[Gene therapy for attenuating chronic rejection of cardiac allografts].

信 州大 学 第1内 科 ・4*第2外 科, 1*東 京 医科 歯 科 大 学循 環 器 内科, 2*大 阪大 学遺 伝 子 治療 学, 3*東 京 大 学心 臓外 科 滑筋細胞 とマクロファージを含み,時 に中膜を巻き込 んだ血管炎の所見が認められることから,炎 症が移植 後硬化の初期変化 として重要であることが示唆され る2~4).移植心の冠動脈病変においては血管平滑筋細 胞が増殖するが,そ の過程で細胞の形質が変換してい ることは重要である.こ の形質変換を表す血管ミオシ ン平滑筋重鎖: SM 1, SM 2, SMembが 報告されて いる. SM 1は 未分化型から分化型まで発現している が, SM 2は 分化型に, SMembは 未分化な形質に特 異的である.慢 性拒絶で内膜肥厚をきたした移植心冠 動脈では未分化な平滑筋細胞の形質 を示すSMemb の発現が観察された.こ れらの所見は平滑筋細胞が増 殖する際には分化型から未分化型への変換しているこ とを示している5).

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