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Raval AJ, Parikh JK, Desai MA. A review on the treatment of intimal hyperplasia with perivascular medical devices: role of mechanical factors and drug release kinetics. Expert Rev Med Devices 2023; 20:805-819. [PMID: 37559556 DOI: 10.1080/17434440.2023.2244875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/02/2023] [Indexed: 08/11/2023]
Abstract
INTRODUCTION Intimal hyperplasia (IH) is a significant factor limiting the success of revascularization surgery for blood flow restoration. IH results from a foreign body response and mechanical disparity that involves complex biochemical reactions resulting in graft failure. The available treatment option utilizes either different pharmacological interventions or mechanical support to the vascular grafts with limited success. AREAS COVERED This review explains the pathophysiology of IH, responsible mechanical and biological factors, and treatment options, emphasizing perivascular devices. They are designed to provide mechanical support and pharmacology actions. The perivascular drug delivery concept has successfully demonstrated efficacy in various animal studies. Accurate projections of drug release mechanisms using mathematical modeling could be used to formulate prolonged drug elution devices. Numerical modeling aspects for the prediction of design outcomes have been given due importance that fulfills the unmet clinical need for better patient care. EXPERT OPINION IH could be effectively prevented by simultaneous mechanical scaffolding and sustained local drug delivery. Future perivascular medical devices could be designed to integrate these essential features. Numerical modeling for device performance prediction should be utilized in the development of next-generation perivascular devices.
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Affiliation(s)
- Ankur J Raval
- Department of Chemical Engineering, Sardar Vallabhbhai National of Technology, Surat, Gujarat, India
- Research and Development Department, Sahajanand Medical Technologies Ltd, Surat, Gujarat, India
| | - Jigisha K Parikh
- Department of Chemical Engineering, Sardar Vallabhbhai National of Technology, Surat, Gujarat, India
| | - Meghal A Desai
- Department of Chemical Engineering, Sardar Vallabhbhai National of Technology, Surat, Gujarat, India
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2
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Cao X, Chen G. Advances in microneedles for non-transdermal applications. Expert Opin Drug Deliv 2022; 19:1081-1097. [DOI: 10.1080/17425247.2022.2118711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Xiaona Cao
- Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
- Rosalind & Morris Goodman Cancer Institute, McGill University, Montreal, Quebec, Canada
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Guojun Chen
- Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
- Rosalind & Morris Goodman Cancer Institute, McGill University, Montreal, Quebec, Canada
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3
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Lin EMJ, Lay CL, Subramanian GS, Tan WS, Leong SSJ, Moh LCH, Lim K. Control Release Coating for Urinary Catheters with Enhanced Released Profile for Sustained Antimicrobial Protection. ACS APPLIED MATERIALS & INTERFACES 2021; 13:59263-59274. [PMID: 34846837 DOI: 10.1021/acsami.1c17697] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Catheter-associated urinary tract infections (CAUTIs) are common and pose significant costs to healthcare systems. To date, this problem is largely unsolved as commercially available antimicrobial catheters are still lacking in functionality and performance. A prior study by Lim et al. ( Biotechnol. Bioeng. 2018, 115 (8), 2000-2012) reported the development of a novel anhydrous polycaprolactone (PCL) polymer formulation with controlled-release functionality for antimicrobial peptides. In this follow-up study, we developed an improved antimicrobial peptide (AMP)-impregnated poly(ethylene glycol) (PEG)-polycaprolactone (PCL) anhydrous polymer coating for enhanced sustained controlled-release functionality to provide catheters with effective antimicrobial properties. Varying the ratio of PEG and PEG-PCL copolymers resulted in polymers with different morphologies, consequently affecting the AMP release profiles. The optimal coating, formulated with 10% (w/w) PEG-PCL in PCL, achieved a controlled AMP release rate of 31.65 ± 6.85 μg/mL daily for up to 19 days, with a moderate initial burst release. Such profile is desired for antimicrobial coating as the initial burst release acts as a sterilizer to kill the bacteria present in the urinary tract upon insertion, and the subsequent linear release functions as a prophylaxis to deter opportunistic microbial infections. As a proof-of-concept application, our optimized coating was then applied to a commercial silicone catheter for further antibacterial tests. Preliminary results revealed that our coated catheters outperformed commercial silver-based antimicrobial catheters in terms of antimicrobial performance and sustainability, lasting for 4 days. Application of the controlled-release coating also aids in retarding biofilm formation, showing a lower extent of biofilm formation at the end of seven inoculation cycles.
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Affiliation(s)
- Esther Marie JieRong Lin
- Institute of Materials Research and Engineering, Agency for Science, Technology and Research, 2 Fusionopolis Way, 138634 Singapore
| | - Chee Leng Lay
- Institute of Materials Research and Engineering, Agency for Science, Technology and Research, 2 Fusionopolis Way, 138634 Singapore
| | - Gomathy Sandhya Subramanian
- Institute of Materials Research and Engineering, Agency for Science, Technology and Research, 2 Fusionopolis Way, 138634 Singapore
- Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, 31 Biopolis Way, #01-02 Nanos, 138669 Singapore
| | - Wui Siew Tan
- Dornier Medtech Asia Pte Ltd., 2 Venture Drive, Vision Exchange, 608526 Singapore
| | | | - Lionel Chuan Hui Moh
- Institute of Materials Research and Engineering, Agency for Science, Technology and Research, 2 Fusionopolis Way, 138634 Singapore
| | - Kaiyang Lim
- ES-TA Technology Pte Ltd., 21 Jalan Mesin, 368819 Singapore
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4
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Zhou R, Yu J, Gu Z, Zhang Y. Microneedle-mediated therapy for cardiovascular diseases. Drug Deliv Transl Res 2021; 12:472-483. [PMID: 34637115 DOI: 10.1007/s13346-021-01073-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
Cardiovascular diseases remain a leading cause of global disease burden. To date, the limited drug delivery efficacy confines the therapeutic effect in most conventional approaches, such as intramyocardial injections and vascular devices, due to short-term drug release and low retention within the disease sites. As a typical transdermal medical device with a minimally invasive manner and controlled/sustained drug release pattern, microneedles have gained momentum in the field of cardiovascular therapy, from which several cardiovascular diseases have been benefited to the ultimate therapeutic effects. In this concise review, strategies based on the microneedles for the treatments of cardiovascular diseases are introduced, mainly focus on hypertension, atherosclerosis, thrombus, and myocardial diseases. The limitations at the present stage and perspectives of the next-generation microneedles for cardiovascular therapy are also discussed.
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Affiliation(s)
- Ruyi Zhou
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Jicheng Yu
- Zenomics Inc., Los Angeles, CA, 90095, USA
| | - Zhen Gu
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China. .,Department of General Surgery, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, 310016, China. .,Zhejiang Laboratory of Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou, 311121, China. .,MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China.
| | - Yuqi Zhang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China. .,Department of Burns and Wound Center, College of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
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5
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Okeyo PO, Rajendran ST, Zór K, Boisen A. Sensing technologies and experimental platforms for the characterization of advanced oral drug delivery systems. Adv Drug Deliv Rev 2021; 176:113850. [PMID: 34182015 DOI: 10.1016/j.addr.2021.113850] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 12/18/2022]
Abstract
Complex and miniaturized oral drug delivery systems are being developed rapidly for targeted, controlled drug release and improved bioavailability. Standard analytical techniques are widely used to characterize i) drug carrier and active pharmaceutical ingredients before loading into a delivery device (to ensure the solid form), and ii) the entire drug delivery system during the development process. However, in light of the complexity and the size of some of these systems, standard techniques as well as novel sensing technologies and experimental platforms need to be used in tandem. These technologies and platforms are discussed in this review, with a special focus on passive delivery systems in size range from a few 100 µm to a few mm. Challenges associated with characterizing these systems and evaluating their effect on oral drug delivery in the preclinical phase are also discussed.
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6
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Yang Q, Lei D, Huang S, Yang Y, Jiang C, Shi H, Chen W, Zhao Q, You Z, Ye X. A novel biodegradable external stent regulates vein graft remodeling via the Hippo-YAP and mTOR signaling pathways. Biomaterials 2020; 258:120254. [PMID: 32805499 DOI: 10.1016/j.biomaterials.2020.120254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/15/2020] [Accepted: 07/20/2020] [Indexed: 01/10/2023]
Abstract
Coronary artery bypass graft (CABG) has been confirmed to effectively improve the prognosis of coronary artery disease, which is a major public health concern worldwide. As the most frequently used conduits in CABG, saphenous vein grafts have the disadvantage of being susceptible to restenosis due to intimal hyperplasia. To meet the urgent clinical demand, adopting external stents (eStents) and illuminating the potential mechanisms underlying their function are important for preventing vein graft failure. Here, using 4-axis printing technology, we fabricated a novel biodegradable and flexible braided eStent, which exerts excellent inhibitory effect on intimal hyperplasia. The stented grafts downregulate Yes-associated protein (YAP), indicating that the eStent regulates vein graft remodeling via the Hippo-YAP signaling pathway. Further, as a drug-delivery vehicle, a rapamycin (RM)-coated eStent was designed to amplify the inhibitory effect of eStent on intimal hyperplasia through the synergistic effects of the Hippo and mammalian target of rapamycin (mTOR) signaling pathways. Overall, this study uncovers the underlying mechanisms of eStent function and identifies a new therapeutic target for the prevention of vein graft restenosis.
