title: Immune response in patients receiving a bioprosthetic heart valve: lack of response with decellularized valves.
abstract: Conventional biological heart valves treated with glutaraldehyde (GA) reveal a limited lifespan due to calcification. This is assumed to be an immune response initiated process, which is not seen with decellularized valves. However, their immunological potential is still a matter of debate. Therefore, serum samples from patients undergoing heart valve surgery were obtained before (Pre), after (Post), and 9-12 months after operation (Follow Up). Immunoglobulin G (IgG) and M (IgM) antibodies against porcine collagen I and α-Gal (Gal-alpha1,3-Gal-beta1,4-GlcNac-R) were determined for decellularized and GA treated valves. Antibody titers for collagen type I revealed no significant alteration for both types of valves. However, a considerable anti-α-Gal antibody response was observed in patients with GA-treated porcine valves. In detail, IgM antibodies were increased during follow up (p<0.05), whereas decellularized valves revealed a minor decrease in the IgM response (p<0.001). IgG antibodies were considerably increased with GA-treated porcine (p<0.05) and bovine (p<0.01) xenografts, whereas there was lack of response with decellularized valves. This indicates that GA treatment is not sufficient to eliminate immune response to the α-Gal epitope completely. Future investigations will have to verify whether immune response to α-Gal can be linked to the limited durability of conventional valves.
authors.affiliation: AutoTissue GmbH, Goerzallee 305 D, Berlin, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bloch
authors.forename: Pia
authors.initials: P
authors.lastname: Golde
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Dohmen
authors.forename: Steffen
authors.initials: S
authors.lastname: Posner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Konertz
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Erdbrügger
mesh_terms: D000328:Adult; D000818:Animals; D001705:Bioprosthesis; D002417:Cattle; D024042:Collagen Type I / Q000378:metabolism; D057075:Enzyme Assays; D005260:Female; D005976:Glutaral / Q000494:pharmacology; D006350:Heart Valve Prosthesis; D006801:Humans; D007109:Immunity / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D034421:Sus scrofa; D000519:alpha-Galactosidase / Q000378:metabolism
chemical_list: D024042:Collagen Type I; D000519:alpha-Galactosidase; D005976:Glutaral