Valvular heart disease continues to afflict millions of people around the world. In many cases, the only corrective treatment for valvular heart disease is valve replacement. Valve replacement options are currently limited, and the most common construct utilized are xenogenic tissue heart valves. The main limitation with the use of this valve type is the development of valvular deterioration. Valve deterioration results in intrinsic permanent changes in the valve structure, often leading to hemodynamic compromise and clinical symptoms of valve re‐stenosis. A significant amount of research has been performed regarding the incidence of valve deterioration and determination of significant risk factors for its development. As a result, many believe that the underlying driver of valve deterioration is a chronic immune‐mediated rejection process of the foreign xenogenic‐derived tissue. The underlying mechanisms of how this occurs are an area of ongoing research and active debate. In this review, we provide an overview of the important components of the immune system and how they respond to xenografts. A review of the proposed mechanisms of xenogenic heart valve deterioration is provided including the immune response to xenografts. Finally, we discuss the role of strategies to combat valve degeneration such as preservation protocols, epitope modification and decellularization.

中文翻译：

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异种组织心脏瓣膜刺激的免疫反应综述

瓣膜性心脏病继续困扰着全球数百万人。在许多情况下，瓣膜性心脏病的唯一矫正治疗是瓣膜置换术。瓣膜置换的选择目前受到限制，最常用的结构是异种组织心脏瓣膜。使用这种阀的主要限制是瓣膜变质的发展。瓣膜恶化会导致瓣膜结构固有的永久性变化，通常会导致血液动力学损害和瓣膜再狭窄的临床症状。关于瓣膜恶化的发生率和确定其发展的重要危险因素的研究已经进行了很多。因此，许多人认为，瓣膜恶化的潜在驱动因素是异种异源性组织的慢性免疫介导排斥过程。如何发生这种情况的潜在机制是一个正在进行的研究和积极辩论的领域。在本文中，我们概述了免疫系统的重要组成部分以及它们对异种移植物的反应。提供了对异种心脏瓣膜恶化的拟议机制的综述，包括对异种移植物的免疫反应。最后，我们讨论了对抗瓣膜变性的策略的作用，例如保存方案，表位修饰和脱细胞作用。我们提供了免疫系统重要组成部分及其对异种移植物反应的概述。提供了对异种心脏瓣膜恶化的拟议机制的综述，包括对异种移植物的免疫反应。最后，我们讨论了应对瓣膜变性的策略的作用，例如保存方案，表位修饰和脱细胞作用。我们提供了免疫系统重要组成部分及其对异种移植物反应的概述。提供了对异种心脏瓣膜恶化的拟议机制的综述，包括对异种移植物的免疫反应。最后，我们讨论了应对瓣膜变性的策略的作用，例如保存方案，表位修饰和脱细胞作用。