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Affiliation(s)
- Qi Yang
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Dong Lei
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Belt and Road Joint Laboratory of Advanced Fiber and Low-dimension Materials (Donghua University), College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China
| | - Shixing Huang
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Yang Yang
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China
| | - Chenyu Jiang
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Hongpeng Shi
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Wenyi Chen
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Belt and Road Joint Laboratory of Advanced Fiber and Low-dimension Materials (Donghua University), College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China
| | - Qiang Zhao
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
| | - Zhengwei You
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Belt and Road Joint Laboratory of Advanced Fiber and Low-dimension Materials (Donghua University), College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China.
| | - Xiaofeng Ye
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
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7
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Myostatin Inhibits Vascular Smooth Muscle Cell Proliferation and Local 14q32 microRNA Expression, But Not Systemic Inflammation or Restenosis. Int J Mol Sci 2020; 21:ijms21103508. [PMID: 32429150 PMCID: PMC7278907 DOI: 10.3390/ijms21103508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 01/08/2023] Open
Abstract
Myostatin is a negative regulator of muscle cell growth and proliferation. Furthermore, myostatin directly affects the expression of 14q32 microRNAs by binding the 14q32 locus. Direct inhibition of 14q32 microRNA miR-495-3p decreased postinterventional restenosis via inhibition of both vascular smooth muscle cell (VSMC) proliferation and local inflammation. Here, we aimed to investigate the effects of myostatin in a mouse model for postinterventional restenosis. In VSMCs in vitro, myostatin led to the dose-specific downregulation of 14q32 microRNAs miR-433-3p, miR-494-3p, and miR-495-3p. VSMC proliferation was inhibited, where cell migration and viability remained unaffected. In a murine postinterventional restenosis model, myostatin infusion did not decrease restenosis, neointimal area, or lumen stenosis. Myostatin inhibited expression of both proliferation marker PCNA and of 14q32 microRNAs miR-433-3p, miR-494-3p, and miR-495-3p dose-specifically in cuffed femoral arteries. However, 14q32 microRNA expression remained unaffected in macrophages and macrophage activation as well as macrophage influx into lesions were not decreased. In conclusion, myostatin did not affect postinterventional restenosis. Although myostatin inhibits 14q32 microRNA expression and proliferation in VSMCs, myostatin had no effect on macrophage activation and infiltration. Our findings underline that restenosis is driven by both VSMC proliferation and local inflammation. Targeting only one of these components is insufficient to prevent restenosis.
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Santos-Coquillat A, Martínez-Campos E, Vargas-Alfredo N, Arrabal R, Rodríguez-Hernández J, Matykina E. Hierarchical Functionalized Polymeric-Ceramic Coatings on Mg-Ca Alloys for Biodegradable Implant Applications. Macromol Biosci 2019; 19:e1900179. [PMID: 31490621 DOI: 10.1002/mabi.201900179] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/09/2019] [Indexed: 11/12/2022]
Abstract
Magnesium-based implants present several advantages for clinical applications, in particular due to their biocompatibility and degradability. However, degradation products can affect negatively the cell activity. In this work, a combined coating strategy to control the implant degradation and cell regulation processes is evaluated, including plasma electrolytic oxidation (PEO) that produces a 13 µm-thick Ca, P, and Si containing ceramic coating with surface porosity, and breath figures (BF) approach that produces a porous polymeric poly(ε-caprolactone) surface. The degradation of PCL-PEO-coated Mg hierarchical scaffold can be tailored to promote cell adhesion and proliferation into the porous structure. As a result, cell culture can colonize the inner PEO-ceramic coating structure where higher amount of bioelements are present. The Mg/PEO/PCL/BF scaffolds exhibit equally good or better premyoblast cell adhesion and proliferation compared with Ti CP control. The biological behavior of this new hierarchical functionalized scaffold can improve the implantation success in bone and cardiovascular clinical applications.
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Affiliation(s)
- Ana Santos-Coquillat
- Departamento de Ingenieria Química y de Materiales, Facultad de Ciencias Químicas, Universidad Complutense, 28040, Madrid, Spain.,Tissue Engineering Group, Institute of Biofunctional Studies (IEB-UCM), Associated Unit to the Institute of Polymer Science and Technology (CSIC), Polymer Functionalization Group, 28040, Madrid, Spain
| | - Enrique Martínez-Campos
- Tissue Engineering Group, Institute of Biofunctional Studies (IEB-UCM), Associated Unit to the Institute of Polymer Science and Technology (CSIC), Polymer Functionalization Group, 28040, Madrid, Spain.,Institute of Polymer Science and Technology (CSIC), Polymer Functionalization Group, 28040, Madrid, Spain
| | - Nelson Vargas-Alfredo
- Institute of Polymer Science and Technology (CSIC), Polymer Functionalization Group, 28040, Madrid, Spain
| | - Raúl Arrabal
- Departamento de Ingenieria Química y de Materiales, Facultad de Ciencias Químicas, Universidad Complutense, 28040, Madrid, Spain
| | - Juan Rodríguez-Hernández
- Institute of Polymer Science and Technology (CSIC), Polymer Functionalization Group, 28040, Madrid, Spain
| | - Endzhe Matykina
- Departamento de Ingenieria Química y de Materiales, Facultad de Ciencias Químicas, Universidad Complutense, 28040, Madrid, Spain
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9
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Li Z, Jiang Z, Zhao L, Yang X, Zhang J, Song X, Liu B, Ding J. PEGylated stereocomplex polylactide coating of stent for upregulated biocompatibility and drug storage. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 81:443-451. [PMID: 28887996 DOI: 10.1016/j.msec.2017.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/24/2017] [Accepted: 08/02/2017] [Indexed: 02/05/2023]
Abstract
Treatment of coronary heart disease by percutaneous coronary intervention (PCT) is usually limited to the high restenosis rate after implantation of bare-metal stent. To solve the problem, the coating of PEGylated stereocomplex poly(l-lactide) (PEG-cPLA) was utilized on the surface modification of stainless steel (SS) sheet. Specifically, the 3-aminopropyltriethoxysilane (APTES)-modified methoxy-poly(ethylene glycol)-poly(d-lactide) (mPEG-PDLA) was grafted onto the surface of hydroxylated SS sheet through coupling reaction, and poly(l-lactide)-poly(ethylene glycol)-poly(l-lactide) (PLLA-PEG-PLLA) was coated onto the surface through stereocomplex interaction between DLA and LLA units. The increase of contact angle firstly confirmed the changes of surface composition and hydrophilicity for the PEG-scPLA-modified SS sheet. The decreased fibrinogen adsorption, down-regulated platelet activation, and improved adhesion of human umbilical vein endothelial cells (HUVECs) indicated the excellent biocompatibility of PEG-scPLA-modified SS sheet. In addition, the drug loading capability of SS sheet was greatly upregulated through the formation of scPLA coating on the surface, where fluorescein (FLU) was chosen as a model molecule. Overall, the surface modification of SS sheet with PEG-scPLA could enhance the comprehensive performances, such as biocompatibility and drug loading capability, demonstrating that PEG-scPLA is a promising coating of coronary stent for PCT.
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Affiliation(s)
- Zhibo Li
- Department of Cardiology, The Second Hospital of Jilin University, Changchun 130041, PR China
| | - Zhongyu Jiang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, PR China
| | - Lei Zhao
- Department of Cardiology, The Second Hospital of Jilin University, Changchun 130041, PR China
| | - Xianrui Yang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
| | - Jin Zhang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, PR China; College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, PR China
| | - Xianjing Song
- Department of Cardiology, The Second Hospital of Jilin University, Changchun 130041, PR China
| | - Bin Liu
- Department of Cardiology, The Second Hospital of Jilin University, Changchun 130041, PR China.
| | - Jianxun Ding
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, PR China
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10
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Chen G, Shi X, Wang B, Xie R, Guo LW, Gong S, Kent KC. Unimolecular Micelle-Based Hybrid System for Perivascular Drug Delivery Produces Long-Term Efficacy for Neointima Attenuation in Rats. Biomacromolecules 2017; 18:2205-2213. [PMID: 28613846 DOI: 10.1021/acs.biomac.7b00617] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
At present, there are no clinical options for preventing neointima-caused (re)stenosis after open surgery such as bypass surgery for treating flow-limiting vascular disease. Perivascular drug delivery is a promising strategy, but in translational research, it remains a major challenge to achieve long-term (e.g., > 3 months) anti(re)stenotic efficacy. In this study, we engineered a unique drug delivery system consisting of durable unimolecular micelles, formed by single multiarm star amphiphilic block copolymers with only covalent bonds, and a thermosensitive hydrogel formed by a poly(lactide-co-glycolide)-poly(ethylene glycol)-poly(lactide-co-glycolide) triblock copolymer (abbreviated as triblock gel) that is stable for about 4 weeks in vitro. The drug-containing unimolecular micelles (UMs) suspended in Triblock gel were able to sustain rapamycin release for over 4 months. Remarkably, even 3 months after perivascular application of the rapamycin-loaded micelles in Triblock gel in the rat model, the intimal/medial area ratio (a restenosis measure) was still 80% inhibited compared to the control treated with empty micelle/gel (no drug). This could not be achieved by applying rapamycin in Triblock gel alone, which reduced the intimal/medial ratio only by 27%. In summary, we created a new UM/Triblock gel hybrid system for perivascular drug delivery, which produced a rare feat of 3-month restenosis inhibition in animal tests. This system exhibits a real potential for further translation into an anti(re)stenotic application with open surgery.
