TITLE:
Role of Oxidative Stress in Cardiac Allograft Vasculopathy
AUTHORS:
Nandini Nair, Enrique Gongora, Joshua Reynolds
KEYWORDS:
Cardiac Allograft Vasculopathy; Oxidative Stress; Asymmetric Dimethyl Arginine; Cyto Megalo Virus; Transplantation
JOURNAL NAME:
Open Journal of Organ Transplant Surgery,
Vol.3 No.2,
May
24,
2013
ABSTRACT: Cardiac Allograft Vasculopathy, an accelerated form of arterial occlusive disease, is the major cause of death in the long-term after heart transplantation. Multiple factors influence the initiation and progression of CAV. These include ischemia-reperfusion, dyslipidemia, insulin resistance, and hypertension due to the use of immunosuppressive agents, the direct effects of immunosuppressive agents on endothelial function, and viruses (CMV). Impaired endothelial function reflects abnormalities in the production or activity of several vasoactive substances. Disruption of the nitric oxide synthase (NOS) pathway leads to changes in vascular reactivity, structure, and interaction with circulating blood components. Since endothelium-derived nitric oxide (NO) suppresses vascular cell proliferation and vascular inflammation, a deficit in vascular NO facilitates development of CAV. The link between oxidative stress and CAV largely exists in the balance between free radical superoxide generation and NO production. This review focuses on identifying the oxidative stress factors affecting CAV.