Late multiglycosidorum tripterygium treatment ameliorates established graft coronary arteriosclerosis after heart transplantation in the rat

Abstract

GRAFT coronary arteriaosclerosis (GCA) is the major determinant of long-term survival following heart transplantation. GCA consists of concentric intimal arterial lesions that are diffusely distributed within epicardial and intramural coronary arteries of engrafted hearts and may result in myocardial ischemia, infarction, and sudden death. The clinical diagnosis of GCA is often delayed until late progress of GCA because patients with denervated engrafted hearts do not experience anginal symptoms, and the diffuse and concentric nature of occlusive lesions may obscure the early angiographic findings. In addition, therapeutic interventions for GCA such as angioplasty and coronary bypass grafting are limited because of the diffuse nature of the process. Therapeutic options are, therefore, limited, and retransplantation is often the last choice. Recent reports have suggested GCA is a type of chronic vascular rejection. It remains controversial whether established GCA can be improved by modification in immunosuppressive therapy. Previously our study indicated that multiglycosidorum tripterygium (MT) has effective immunosuppressive effect and could prevent the development of GCA following transplantation. The purpose of this study was to examine whether the therapy of MT initiated after GCA was already established could halt or reverse the progress of GCA in a rat allograft model.