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Affiliation(s)
- Guojun Chen
- Department of Materials Science and Engineering, and Wisconsin Institute for Discovery and ‡Department of Biomedical Engineering and Department of Chemistry, University of Wisconsin-Madison , Madison, Wisconsin 53715, United States.,Department of Surgery, 5151 Wisconsin Institutes for Medical Research and ⊥McPherson Eye Research Institute, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States.,Department of Surgery, Department of Physiology & Cell Biology, Davis Heart and Lung Research Institute and #Department of Surgery, College of Medicine, The Ohio State University , Columbus, Ohio 43210, United States
| | - Xudong Shi
- Department of Materials Science and Engineering, and Wisconsin Institute for Discovery and ‡Department of Biomedical Engineering and Department of Chemistry, University of Wisconsin-Madison , Madison, Wisconsin 53715, United States.,Department of Surgery, 5151 Wisconsin Institutes for Medical Research and ⊥McPherson Eye Research Institute, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States.,Department of Surgery, Department of Physiology & Cell Biology, Davis Heart and Lung Research Institute and #Department of Surgery, College of Medicine, The Ohio State University , Columbus, Ohio 43210, United States
| | - Bowen Wang
- Department of Materials Science and Engineering, and Wisconsin Institute for Discovery and ‡Department of Biomedical Engineering and Department of Chemistry, University of Wisconsin-Madison , Madison, Wisconsin 53715, United States.,Department of Surgery, 5151 Wisconsin Institutes for Medical Research and ⊥McPherson Eye Research Institute, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States.,Department of Surgery, Department of Physiology & Cell Biology, Davis Heart and Lung Research Institute and #Department of Surgery, College of Medicine, The Ohio State University , Columbus, Ohio 43210, United States
| | - Ruosen Xie
- Department of Materials Science and Engineering, and Wisconsin Institute for Discovery and ‡Department of Biomedical Engineering and Department of Chemistry, University of Wisconsin-Madison , Madison, Wisconsin 53715, United States.,Department of Surgery, 5151 Wisconsin Institutes for Medical Research and ⊥McPherson Eye Research Institute, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States.,Department of Surgery, Department of Physiology & Cell Biology, Davis Heart and Lung Research Institute and #Department of Surgery, College of Medicine, The Ohio State University , Columbus, Ohio 43210, United States
| | - Lian-Wang Guo
- Department of Materials Science and Engineering, and Wisconsin Institute for Discovery and ‡Department of Biomedical Engineering and Department of Chemistry, University of Wisconsin-Madison , Madison, Wisconsin 53715, United States.,Department of Surgery, 5151 Wisconsin Institutes for Medical Research and ⊥McPherson Eye Research Institute, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States.,Department of Surgery, Department of Physiology & Cell Biology, Davis Heart and Lung Research Institute and #Department of Surgery, College of Medicine, The Ohio State University , Columbus, Ohio 43210, United States
| | - Shaoqin Gong
- Department of Materials Science and Engineering, and Wisconsin Institute for Discovery and ‡Department of Biomedical Engineering and Department of Chemistry, University of Wisconsin-Madison , Madison, Wisconsin 53715, United States.,Department of Surgery, 5151 Wisconsin Institutes for Medical Research and ⊥McPherson Eye Research Institute, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States.,Department of Surgery, Department of Physiology & Cell Biology, Davis Heart and Lung Research Institute and #Department of Surgery, College of Medicine, The Ohio State University , Columbus, Ohio 43210, United States
| | - K Craig Kent
- Department of Materials Science and Engineering, and Wisconsin Institute for Discovery and ‡Department of Biomedical Engineering and Department of Chemistry, University of Wisconsin-Madison , Madison, Wisconsin 53715, United States.,Department of Surgery, 5151 Wisconsin Institutes for Medical Research and ⊥McPherson Eye Research Institute, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States.,Department of Surgery, Department of Physiology & Cell Biology, Davis Heart and Lung Research Institute and #Department of Surgery, College of Medicine, The Ohio State University , Columbus, Ohio 43210, United States
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11
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Turaihi AH, van Poelgeest EM, van Hinsbergh VWM, Serné EH, Smulders YM, Eringa EC. Combined Intravital Microscopy and Contrast-enhanced Ultrasonography of the Mouse Hindlimb to Study Insulin-induced Vasodilation and Muscle Perfusion. J Vis Exp 2017. [PMID: 28362362 PMCID: PMC5407697 DOI: 10.3791/54912] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
It has been demonstrated that insulin's vascular actions contribute to regulation of insulin sensitivity. Insulin's effects on muscle perfusion regulate postprandial delivery of nutrients and hormones to insulin-sensitive tissues. We here describe a technique for combining intravital microscopy (IVM) and contrast-enhanced ultrasonography (CEUS) of the adductor compartment of the mouse hindlimb to simultaneously visualize muscle resistance arteries and perfusion of the microcirculation in vivo. Simultaneously assessing insulin's effect at multiple levels of the vascular tree is important to study relationships between insulin's multiple vasoactive effects and muscle perfusion. Experiments in this study were performed in mice. First, the tail vein cannula is inserted for the infusion of anesthesia, vasoactive compounds and ultrasound contrast agent (lipid-encapsulated microbubbles). Second, a small incision is made in the groin area to expose the arterial tree of the adductor muscle compartment. The ultrasound probe is then positioned at the contralateral upper hindlimb to view the muscles in cross-section. To assess baseline parameters, the arterial diameter is assessed and microbubbles are subsequently infused at a constant rate to estimate muscle blood flow and microvascular blood volume (MBV). When applied before and during a hyperinsulinemic-euglycemic clamp, combined IVM and CEUS allow assessment of insulin-induced changes of arterial diameter, microvascular muscle perfusion and whole-body insulin sensitivity. Moreover, the temporal relationship between responses of the microcirculation and the resistance arteries to insulin can be quantified. It is also possible to follow-up the mice longitudinally in time, making it a valuable tool to study changes in vascular and whole-body insulin sensitivity.
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Affiliation(s)
- Alexander H Turaihi
- Laboratory for Physiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center;
| | - Erik M van Poelgeest
- Laboratory for Physiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center
| | - Victor W M van Hinsbergh
- Laboratory for Physiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center
| | - Erik H Serné
- Department of Internal Medicine, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center
| | - Yvo M Smulders
- Department of Internal Medicine, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center
| | - Etto C Eringa
- Laboratory for Physiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center
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12
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Lee CH, Hsieh MJ, Chang SH, Chiang CL, Fan CL, Liu SJ, Chen WJ, Wang CJ, Hsu MY, Hung KC, Chou CC, Chang PC. Biodegradable Cable-Tie Rapamycin-eluting Stents. Sci Rep 2017; 7:111. [PMID: 28273914 PMCID: PMC5427919 DOI: 10.1038/s41598-017-00131-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 02/08/2017] [Indexed: 12/03/2022] Open
Abstract
"Cable-tie" type biodegradable stents with drug-eluting nanofiber were developed to treat rabbit denuded arteries in this study. Biodegradable stents were fabricated using poly-L-lactide film following being cut and rolled into a cable-tie type stent. Additionally, drug-eluting biodegradable nanofiber tubes were electrospun from a solution containing poly (lactic-co-glycolic acid), rapamycin, and hexafluoroisopropanol, and then mounted onto the stents. The fabricated rapamycin-eluting cable-tie stents exhibited excellent mechanical properties on evaluation of compression test and collapse pressure, and less than 8% weight loss following being immersed in phosphate-buffered saline for 16 weeks. Furthermore, the biodegradable stents delivered high rapamycin concentrations for over 4 weeks and achieved substantial reductions in intimal hyperplasia associated with elevated heme oxygenase-1 and calponin level on the denuded rabbit arteries during 6 months of follow-up. The drug-eluting cable-tie type stents developed in this study might have high potential impacts for the local drug delivery to treat various vascular diseases.
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Affiliation(s)
- Cheng-Hung Lee
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Ming-Jer Hsieh
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Shang-Hung Chang
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Chang-Lin Chiang
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Lung Fan
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Jung Liu
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan.
| | - Wei-Jan Chen
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Chao-Jan Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Ming-Yi Hsu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Kuo-Chun Hung
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Chung-Chuan Chou
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Po-Cheng Chang
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taipei, Taiwan
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13
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Mylonaki I, Allémann É, Saucy F, Haefliger JA, Delie F, Jordan O. Perivascular medical devices and drug delivery systems: Making the right choices. Biomaterials 2017; 128:56-68. [PMID: 28288349 DOI: 10.1016/j.biomaterials.2017.02.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/13/2017] [Accepted: 02/26/2017] [Indexed: 12/31/2022]
Abstract
Perivascular medical devices and perivascular drug delivery systems are conceived for local application around a blood vessel during open vascular surgery. These systems provide mechanical support and/or pharmacological activity for the prevention of intimal hyperplasia following vessel injury. Despite abundant reports in the literature and numerous clinical trials, no efficient perivascular treatment is available. In this review, the existing perivascular medical devices and perivascular drug delivery systems, such as polymeric gels, meshes, sheaths, wraps, matrices, and metal meshes, are jointly evaluated. The key criteria for the design of an ideal perivascular system are identified. Perivascular treatments should have mechanical specifications that ensure system localization, prolonged retention and adequate vascular constriction. From the data gathered, it appears that a drug is necessary to increase the efficacy of these systems. As such, the release kinetics of pharmacological agents should match the development of the pathology. A successful perivascular system must combine these optimized pharmacological and mechanical properties to be efficient.
