我们发现血清中α-Gal特异性IgG3、补体因子补体因子3a、瓜氨酸化H3水平,和可溶性肿瘤形成抑制(分别为P=0.002,P=.001,P=.025和P=.039)。TAVI后,所有患者中有55%发生了α-Gal特异性IgE抗体的敏化。
未经评估:我们的结果表明,TAVI引发了中期,与接受MitraClip植入的患者相比,针对α-Gal的特异性体液免疫应答会导致非特异性体液炎症。这一观察结果将使人们更好地了解干预后的发病率和生物假体的长期耐久性,并表明在为年轻患者设计植入策略时谨慎行事。
UNASSIGNED: Transcatheter aortic valve implantation (TAVI) is rapidly replacing cardiac surgery due to its minimal invasiveness and practicality. Midterm immunological studies on the biocompatibility of galactose-alpha-1,3-galactose (α-Gal)-carrying bioprosthetic heart valves for TAVI are not available. In this study we investigated whether bioprosthetic heart valves employed for TAVI augment an α-Gal-specific antibody-dependent and antibody-independent immune response 3 months after TAVI implantation.
UNASSIGNED: This prospective observational study included 27 patients with severe aortic valve stenosis undergoing TAVI and 10 patients with severe mitral valve regurgitation treated with a transcatheter MitraClip (Abbott Laboratories, Abbott Park, Ill) procedure. Blood samples were drawn before and 90 days after treatment at a routine checkup. Serum samples were analyzed using enzyme-linked immunosorbent assay. Serum concentrations of α-Gal-specific immunoglobulin (Ig) G, IgG subclasses and IgE, complement factor 3a, NETosis-specific citrullinated H3, and the systemic inflammation markers soluble suppression of tumorigenicity and interleukin 33 were evaluated.
UNASSIGNED: Three months after TAVI, we found significantly increased serum concentrations of α-Gal-specific IgG3, complement factor complement factor 3a, citrullinated H3 levels, and soluble suppression of tumorigenicity (P = .002, P = .001, P = .025, and P = .039, respectively). Sensitization of α-Gal-specific IgE antibodies occurred in 55% of all patients after TAVI.
UNASSIGNED: Our results indicate that TAVI elicits a midterm, specific humoral immune response against α-Gal and causes an unspecific humoral inflammation compared with patients undergoing MitraClip implantation. This observation will lead to a better understanding of postintervention morbidity and the long-term durability of bioprostheses and indicates that caution is appropriate when designing implantation strategies for younger patients.