Oestrogen and transplant vascular disease

1. The aetiology of chronic rejection is clearly multifactorial and relates to both immunological and non-immunological factors. 2. Our studies suggest that the insulin-like growth factor (IGF)-I ligand a nd receptor genes are rate limiting in smooth muscle proliferation in the d evelopment of transplant arteriosclerosis. 3. Suppressing growth factor ligand or receptor expression could be effecti ve strategies for the prevention or treatment of transplant arteriosclerosi s. 4. We consistently find chronic oestradiol treatment of transplant recipien ts inhibits arteriosclerosis by attenuating both IGF-I expression and the i mmune response, particularly major histocompatibility complex class II expr ession. 5. Thus, a cell- or tissue-specific oestrogen with minimal feminizing prope rties may be an ideal drug for prevention of one of the major causes of los s of transplant function.