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Affiliation(s)
- Ioanna Mylonaki
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - Éric Allémann
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - François Saucy
- Department of Vascular Surgery, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland
| | - Jacques-Antoine Haefliger
- Department of Vascular Surgery, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland
| | - Florence Delie
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - Olivier Jordan
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland.
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14
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Lance KD, Chatterjee A, Wu B, Mottola G, Nuhn H, Lee PP, Sansbury BE, Spite M, Desai TA, Conte MS. Unidirectional and sustained delivery of the proresolving lipid mediator resolvin D1 from a biodegradable thin film device. J Biomed Mater Res A 2016; 105:31-41. [PMID: 27508346 DOI: 10.1002/jbm.a.35861] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/24/2016] [Accepted: 08/08/2016] [Indexed: 12/20/2022]
Abstract
Resolvin D1 (RvD1) belongs to a family of endogenously derived proresolving lipid mediators that have been shown to attenuate inflammation, activate proresolution signaling, and promote homeostasis and recovery from tissue injury. In this study we present a poly(lactic-co-glycolic acid) (PLGA) based thin-film device composed of layers of varying ratios of lactic and glycolic acid that elutes RvD1 unidirectionally to target tissues. The device demonstrated sustained release in vitro for 56 days with an initial burst of release over 14 days. The asymmetric design of the device released 98% of RvD1 through the layer with the lowest molar ratio of lactic acid to glycolic acid, and the remainder through the opposite side. We validated structural integrity of RvD1 released from the device by mass spectrometry and investigated its bioactivity on human vascular endothelial (EC) and smooth muscle cells (VSMC). RvD1 released from the device attenuated VSMC migration, proliferation, and TNF-α induced NF-κB activation, without evidence of cytotoxicity. Delivery of RvD1 to blood vessels was demonstrated ex vivo in a flow chamber system using perfused rabbit aortas and in vivo in a rat carotid artery model, with the devices applied as an adventitial wrap. Our results demonstrate a novel approach for sustained, local delivery of Resolvin D1 to vascular tissue at therapeutically relevant levels. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 31-41, 2017.
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Affiliation(s)
- Kevin D Lance
- UC Berkeley-UCSF Graduate Group in Bioengineering, San Francisco, California, 94158.,Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, 94158
| | - Anuran Chatterjee
- Cardiovascular Research Institute (CVRI) and Department of Surgery, University of California San Francisco, San Francisco, California, 94143
| | - Bian Wu
- Cardiovascular Research Institute (CVRI) and Department of Surgery, University of California San Francisco, San Francisco, California, 94143
| | - Giorgio Mottola
- Cardiovascular Research Institute (CVRI) and Department of Surgery, University of California San Francisco, San Francisco, California, 94143
| | - Harald Nuhn
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, 94158
| | - Phin Peng Lee
- UC Berkeley-UCSF Graduate Group in Bioengineering, San Francisco, California, 94158
| | - Brian E Sansbury
- Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard Institutes of Medicine HIM 830, Boston, Massachusetts, 02115
| | - Matthew Spite
- Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard Institutes of Medicine HIM 830, Boston, Massachusetts, 02115
| | - Tejal A Desai
- UC Berkeley-UCSF Graduate Group in Bioengineering, San Francisco, California, 94158.,Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, 94158
| | - Michael S Conte
- Cardiovascular Research Institute (CVRI) and Department of Surgery, University of California San Francisco, San Francisco, California, 94143
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15
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Periadventitial drug delivery for the prevention of intimal hyperplasia following open surgery. J Control Release 2016; 233:174-80. [PMID: 27179635 DOI: 10.1016/j.jconrel.2016.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/02/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Intimal hyperplasia (IH) remains a major cause of poor patient outcomes after surgical revascularization to treat atherosclerosis. A multitude of drugs have been shown to prevent the development of IH. Moreover, endovascular drug delivery following angioplasty and stenting has been achieved with a marked diminution in the incidence of restenosis. Despite advances in endovascular drug delivery, there is currently no clinically available method of periadventitial drug delivery suitable for open vascular reconstructions. Herein we provide an overview of the recent literature regarding innovative polymer platforms for periadventitial drug delivery in preclinical models of IH as well as insights about barriers to clinical translation. METHODS A comprehensive PubMed search confined to the past 15years was performed for studies of periadventitial drug delivery. Additional searches were performed for relevant clinical trials, patents, meeting abstracts, and awards of NIH funding. RESULTS Most of the research involving direct periadventitial delivery without a drug carrier was published prior to 2000. Over the past 15years there have been a surge of reports utilizing periadventitial drug-releasing polymer platforms, most commonly bioresorbable hydrogels and wraps. These methods proved to be effective for the inhibition of IH in various animal models (e.g. balloon angioplasty, wire injury, and vein graft), but very few have advanced to clinical trials. There are a number of barriers that may account for this lack of translation. Promising new approaches including the use of nanoparticles will be described. CONCLUSIONS No periadventitial drug delivery system has reached clinical application. For periadventitial delivery, polymer hydrogels, wraps, and nanoparticles exhibit overlapping and complementary properties. The ideal periadventitial delivery platform would allow for sustained drug release yet exert minimal mechanical and inflammatory stresses to the vessel wall. A clinically applicable strategy for periadventitial drug delivery would benefit thousands of patients undergoing open vascular reconstruction each year.
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16
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Lee KJ, Park SH, Lee JY, Joo HC, Jang EH, Youn YN, Ryu W. Perivascular biodegradable microneedle cuff for reduction of neointima formation after vascular injury. J Control Release 2014; 192:174-81. [PMID: 25025286 DOI: 10.1016/j.jconrel.2014.07.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 06/30/2014] [Accepted: 07/06/2014] [Indexed: 11/28/2022]
Abstract
Restenosis often occurs at the site of vascular grafting and may become fatal for patients. Restenosis at anastomosis sites is due to neointimal hyperplasia (NH) and difficult to treat with conventional treatments. Such abnormal growth of smooth muscle cells in tunica media of vascular tissue can be reduced by delivering anti-proliferation drugs such as paclitaxel (PTX) to the inner vascular layer. Drug eluting stents (DES) or drug eluting balloon (DEB) have been developed to treat such vascular diseases. However, they are less efficient in drug delivery due to the drug loss to blood stream and inadequate to be applied to re-stenotic area in the presence of stent or anastomosis sites. Recently, we have introduced microneedle cuff (MNC) as perivascular delivery devices to achieve high delivery efficiency to tunica media. In this study, we investigated in vivo microneedle insertion and efficacy in treating NH using a rabbit balloon injury model. Microneedle shape was optimized for reliable insertion into tunica media layer. Uniform distribution of PTX in tunica media delivered by MNC devices was also confirmed. Animal study demonstrated significant NH reduction by MNC treatments and much higher delivery efficiency than flat type devices.
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Affiliation(s)
- Kang Ju Lee
- School of Mechanical Engineering, Yonsei University, Seoul 120-749, Republic of Korea
| | - Seung Hyun Park
- School of Mechanical Engineering, Yonsei University, Seoul 120-749, Republic of Korea
| | - Ji Yong Lee
- School of Mechanical Engineering, Yonsei University, Seoul 120-749, Republic of Korea
| | - Hyun Chel Joo
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea
| | - Eui Hwa Jang
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea
| | - Young-Nam Youn
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.
| | - WonHyoung Ryu
- School of Mechanical Engineering, Yonsei University, Seoul 120-749, Republic of Korea.
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17
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New strategies for developing cardiovascular stent surfaces with novel functions (Review). Biointerphases 2014; 9:029017. [DOI: 10.1116/1.4878719] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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18
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Yu X, Takayama T, Goel SA, Shi X, Zhou Y, Kent KC, Murphy WL, Guo LW. A rapamycin-releasing perivascular polymeric sheath produces highly effective inhibition of intimal hyperplasia. J Control Release 2014; 191:47-53. [PMID: 24852098 DOI: 10.1016/j.jconrel.2014.05.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/30/2014] [Accepted: 05/08/2014] [Indexed: 01/02/2023]
Abstract
Intimal hyperplasia produces restenosis (re-narrowing) of the vessel lumen following vascular intervention. Drugs that inhibit intimal hyperplasia have been developed, however there is currently no clinical method of perivascular drug-delivery to prevent restenosis following open surgical procedures. Here we report a poly(ε-caprolactone) (PCL) sheath that is highly effective in preventing intimal hyperplasia through perivascular delivery of rapamycin. We first screened a series of bioresorbable polymers, i.e., poly(lactide-co-glycolide) (PLGA), poly(lactic acid) (PLLA), PCL, and their blends, to identify desired release kinetics and sheath physical properties. Both PLGA and PLLA sheaths produced minimal (<30%) rapamycin release within 50days in PBS buffer. In contrast, PCL sheaths exhibited more rapid and near-linear release kinetics, as well as durable integrity (>90days) as evidenced in both scanning electron microscopy and subcutaneous embedding experiments. Moreover, a PCL sheath deployed around balloon-injured rat carotid arteries was associated with a minimum rate of thrombosis compared to PLGA and PLLA. Morphometric analysis and immunohistochemistry revealed that rapamycin-loaded perivascular PCL sheaths produced pronounced (85%) inhibition of intimal hyperplasia (0.15±0.05 vs 1.01±0.16), without impairment of the luminal endothelium, the vessel's anti-thrombotic layer. Our data collectively show that a rapamycin-loaded PCL delivery system produces substantial mitigation of neointima, likely due to its favorable physical properties leading to a stable yet flexible perivascular sheath and steady and prolonged release kinetics. Thus, a PCL sheath may provide useful scaffolding for devising effective perivascular drug delivery particularly suited for preventing restenosis following open vascular surgery.
