Cellular, molecular and immunological mechanisms in the pathophysiology of vein graft intimal hyperplasia

Amit K. Mitra, Deepak M. Gangahar, Devendra K. Agrawal

Research output: Contribution to journalReview article

113 Citations (Scopus)

Abstract

Coronary artery disease, leading to myocardial infarction and ischaemia, affects millions of persons and is one of the leading causes of morbidity and mortality worldwide. Invasive techniques such as coronary artery bypass grafting are used to alleviate the sequelae of arterial occlusion. Unfortunately, restenosis or occlusion of the grafted conduit occurs over a time frame of months to years with a gradual reduction in patency, especially in vein grafts. The events leading to intimal hyperplasia (IH) formation involve numerous cellular and molecular components. Various cellular elements of the vessel wall are involved as are leucocyte-endothelial interactions that trigger the coagulation cascade leading to localized thrombus formation. Subsequent phenotypic modification of the medial smooth muscle cells and their intimal migration is the basis of the lesion formation that is thought to be propagated by an immune-mediated reaction. Despite intense scrutiny, the pathophysiology of IH remains an enigma. Although several growth factors, cytokines and numerous other biomolecules have been implicated and their relationship to prohyperplasia pathways such as the phosphatidyl-inositol 3-kinase (PI3K)-Akt pathway has been established, many pieces of the puzzle are still missing. An in-depth understanding of early vein graft adaptation and progression is necessary to improve the long-term prognosis and develop more effective therapeutic measures. In this review, we have critically evaluated and summarized the literature to elucidate and interlink the numerous established and emerging factors that play a key role in the development of IH leading to vein graft restenosis.

Original languageEnglish
Pages (from-to)115-124
Number of pages10
JournalImmunology and Cell Biology
Volume84
Issue number2
DOIs
StatePublished - Apr 2006

Fingerprint

Tunica Intima
Grafts
Hyperplasia
Veins
Transplants
Antigen-antibody reactions
Biomolecules
Phosphatidylinositols
Coagulation
Muscle
Intercellular Signaling Peptides and Proteins
Phosphotransferases
Cells
Coronary Artery Bypass
Cytokines
Smooth Muscle Myocytes
Myocardial Ischemia
Coronary Artery Disease
Thrombosis
Leukocytes

All Science Journal Classification (ASJC) codes

  • Immunology
  • Clinical Biochemistry
  • Cell Biology

Cite this

Cellular, molecular and immunological mechanisms in the pathophysiology of vein graft intimal hyperplasia. / Mitra, Amit K.; Gangahar, Deepak M.; Agrawal, Devendra K.

In: Immunology and Cell Biology, Vol. 84, No. 2, 04.2006, p. 115-124.

Research output: Contribution to journalReview article

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