doi: 10.1161/CIRCRESAHA.108.171488
© 2008 American Heart Association, Inc.
Review |
Stem Cells and Transplant Arteriosclerosis
From the Cardiovascular Division, King’s College London, United Kingdom.
Correspondence to Prof Qingbo Xu, Cardiovascular Division, King’s College London, 125 Coldharbour Ln, London SE5 9NU, United Kingdom. E-mail qingbo.xu{at}kcl.ac.uk
This Review is part of a thematic series on Transplant Vasculopathy, which includes the following articles:
Allograft Vasculopathy Versus Atherosclerosis
Antibody and Complement in Transplant Vasculopathy
Interferon-
Axis in Graft Arteriosclerosis
Vascular Remodeling in Transplant Vasculopathy
Stem Cells and Transplant Arteriosclerosis
Chemokines and Transplant Vasculopathy
William Baldwin and Jordan Pober Guest Editors
Stem cells can differentiate into a variety of cells to replace dead cells or to repair damaged tissues. Recent evidence indicates that stem cells are involved in the pathogenesis of transplant arteriosclerosis, an alloimmune initiated vascular stenosis that often results in transplant organ failure. Although the pathogenesis of transplant arteriosclerosis is not yet fully understood, recent developments in stem cell research have suggested novel mechanisms of vascular remodeling in allografts. For example, stem cells derived from the recipient may repair damaged endothelial cells of arteries in transplant organs. Further evidence suggests that stem cells or endothelial progenitor cells may be released from both bone marrow and non–bone marrow tissues. Vascular stem cells appear to replenish cells that died in donor vessels. Concomitantly, stem/progenitor cells may also accumulate in the intima, where they differentiate into smooth muscle cells. However, several issues concerning the contribution of stem cells to the pathogenesis of transplant arteriosclerosis are controversial, eg, whether bone marrow–derived stem cells can differentiate into smooth muscle cells that form neointimal lesions of the vessel wall. This review summarizes recent research on the role of stem cells in transplant arteriosclerosis, discusses the mechanisms of stem cell homing and differentiation into mature endothelial and smooth muscle cells, and highlights the controversial issues in the field.
Key Words: stem cells • endothelial progenitors • smooth muscle progenitors • common progenitors • arteriosclerosis
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