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Affiliation(s)
- Xiaohua Yu
- Department of Biomedical Engineering, University of Wisconsin, 5009 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
| | - Toshio Takayama
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA
| | - Shakti A Goel
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA
| | - Xudong Shi
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA
| | - Yifan Zhou
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA
| | - K Craig Kent
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA; Department of Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - William L Murphy
- Department of Biomedical Engineering, University of Wisconsin, 5009 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA.
| | - Lian-Wang Guo
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA.
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19
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Shi X, Chen G, Guo LW, Si Y, Zhu M, Pilla S, Liu B, Gong S, Kent KC. Periadventitial application of rapamycin-loaded nanoparticles produces sustained inhibition of vascular restenosis. PLoS One 2014; 9:e89227. [PMID: 24586612 PMCID: PMC3931710 DOI: 10.1371/journal.pone.0089227] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/16/2014] [Indexed: 01/20/2023] Open
Abstract
Open vascular reconstructions frequently fail due to the development of recurrent disease or intimal hyperplasia (IH). This paper reports a novel drug delivery method using a rapamycin-loaded poly(lactide-co-glycolide) (PLGA) nanoparticles (NPs)/pluronic gel system that can be applied periadventitially around the carotid artery immediately following the open surgery. In vitro studies revealed that rapamycin dispersed in pluronic gel was rapidly released over 3 days whereas release of rapamycin from rapamycin-loaded PLGA NPs embedded in pluronic gel was more gradual over 4 weeks. In cultured rat vascular smooth muscle cells (SMCs), rapamycin-loaded NPs produced durable (14 days versus 3 days for free rapamycin) inhibition of phosphorylation of S6 kinase (S6K1), a downstream target in the mTOR pathway. In a rat balloon injury model, periadventitial delivery of rapamycin-loaded NPs produced inhibition of phospho-S6K1 14 days after balloon injury. Immunostaining revealed that rapamycin-loaded NPs reduced SMC proliferation at both 14 and 28 days whereas rapamycin alone suppressed proliferation at day 14 only. Moreover, rapamycin-loaded NPs sustainably suppressed IH for at least 28 days following treatment, whereas rapamycin alone produced suppression on day 14 with rebound of IH by day 28. Since rapamycin, PLGA, and pluronic gel have all been approved by the FDA for other human therapies, this drug delivery method could potentially be translated into human use quickly to prevent failure of open vascular reconstructions.
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Affiliation(s)
- Xudong Shi
- Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, United States of America
| | - Guojun Chen
- Wisconsin Institutes for Discovery, University of Wisconsin, Madison, Wisconsin, United States of America ; Materials Science Program, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Lian-Wang Guo
- Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, United States of America
| | - Yi Si
- Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, United States of America
| | - Men Zhu
- Wisconsin Institutes for Discovery, University of Wisconsin, Madison, Wisconsin, United States of America ; Materials Science Program, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Srikanth Pilla
- Wisconsin Institutes for Discovery, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Bo Liu
- Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, United States of America
| | - Shaoqin Gong
- Wisconsin Institutes for Discovery, University of Wisconsin, Madison, Wisconsin, United States of America ; Materials Science Program, University of Wisconsin, Madison, Wisconsin, United States of America ; Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, United States of America
| | - K Craig Kent
- Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, United States of America
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20
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Haeri A, Sadeghian S, Rabbani S, Anvari MS, Lavasanifar A, Amini M, Dadashzadeh S. Sirolimus-loaded stealth colloidal systems attenuate neointimal hyperplasia after balloon injury: a comparison of phospholipid micelles and liposomes. Int J Pharm 2013; 455:320-30. [PMID: 23867987 DOI: 10.1016/j.ijpharm.2013.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 06/29/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
Restenosis after angioplasty remains a serious complication in clinical cardiology. This study aims to investigate the stealth colloidal systems for local intra-arterial drug delivery. Micelles from polyethylene glycol conjugated with phosphatidylethanolamine and PEGylated liposomes loaded with sirolimus were prepared and characterized with regard to their loading efficiency, particle size distribution, zeta potential, morphology, nuclear magnetic resonance spectroscopy, drug release profile and stability. The antirestenotic effects of the sirolimus-loaded micelles (14 nm) and liposomes (90 nm) were evaluated and compared in the rat carotid injury model following local intravascular delivery. In comparison to control groups, treatment of balloon injured rats with drug loaded micelles and nanoliposomes significantly reduced vascular stenosis by 42% and 19%, respectively (P<0.05). In addition, the luminal area was significantly enlarged by 39% and 60% following treatment with sirolimus-loaded liposomes and micelles, respectively (P<0.05). Immunohistochemistry revealed that sirolimus-loaded nanocarriers suppressed cell proliferation (Ki67-positive cells) as compared to control groups without affecting the density of smooth muscle actin staining. These results suggest that both colloidal nanocarriers could serve as effective intramural drug delivery systems for the treatment of restenosis; however, phospholipid based micelles provided better antirestenotic effects than PEGylated liposomes.
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Affiliation(s)
- Azadeh Haeri
- Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Choi CK, Kim JB, Jang EH, Youn YN, Ryu WH. Curved biodegradable microneedles for vascular drug delivery. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2012; 8:2483-8. [PMID: 22628194 DOI: 10.1002/smll.201200441] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Indexed: 05/15/2023]
Abstract
Curved biodegradable microneedles for application to the outer surface of blood vessels are produced to enhance drug delivery to vascular tissues suffering from hyperplasia or atherosclerosis. Spatially discrete thermal drawing and post-annealing processes are employed to fabricate microneedles on a curved surface. Insertion of microneedles into arteries in vivo and ex vivo is demonstrated, and their mechanical properties and drug-delivery function are studied.
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Affiliation(s)
- Chang Kuk Choi
- School of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-749, Republic of Korea
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22
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A perivascular system releasing sirolimus prevented intimal hyperplasia in a rabbit model in a medium-term study. Int J Pharm 2012; 427:311-9. [DOI: 10.1016/j.ijpharm.2012.02.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Revised: 02/12/2012] [Accepted: 02/13/2012] [Indexed: 12/20/2022]
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23
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Lee CH, Chen CJ, Liu SJ, Hsiao CY, Chen JK. The Development of Novel Biodegradable Bifurcation Stents for the Sustainable Release of Anti-Proliferative Sirolimus. Ann Biomed Eng 2012; 40:1961-70. [DOI: 10.1007/s10439-012-0556-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 03/21/2012] [Indexed: 12/18/2022]
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24
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In-vitro release of anti-proliferative paclitaxel from novel balloon-expandable polycaprolactone stents. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2011. [DOI: 10.1016/j.msec.2011.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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25
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Filova E, Parizek M, Olsovska J, Kamenik Z, Brynda E, Riedel T, Vandrovcova M, Lisa V, Machova L, Skalsky I, Szarszoi O, Suchy T, Bacakova L. Perivascular sirolimus-delivery system. Int J Pharm 2011; 404:94-101. [DOI: 10.1016/j.ijpharm.2010.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 10/27/2010] [Accepted: 11/06/2010] [Indexed: 12/28/2022]
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26
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Paclitaxel/sirolimus combination coated drug-eluting stent: in vitro and in vivo drug release studies. J Pharm Biomed Anal 2010; 54:807-11. [PMID: 21126843 DOI: 10.1016/j.jpba.2010.10.027] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Revised: 10/28/2010] [Accepted: 10/29/2010] [Indexed: 11/22/2022]
Abstract
Paclitaxel and sirolimus are the two major drugs for the treatment of coronary arterial disease in current drug-eluting stents. The two drugs can effectively inhibit the in-stent restenosis through their independent pathways and show synergistic effect in preventing tumor tissue growth. We hypothesize that the combination of the two drugs in a drug-eluting stent (DES) can also effectively suppress the neointima growth in the stented artery. The present work was focused on the investigation of paclitaxel/sirolimus combination release profiles from a novel biodegradable polymer (poly (D, L-lactide-co-glycolide)/amorphous calcium phosphate, PLGA/ACP) coated stent both in vitro and in vivo. For the in vitro, the drug releasing profiles were characterized by measuring the drug concentration in a drug release medium (Dulbecco's phosphate buffered saline, DPBS, pH 7.4) at predetermined time points. For the in vivo, a rat aorta stenting model was employed. The results showed that both paclitaxel and sirolimus had a two-phase release profile both in vitro and in vivo, which is similar to the drug release profile of their individual coated DESs, and there is no evident of interference between two drugs. The data suggest that paclitaxel and sirolimus can be combined pharmacokinetically in a DES for the treatment of coronary arterial diseases.
