kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2023-12-4S-196-205kpccz-1082Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОР. Патологическая физиологияREVIEWS. Pathological physiologyИМПЛАНТАЦИЯ БИОЛОГИЧЕСКИХ ПРОТЕЗОВ КЛАПАНОВ СЕРДЦА КАК РАЗНОВИДНОСТЬ ТРАНСПЛАНТАЦИИ: ИММУНОЛОГИЧЕСКИЕ СЛЕДСТВИЯ НОВОЙ КОНЦЕПЦИИBIOPROSTHETIC VALVE IMPLANTATION AS TYPE OF TRANSPLANTATION: IMMUNOLOGICAL CONSEQUENCES OF NEW CONCEPThttps://orcid.org/0000-0001-6099-0315КостюнинАлександр ЕвгеньевичKostyuninAlexander E.

кандидат биологических наук научный сотрудник лаборатории новых биоматериалов отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация

PhD, Researcher at the Laboratory of New Biomaterials, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute of Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation

Rhabdophis_tigrina@mail.ruhttps://orcid.org/0000-0003-4890-0393ГлушковаТатьяна ВладимировнаGlushkovaTatiana V.

кандидат биологических наук старший научный сотрудник лаборатории новых биоматериалов отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация

PhD, Senior Researcher at the Laboratory of New Biomaterials, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute of Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation

bio.tvg@mail.ruhttps://orcid.org/0000-0001-7477-3979ОвчаренкоЕвгений АндреевичOvcharenkoEvgeny A.

кандидат технических наук заведующий лабораторией новых биоматериалов отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация

PhD, Head of the Laboratory of New Biomaterials, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute of Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation

ov.eugene@gmail.comФедеральное государственное бюджетное научное учреждение «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»РоссияFederal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”Russian Federation202329122023124Sприложение196205Copyright © Костюнин А.Е., Глушкова Т.В., Овчаренко Е.А., 20242024Костюнин А.Е., Глушкова Т.В., Овчаренко Е.А.Kostyunin A.E., Glushkova T.V., Ovcharenko E.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1082Основные положения

Основные положения

 

 

Резюме

Резюме

Биологические протезы клапанов сердца характеризуются низкой тромбогенностью, позволяющей избежать рисков пожизненной антикоагулянтной терапии. Вместе с тем сроки их функционирования ограничены в среднем 10–15 годами, поскольку их биологический компонент подвержен структурной дегенерации. Данные исследований последних 20 лет демонстрируют, что развитие структурной дегенерации обусловлено иммунозависимыми процессами, напоминающие таковые гуморального и клеточного отторжения алло- и ксенотрансплантатов. В настоящем обзоре мы суммируем актуальную информацию об иммунологических триггерах и механизмах структурной дегенерации. Кроме того, мы анализируем последние достижения в разработке подходов к снижению иммуногенности биологических протезов, включающие проверку иммунологической совместимости аллогенного материала и получение низкоиммуногенного ксенобиоматериала от генномодифицированных животных, децеллюляризацию биологических протезов, а также медикаментозное торможение структурной дегенерации.

Highlights

Highlights

 

 

Abstract

Abstract

Bioprosthetic heart valves (BHV) are characterized by low thrombogenicity, thus circumventing the need for long‐term anticoagulation. However, BHV lifespan is limited to 10–15 years because its tissue components are subject to degeneration. Recent research data indicate that immune responses forming the basis of humoral and cellular rejection of allografts and xenografts play a major role in the development of structural valve degeneration (SVD). This review summarizes up-to-date data on immune processes involved in SVD pathogenesis. Moreover, the latest achievements in the development of strategies to reduce the immunogenicity of BHV, such as data on immune compatibility of allogeneic material and the process of deriving low immunogenic biomaterial from genetically modified animals, decellularization of BHV, and the ways of slowing the process of degeneration are analyzed.

Биологические протезы клапанов сердцаСтруктурная дегенерация клапановИммунное отторжениеТрансплантацияBioprosthetic heart valveStructural valve degenerationImmune rejectionTransplantationРабота выполнена в рамках комплексной программы фундаментальных научных исследований СО РАН по фундаментальной теме НИИ КПССЗ № 0419-2022-0001 «Молекулярные, клеточные и биомеханические механизмы патогенеза сердечно-сосудистых заболеваний в разработке новых методов лечения заболеваний сердечно-сосудистой системы на основе персонифицированной фармакотерапии, внедрения малоинвазивных медицинских изделий, биоматериалов и тканеинженерных имплантатов».ReferencesOtto C.M., Nishimura R.A., Bonow R.O., Carabello B.A., Erwin J.P. 3rd, Gentile F., Jneid H., Krieger E.V., Mack M., McLeod C., O'Gara P.T., Rigolin V.H., Sundt T.M. 3rd, Thompson A., Toly C. 2020 ACC/AHA Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. 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The authors declare that there are no conflicts of interest present.