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27
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Abdur Rouf M, Vural I, Bilensoy E, Hincal A, Erol DD. Rapamycin-cyclodextrin complexation: improved solubility and dissolution rate. J INCL PHENOM MACRO 2010. [DOI: 10.1007/s10847-010-9885-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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28
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Huang J, Zhang J, Pathak A, Li J, Stouffer GA. Perivascular delivery of blebbistatin reduces neointimal hyperplasia after carotid injury in the mouse. J Pharmacol Exp Ther 2010; 336:116-26. [PMID: 20956482 DOI: 10.1124/jpet.110.174615] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Proliferation and migration of smooth muscle cells (SMC) require myosin II activity; thus, we examined whether blebbistatin, a cell-permeable selective inhibitor of myosin II ATP activity, would impair neointimal hyperplasia after vascular injury. Delivery of blebbistatin via a perivascular polymer cuff reduced neointimal formation by 73% and luminal obstruction by 75% after carotid denudation injury in C57BL/6 mice. Blebbistatin treatment was also associated with a reduction in cell density within the neointima; total number of cells (76 ± 7 to 27 ± 3 cells/high-powered field) and actin-positive cells (64 ± 4 to 24 ± 2 cells/high-powered field) in the neointima were reduced in blebbistatin-treated mice compared with vehicle-treated mice. In a model of vascular injury with an intact endothelium, implantation of a blebbistatin-secreting cuff after carotid ligation in FVB/N mice was associated with a 61% decrease in neointimal area and a significant decrease in luminal obstruction (88 ± 4% in vehicle-treated mice versus 36 ± 4% in blebbistatin-treated mice; p < 0.0001). In cultured rat aortic SMC, blebbistatin disrupted cellular morphology and actin cytoskeleton structure, and these effects were rapid and completely reversible. Blebbistatin had a dose-dependent inhibitory effect on DNA replication and cell proliferative responses to platelet-derived growth factor-BB, angiotensin II, and α-thrombin, migratory responses to serum, and migratory responses after blunt injury. In summary, perivascular delivery of blebbistatin reduced neointimal hyperplasia after carotid injury in the mouse.
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Affiliation(s)
- Jianhua Huang
- McAllister Heart Institute, University of North Carolina, Chapel Hill, NC, USA
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29
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Liu SJ, Chiang FJ, Hsiao CY, Kau YC, Liu KS. Fabrication of Balloon-Expandable Self-Lock Drug-Eluting Polycaprolactone Stents Using Micro-Injection Molding and Spray Coating Techniques. Ann Biomed Eng 2010; 38:3185-94. [DOI: 10.1007/s10439-010-0075-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 05/11/2010] [Indexed: 10/19/2022]
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30
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Owen SC, Li H, Sanders WG, Cheung AK, Terry CM. Correlation of tissue drug concentrations with in vivo magnetic resonance images of polymer drug depot around arteriovenous graft. J Control Release 2010; 146:23-30. [PMID: 20457189 DOI: 10.1016/j.jconrel.2010.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 03/18/2010] [Accepted: 05/04/2010] [Indexed: 12/15/2022]
Abstract
Sustained delivery of anti-proliferative drugs to the perivascular area using an injectable polymeric platform is a strategy to inhibit vascular hyperplasia and stenosis. In this study, the concentrations of sirolimus in vascular tissues were evaluated after delivery using an injectable platform made of poly(lactic-co-glycolic acid)-polyethylene glycol-poly(lactic-co-glycolic acid) (PLGA-PEG-PLGA). In order to optimize the drug release profile, the effect of two solvents or solid loading of the sirolimus into the polymer gel was first examined in vitro. The early release was slower with loading of dry drug into the polymer, compared to drug dissolution in solvents. Dry sirolimus was therefore used to load the polymer and applied to the perivascular surface of the graft-venous anastomosis at the time of surgical placement of a carotid-jugular synthetic hemodialysis graft in a porcine model. This was replenished by ultrasound-guided injection of additional drug-laden polymer at one, two and three weeks post-operatively. Magnetic resonance imaging (MRI) using pulse sequences specifically designed for optimal detection of the polymeric gel showed that the polymer injected post-operatively remained at the juxta-anastomotic perivascular site at two weeks. Sirolimus was extracted from various segments of the juxta-anastomotic tissues and the drug concentrations were determined using HPLC MS/MS. Tissue sirolimus concentrations at one and two weeks were highest near the venous anastomosis, which were approximately 100- to 500-fold greater than the concentrations necessary to inhibit vascular smooth muscle cell proliferation in vitro. Drug concentrations remained above the inhibitory concentrations for at least six weeks post-operatively. Thus, serial injections of sustained-delivery polymer gel loaded with sirolimus can provide high localized concentrations at target vascular tissues and thus may be useful for the prevention and treatment of vascular proliferative disorders such as hemodialysis graft stenosis. In addition, MRI is useful for the monitoring of the location of the drug depot.
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Affiliation(s)
- Shawn C Owen
- Department of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, 301 Skaggs Hall, 30 South 2000 East, Salt Lake City, UT 84112, USA
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31
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Sarısözen C, Arıca B, Orman MN, Hıncal AA, Çalış S. Optimization of prednisolone acetate-loaded chitosan microspheres using a 23factorial design for preventing restenosis. Drug Deliv 2010; 17:178-86. [DOI: 10.3109/10717541003667780] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Leigh Perkins LE. Preclinical Models of Restenosis and Their Application in the Evaluation of Drug-Eluting Stent Systems. Vet Pathol 2010; 47:58-76. [DOI: 10.1177/0300985809352978] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Coronary arterial disease (CAD) is the leading cause of death in the United States, the European Union, and Canada. Percutaneous coronary intervention (PCI) has revolutionized the treatment of CAD, and it is the advent of drug-eluting stent (DES) systems that has effectively allayed much of the challenge of restenosis that has plagued the success of PCI through its 30-year history. However, DES systems have not been a panacea: There yet remain the challenges associated with interventions involving bare metallic stents as well as newly arisen concerns related to the application of DES systems. To effectively address these novel and ongoing issues, animal models are relied on both to project the safety and efficacy of endovascular devices and to provide insight into the pathophysiology underlying the vascular response to injury and mechanisms of restenosis. In this review, preclinical models of restenosis are presented, and their application and limitation in the evaluation of device-based interventional technologies for the treatment of CAD are discussed.
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33
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In vitro andin vivo characterization of a coronary stent coated with an elastic biodegradable polymer for the sustained release of paclitaxel. Macromol Res 2009. [DOI: 10.1007/bf03218654] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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34
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Kim HI, Takai M, Konno T, Matsuno R, Ishihara K. Biodegradable polymer films for releasing nanovehicles containing sirolimus. Drug Deliv 2009; 16:183-8. [PMID: 19514979 DOI: 10.1080/10717540902757416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
To obtain novel biodegradable sirolimus-releasing polymer films that could release nanovehicles incorporating sirolimus, polyester, a water-soluble amphiphilic phospholipid polymer, and sirolimus were blended. The sirolimus-releasing polymer films were characterized by scanning electron microscopy and differential scanning calorimetry. Nanovehicles were formed with the phospholipid polymer chains and could be released from the sirolimus-releasing polymer films. The hydrodynamic diameter of the nanovehicles in phosphate-buffered saline was smaller than 20 nm. The nanovehicles substantially enhanced the carrier-mediated delivery of sirolimus and attenuated its degradation product. This study demonstrates that the delivery of sirolimus was enhanced by nanovehicles released from sirolimus-eluting materials.
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Affiliation(s)
- Hyung Il Kim
- Department of Bioengineering, The University of Tokyo, Japan
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35
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Zadelaar SM, Boesten LSM, Pires NMM, van Nieuwkoop A, Biessen EAL, Jukema W, Havekes LM, van Vlijmen BJM, Willems van Dijk K. Local Cre-mediated gene recombination in vascular smooth muscle cells in mice. Transgenic Res 2009; 15:31-6. [PMID: 16475008 DOI: 10.1007/s11248-005-3226-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Accepted: 09/17/2005] [Indexed: 01/06/2023]
Abstract
Here we describe a means to conditionally modify genes at a predefined and localized region of the vasculature using a perivascular drug delivery device (PDD). A 4-hydroxytamoxifen (4-OHT)-eluting PDD was applied around the carotid or femoral artery of a mouse strain carrying both the tamoxifen-inducible and smooth muscle cell (SMC)-specific Cre-recombinase (SM-Cre-ER(T2)) transgene and a stop-floxed beta-galactosidase gene in the Rosa26 locus: the SM-CreER(T2)(ki)/rosa26 mouse. A dose and time curve of 0-10% (w/w) 4-OHT and 0-14 days application of the PDD in SM-CreER(T2)(ki)/rosa26 mice showed optimal gene recombination at 1% (w/w) 4-OHT loading at 7 days post application (carotid artery 2.4+/-1.8%; femoral artery 4.0+/-3.8% of SMCs). The unique 4-OHT-eluting PDD allowed us to achieve SMC-specific recombination in the same order of magnitude as compared to systemic tamoxifen administration. In addition, recombination was completely confined to the PDD-treated vessel wall segment. Thus, local application of a 4-OHT-eluting PDD results in vascular SMC-specific Cre-mediated recombination in SM-CreER(T2)(ki)/rosa26 mice without affecting additional SMCs.
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MESH Headings
- Animals
- Drug Delivery Systems
- Integrases/genetics
- Integrases/physiology
- Mice
- Mice, Transgenic
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/metabolism
- Promoter Regions, Genetic
- Recombination, Genetic/drug effects
- Tamoxifen/analogs & derivatives
- Tamoxifen/pharmacology
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Affiliation(s)
- Susanne M Zadelaar
- Department of Cardiology, p/o TNO-Quality of Life Gaubius Laboratory, Leiden University Medical Centre, Zernikedreef 9, P.O. Box 2215, 2301 CE, Leiden, The Netherlands.
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36
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Silvestri D, Gagliardi M, Barbani N, Cristallini C, Giusti P. Synthesis and characterization of copolymers of methylmethacrylate and 2-hydroxyethyl methacrylate for the aqueous solubilization of Paclitaxel. Drug Deliv 2009; 16:116-24. [DOI: 10.1080/10717540802666980] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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37
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Lee HJ, Choi SH, Nah MH, Lim JO, Lee IK. Fabrication of an alpha-lipoic acid-eluting poly-(D,L-lactide-co-caprolactone) cuff for the inhibition of neointimal formation. Exp Mol Med 2009; 41:25-32. [PMID: 19287197 DOI: 10.3858/emm.2009.41.1.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The purpose of this study was to develop a novel polymer cuff for the local delivery of alpha-lipoic acid (ALA) to inhibit neointimal formation in vivo. The polymer cuff was fabricated by incorporating the ALA into poly- (D,L-lactide-co-caprolactone) 40:60 (PLC), with or without methoxy polyethylene glycol (MethoxyPEG). The release kinetics of ALA and in vitro degradation by hydrolysis were analyzed by HPLC and field emission scanning electron microscopy (FE-SEM), respectively. In vivo evaluation of the effect of the ALA-containing polymer cuff was carried out using a rat femoral artery cuff injury model. At 24 h, 48% or 87% of the ALA was released from PCL cuffs with or without MethoxyPEG. FE-SEM results indicated that ALA was blended homogenously in the PLC with MethoxyPEG, whereas ALA was distributed on the surface of the PLC cuff without MethoxyPEG. The PLC cuff with MethoxyPEG showed prolonged and controlled release of ALA in PBS, in contrast to the PLC cuff without MethoxyPEG. Both ALA-containing polymer cuffs had a significant effect on the inhibition of neointimal formation in rat femoral artery. Novel ALA-containing polymer cuffs made of PLC were found to be biocompatible and effective in inhibiting neointimal formation in vivo. Polymer cuffs containing MethoxyPEG allowed the release of ALA for one additional week, and the rate of drug release from the PLC could be controlled by changing the composition of the polymer. These findings demonstrate that polymer cuffs may be an easy tool for the evaluation of anti-restenotic agents in animal models.
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Affiliation(s)
- Hyo Jeong Lee
- Department of Internal Medicine and Biochemistry and Cell Biology, Kyungpook National University School of Medicine, Daegu, 700-721, Korea
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38
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Markelova N, Shishatskaya E, Vinnik Y, Cherdantsev D, Beletskiy I, Kuznetsov M, Zykova L. In Vivo Justification of Using Endobiliary Stents Made of Polyhydroxyalkanoates. ACTA ACUST UNITED AC 2008. [DOI: 10.1002/masy.200850910] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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39
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Miyauchi K, Kasai T, Yokayama T, Aihara K, Kurata T, Kajimoto K, Okazaki S, Ishiyama H, Daida H. Effectiveness of statin-eluting stent on early inflammatory response and neointimal thickness in a porcine coronary model. Circ J 2008; 72:832-838. [PMID: 18441467 DOI: 10.1253/circj.72.832] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
BACKGROUND Drug-eluting stent (DES) implantation is routine during coronary revascularization because DES significantly reduce rates of restenosis and target lesion revascularization compared with bare metal stent (BMS). However, available DES have limitations, such as late thrombosis because of delayed healing with poorer endothelialization and persistent local inflammation. Statins can inhibit cell proliferation, inflammation, and restore endothelial function. The present study evaluated the ability of stent-based cerivastatin delivery to reduce stent-induced inflammatory responses and adverse effects on endothelial function, and to inhibit neointimal hyperplasia in a porcine coronary model. METHODS AND RESULTS Pigs were randomized into groups in which the coronary arteries (9 pigs, 18 coronaries in each group) had either a cerivastatin-eluting stent (CES) or a BMS. All animals survived without any adverse effects. Inflammatory cell infiltration evaluated using scanning electron microscopy on day 3 after stenting was significantly decreased in the treated vessels (inflammation score: 1.15+/-0.12 vs 2.43+/-0.34, p<0.0001). At day 28, endothelial function with intracoronary infusion of bradykinin was preserved in both the CES and BMS groups. Volumetric intravascular ultrasound images revealed decreased intimal volume in the CES group (28.3+/-5.4 vs 75.9+/-4.2 mm3, p<0.0001). Histomorphometric analysis showed reduced neointimal area (1.74+/-0.45 vs 3.83+/-0.51 mm2, p<0.0001) in the CES group despite similar injury scores (1.77+/-0.30 vs 1.77+/-0.22, p=0.97). CONCLUSION In porcine coronary arteries CES significantly decreased neointimal hyperplasia with a decreased early inflammatory response and without endothelial dysfunction.
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Affiliation(s)
- Katsumi Miyauchi
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
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40
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Jung MJ, Kwon JS, Park NK, Kim YK, Shim TJ, Jeong IH, Bae JW, Hwang KK, Kim DW, Cho MC. Perivascular Delivery of Rapamycin in Pluronic Gel Inhibits Neointimal Hyperplasia in a Rat Carotid Artery Injury Model, and the Complementary Role of Carotid Arteriography. Korean Circ J 2008. [DOI: 10.4070/kcj.2008.38.2.80] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Mi-Jin Jung
- Department of Pediatrics, Gil Heart Center, Incheon, Korea
| | - Jin-Sook Kwon
- Department of Internal Medicine, College of Medicine, Chonnam National University, Gwangju, Korea
| | - No-Kwan Park
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Yu-Kyung Kim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Tae Jin Shim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Il Ha Jeong
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jang-Whan Bae
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Kyung-Kuk Hwang
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Dong-Woon Kim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Myeong-Chan Cho
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
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41
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Tsukagoshi T, Kondo Y, Yoshino N. Preparation of thin polymer films with controlled drug release. Colloids Surf B Biointerfaces 2007; 57:219-25. [PMID: 17382526 DOI: 10.1016/j.colsurfb.2007.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Accepted: 02/03/2007] [Indexed: 11/28/2022]
Abstract
Poly(N-isopropylacrylamide) (PAAm) is a thermal responsive polymer that undergoes a structural change in aqueous solution at its lower critical solution temperature (LCST). PAAm-modified silicon substrates were prepared and the effect of PAAm density on the thermal response of the modified surface was examined in terms of changes in the water contact angle as a basis for applying the structural change of the polymer to controlled drug release. Changes with temperature in the ability to load and release of the modified layer for drug were also examined using 2-acetoxybenzoic acid (aspirin) as a model drug. The amount of PAAm was found to greatly affect the thermal response and the ability to load and release of the modified layer for aspirin.
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Affiliation(s)
- Tatsuya Tsukagoshi
- Department of Industrial Chemistry, Faculty of Engineering, Tokyo University of Science, 12-1 Ichigaya-Funagawara, Tokyo, Japan
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42
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Pires NMM, Eefting D, de Vries MR, Quax PHA, Jukema JW. Sirolimus and paclitaxel provoke different vascular pathological responses after local delivery in a murine model for restenosis on underlying atherosclerotic arteries. Heart 2007; 93:922-7. [PMID: 17449502 PMCID: PMC1994420 DOI: 10.1136/hrt.2006.102244] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Drug-eluting stents (DES) have been introduced successfully in clinical practice to prevent post-angioplasty restenosis. Nevertheless, concerns about the safety of DES still exist. OBJECTIVE To investigate the vascular pathology and transcriptional responses to sirolimus and paclitaxel in a murine model for restenosis on underlying diseased atherosclerotic arteries. METHODS Atherosclerotic lesions were induced by placement of a perivascular cuff around the femoral artery of hypercholesterolaemic ApoE*3-Leiden transgenic mice. Two weeks later these cuffs were replaced either by sirolimus- or paclitaxel-eluting cuffs. The vascular pathological effects were evaluated after two additional weeks. RESULTS Both anti-restenotic compounds significantly inhibited restenotic lesion progression on the atherosclerotic plaques. Vascular histopathological analyses showed that local delivery of sirolimus has no significant adverse effects on vascular disease. Conversely, high dosages of paclitaxel significantly increased apoptosis, internal elastic lamina disruption, and decreased medial and intimal smooth muscle cells and collagen content. Moreover, transcriptional analysis by real-time RT-PCR showed an increased level of pro-apoptotic mRNA transcripts (FAS, BAX, caspase 3) in paclitaxel-treated arteries. CONCLUSIONS Sirolimus and paclitaxel are effective in preventing restenosis. Sirolimus has no significant effect on arterial disease. In contrast, paclitaxel at high concentration demonstrated adverse vascular pathology and transcriptional responses, suggesting a narrower therapeutic range of this potent drug. Since the use of overlapping stents is becoming more common in DES technology, this factor is important, given that higher dosages of paclitaxel may lead to increased apoptosis in the vessel wall and, consequently, to a more unstable phenotype of the pre-existing atherosclerotic lesion.
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Affiliation(s)
- Nuno M M Pires
- TNO-Quality of Life, Gaubius Laboratory, Leiden, The Netherlands
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Pires NMM, Pols TWH, de Vries MR, van Tiel CM, Bonta PI, Vos M, Arkenbout EK, Pannekoek H, Jukema JW, Quax PHA, de Vries CJM. Activation of nuclear receptor Nur77 by 6-mercaptopurine protects against neointima formation. Circulation 2007; 115:493-500. [PMID: 17242285 DOI: 10.1161/circulationaha.106.626838] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Restenosis is a common complication after percutaneous coronary interventions and is characterized by excessive proliferation of vascular smooth muscle cells (SMCs). We have shown that the nuclear receptor Nur77 protects against SMC-rich lesion formation, and it has been demonstrated that 6-mercaptopurine (6-MP) enhances Nur77 activity. We hypothesized that 6-MP inhibits neointima formation through activation of Nur77. METHODS AND RESULTS It is demonstrated that 6-MP increases Nur77 activity in cultured SMCs, which results in reduced [3H]thymidine incorporation, whereas Nur77 small interfering RNA knockdown partially restores DNA synthesis. Furthermore, we studied the effect of 6-MP in a murine model of cuff-induced neointima formation. Nur77 mRNA is upregulated in cuffed arteries, with optimal expression after 6 hours and elevated expression up to 7 days after vascular injury. Local perivascular delivery of 6-MP with a drug-eluting cuff significantly inhibits neointima formation in wild-type mice. Locally applied 6-MP does not affect inflammatory responses or apoptosis but inhibits expression of proliferating cell nuclear antigen and enhances protein levels of the cell-cycle inhibitor p27(Kip1) in the vessel wall. An even stronger inhibition of neointima formation in response to local 6-MP delivery was observed in transgenic mice that overexpressed Nur77. In contrast, 6-MP does not alter lesion formation in transgenic mice that overexpress a dominant-negative variant of Nur77 in arterial SMCs, which provides evidence for the involvement of Nur77-like factors. CONCLUSIONS Enhancement of the activity of Nur77 by 6-MP protects against excessive SMC proliferation and SMC-rich neointima formation. We propose that activation of the nuclear receptor Nur77 is a rational approach to treating in-stent restenosis.
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MESH Headings
- Animals
- Antimetabolites, Antineoplastic/pharmacology
- Apoptosis/drug effects
- Cell Division/drug effects
- Cells, Cultured
- Coronary Restenosis/drug therapy
- Coronary Restenosis/metabolism
- Coronary Restenosis/pathology
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Disease Models, Animal
- Drug Implants
- Femoral Artery/pathology
- Humans
- Male
- Mercaptopurine/pharmacology
- Mice
- Mice, Inbred Strains
- Mice, Transgenic
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/pathology
- Nuclear Receptor Subfamily 4, Group A, Member 1
- RNA, Messenger/metabolism
- RNA, Small Interfering
- Receptors, Cytoplasmic and Nuclear/genetics
- Receptors, Cytoplasmic and Nuclear/metabolism
- Receptors, Steroid/genetics
- Receptors, Steroid/metabolism
- Transcription Factors/genetics
- Transcription Factors/metabolism
- Tunica Intima/drug effects
- Tunica Intima/pathology
- Umbilical Arteries/cytology
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Affiliation(s)
- Nuno M M Pires
- Gaubius Laboratory, TNO-Quality of Life, Leiden, The Netherlands
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Mallawaarachchi CM, Weissberg PL, Siow RCM. Antagonism of platelet‐derived growth factor by perivascular gene transfer attenuates adventitial cell migration after vascular injury: new tricks for old dogs? FASEB J 2006; 20:1686-8. [PMID: 16790526 DOI: 10.1096/fj.05-5435fje] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Migration of adventitial fibroblasts contributes to vascular remodeling after angioplasty. This study has used perivascular gene transfer of a truncated platelet-derived growth factor PDGF receptor (PDGFXR) to investigate whether antagonism of PDGF signaling alters adventitial cell migration after balloon injury in rat carotid arteries. Adenoviruses coordinating expression of beta-galactosidase (LacZ) and PDGFXR or LacZ and green fluorescent protein (GFP) were applied to the perivascular surface of arteries and balloon injury performed 4 days later. Vessels were excised at 3, 7, and 14 days to determine morphology and gene expression. Uninjured arteries only expressed LacZ positive cells in the adventitial compartment; however, after injury in LacZ and GFP transfected arteries, LacZ positive cells contributed to the population of cells within the media and neointima at 7-14 days. Overexpression of PDGFXR and LacZ resulted in a significant reduction in the number of LacZ labeled cells in the neointima after vascular injury, concomitant with reduced remodeling, collagen content, expression of matrix metalloproteinase-2, and increased levels of tissue inhibitors of metalloproteinase-1 and -2. We provide evidence that perivascular antagonism of PDGF attenuates remodeling and contribution of adventitial fibroblasts to neointima formation after balloon angioplasty. Perivascular gene transfer may represent a therapeutic strategy to reduce the incidence of restenosis.
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Affiliation(s)
- Chandike M Mallawaarachchi
- Cardiovascular Division, School of Clinical Medicine, University of Cambridge, Addenbrookes Hospital, Cambridge, UK
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45
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Yang C, Burt HM. Drug-eluting stents: factors governing local pharmacokinetics. Adv Drug Deliv Rev 2006; 58:402-11. [PMID: 16616969 DOI: 10.1016/j.addr.2006.01.017] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Accepted: 01/31/2006] [Indexed: 10/24/2022]
Abstract
Stent-based drug delivery system is a revolutionary approach to mitigate the negative affects of balloon angioplasty, improve immune responsiveness and prevent hyperplastic growth of smooth muscle in the restenotic state. Its success is therefore empirically associated with effective delivery of potent therapeutics to the target site at a therapeutic concentration, for a sufficient time, and in a biologically active form. However, local delivery with drug-eluting stents imparts large dynamic concentration gradients across tissues that can be difficult to identify, characterize and control. This review explores the factors such as physiological transport forces, drug physicochemical properties, local biological tissue properties and stent design that governs the local pharmacokinetics within the arterial wall by drug-eluting stent. Rational design and optimization of drug-eluting stents for local delivery thus requires a careful consideration of all these factors.
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Affiliation(s)
- Chiming Yang
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 East Mall, Vancouver, BC, Canada V6T 1Z3
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Pires NMM, Jukema JW, Daemen MJAP, Quax PHA. Drug-eluting stents studies in mice: Do we need atherosclerosis to study restenosis? Vascul Pharmacol 2006; 44:257-64. [PMID: 16527546 DOI: 10.1016/j.vph.2006.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Accepted: 01/01/2006] [Indexed: 10/24/2022]
Abstract
In 2001, the first human study with drug-eluting stents (DES) was published showing a nearly complete abolition of restenosis by using a sirolimus-eluting stent. This success was very encouraging to test new compounds in combination with the DES platform. Nevertheless, several other anti-restenotic compounds have been used in human clinical trials with disappointing outcomes. Little is known concerning potential adverse effects on vessel wall integrity and (re)healing, atherosclerotic lesion formation, progression, and plaque stability of these DES. Although efficacy and safety need to be determined clinically, preclinical testing of candidate drugs in well-defined animal models is extremely helpful to gain insight into the basic biological responses to candidate compounds. Here, we discuss and report an animal model which enables rapid screening of candidate drugs for DES on an atherosclerotic background. The results from drug testing using this novel model could help to quickly and cost-effectively establish the dose range of candidate drugs with reasonable potential for DES.
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Affiliation(s)
- Nuno M M Pires
- TNO-Quality of Life, Gaubius Laboratory, Zernikedreef 9, 2333 CK Leiden, The Netherlands
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Monraats PS, Pires NMM, Schepers A, Agema WRP, Boesten LSM, de Vries MR, Zwinderman AH, de Maat MPM, Doevendans PAFM, de Winter RJ, Tio RA, Waltenberger J, 't Hart LM, Frants RR, Quax PHA, van Vlijmen BJM, Havekes LM, van der Laarse A, van der Wall EE, Jukema JW. Tumor necrosis factor-alpha plays an important role in restenosis development. FASEB J 2006; 19:1998-2004. [PMID: 16319143 DOI: 10.1096/fj.05-4634com] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Genetic factors appear to be important in the restenotic process after percutaneous coronary intervention (PCI), as well as in inflammation, a pivotal factor in restenosis. TNFalpha, a key regulator of inflammatory responses, may exert critical influence on the development of restenosis after PCI. The GENetic DEterminants of Restenosis (GENDER) project included 3104 patients who underwent a successful PCI. Systematic genotyping for six polymorphisms in the TNFalpha gene was performed. The role of TNFalpha in restenosis was also assessed in ApoE*3-Leiden mice, TNFalpha knockout mice, and by local delivery of a TNFalpha biosynthesis inhibitor, thalidomide. The -238G-1031T haplotype of the TNFalpha gene increased clinical and angiographic risk of restenosis (P=0.02 and P=0.002, respectively). In a mouse model of reactive stenosis, arterial TNFalpha mRNA was significantly time-dependently up-regulated. Mice lacking TNFalpha or treated locally with thalidomide showed a reduction in reactive stenosis (P=0.01 and P=0.005, respectively). Clinical and preclinical data indicate that TNFalpha plays an important role in restenosis. Therefore, TNFalpha genotype may be used as a risk marker for restenosis and may contribute to individual patient screening prior to PCI in clinical practice. Inhibition of TNFalpha may be an anti-restenotic target strategy.
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Abstract
In-stent restenosis (ISR) is the major drawback of percutaneous coronary interventions, occurring in 10-40% of patients. Drug eluting stents (DES) are successful in a large majority of patients in preventing restenosis for the first year after implantation. Recently, new stents have emerged that are loaded with anti-inflammatory, antimigratory, antiproliferative, or pro-healing drugs. These drugs are supposed to inhibit inflammation and neointimal growth and subsequently ISR. The future of DES lies in the development of better stents with new stent designs, better polymers including biological polymers and biological biodissolvable stent coatings, and new, better drugs.
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Affiliation(s)
- R R Anis
- Bristol Heart Institute, University of Bristol, Bristol BS2 8HW, UK
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