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Islam P, Schaly S, Abosalha AK, Boyajian J, Thareja R, Ahmad W, Shum-Tim D, Prakash S. Nanotechnology in development of next generation of stent and related medical devices: Current and future aspects. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2024; 16:e1941. [PMID: 38528392 DOI: 10.1002/wnan.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/08/2023] [Accepted: 01/03/2024] [Indexed: 03/27/2024]
Abstract
Coronary stents have saved millions of lives in the last three decades by treating atherosclerosis especially, by preventing plaque protrusion and subsequent aneurysms. They attenuate the vascular SMC proliferation and promote reconstruction of the endothelial bed to ensure superior revascularization. With the evolution of modern stent types, nanotechnology has become an integral part of stent technology. Nanocoating and nanosurface fabrication on metallic and polymeric stents have improved their drug loading capacity as well as other mechanical, physico-chemical, and biological properties. Nanofeatures can mimic the natural nanofeatures of vascular tissue and control drug-delivery. This review will highlight the role of nanotechnology in addressing the challenges of coronary stents and the recent advancements in the field of related medical devices. Different generations of stents carrying nanoparticle-based formulations like liposomes, lipid-polymer hybrid NPs, polymeric micelles, and dendrimers are discussed highlighting their roles in local drug delivery and anti-restenotic properties. Drug nanoparticles like Paclitaxel embedded in metal stents are discussed as a feature of first-generation drug-eluting stents. Customized precision stents ensure safe delivery of nanoparticle-mediated genes or concerted transfer of gene, drug, and/or bioactive molecules like antibodies, gene mimics via nanofabricated stents. Nanotechnology can aid such therapies for drug delivery successfully due to its easy scale-up possibilities. However, limitations of this technology such as their potential cytotoxic effects associated with nanoparticle delivery that can trigger hypersensitivity reactions have also been discussed in this review. This article is categorized under: Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Therapeutic Approaches and Drug Discovery > Emerging Technologies.
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Affiliation(s)
- Paromita Islam
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Sabrina Schaly
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Ahmed Kh Abosalha
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Pharmaceutical Technology Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Jacqueline Boyajian
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Rahul Thareja
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Waqar Ahmad
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Dominique Shum-Tim
- Division of Cardiac Surgery, Royal Victoria Hospital, McGill University Health Centre, McGill University, Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada
| | - Satya Prakash
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
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Patel S, Patel KB, Patel Z, Konat A, Patel A, Doshi JS, Chokshi P, Patel D, Sharma K, Amdani MM, Shah DB, Dholu U, Patel M. Evolving Coronary Stent Technologies - A Glimpse Into the Future. Cureus 2023; 15:e35651. [PMID: 37009355 PMCID: PMC10065169 DOI: 10.7759/cureus.35651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
One of the most widely accepted forms of treatment for coronary artery disease (CAD) is the implementation of stents into the vessel. This area of research is constantly evolving, ranging from bare-metal stents through drug-eluting stents and, more recently, approaching bioresorbable stents and polymer-free stents. This article reviews the evolution of all these devices and emphasizes how they might be further evolved to provide an optimal coronary stent and overcome unsolved challenges in stent development. We thoroughly evaluated a number of published studies in order to advance coronary stent technologies. Additionally, we looked for various literature that highlighted the inadequacies of the coronary stents that are currently available and how they might be modified to create the optimum coronary stent. Coronary stents have significantly improved clinical outcomes in interventional cardiology, but there are still a number of drawbacks, including an persisted risk of thrombosis due to endothelial injury and in-stent restenosis. Gene eluting stents (GES) and customized coronary stents with self-reporting stent sensors are appealing alternatives to existing stent approaches. Considering the adequacy of these gene eluting stents (GES), customized coronary stents produced by novel 4D printing technologies and integrated self-reporting stent sensors should be assumed for anticipating future advancements to optimal coronary stent devices; however, more interventional evidence is required to determine the future prospects of these stent innovations.
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Xu H, Li S, Liu YS. Nanoparticles in the diagnosis and treatment of vascular aging and related diseases. Signal Transduct Target Ther 2022; 7:231. [PMID: 35817770 PMCID: PMC9272665 DOI: 10.1038/s41392-022-01082-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/23/2022] [Accepted: 06/26/2022] [Indexed: 11/09/2022] Open
Abstract
Aging-induced alternations of vasculature structures, phenotypes, and functions are key in the occurrence and development of vascular aging-related diseases. Multiple molecular and cellular events, such as oxidative stress, mitochondrial dysfunction, vascular inflammation, cellular senescence, and epigenetic alterations are highly associated with vascular aging physiopathology. Advances in nanoparticles and nanotechnology, which can realize sensitive diagnostic modalities, efficient medical treatment, and better prognosis as well as less adverse effects on non-target tissues, provide an amazing window in the field of vascular aging and related diseases. Throughout this review, we presented current knowledge on classification of nanoparticles and the relationship between vascular aging and related diseases. Importantly, we comprehensively summarized the potential of nanoparticles-based diagnostic and therapeutic techniques in vascular aging and related diseases, including cardiovascular diseases, cerebrovascular diseases, as well as chronic kidney diseases, and discussed the advantages and limitations of their clinical applications.
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Affiliation(s)
- Hui Xu
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.,Institute of Aging and Age-related Disease Research, Central South University, 410011, Changsha, Hunan, China
| | - Shuang Li
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.,Institute of Aging and Age-related Disease Research, Central South University, 410011, Changsha, Hunan, China
| | - You-Shuo Liu
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China. .,Institute of Aging and Age-related Disease Research, Central South University, 410011, Changsha, Hunan, China.
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Wang X, Gao B, Feng Y. Recent advances in inhibiting atherosclerosis and restenosis: from pathogenic factors, therapeutic agents to nano-delivery strategies. J Mater Chem B 2022; 10:1685-1708. [DOI: 10.1039/d2tb00003b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Due to dominant atherosclerosis etiology, cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide. In clinical trials, advanced atherosclerotic plaques can be removed by angioplasty and vascular...
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Shim JW, Kim SS, Kim HK, Bae IH, Park DS, Park JK, Kim JU, Kim HB, Lee MY, Kim JS, Kim JH, Koo BS, Jeong KJ, Kim SU, Kim MC, Sim DS, Hong YJ, Ahn Y, Lim KS, Jeong MH. Effect of Novel Polymer-Free Nitrogen-Doped Titanium Dioxide Film-Coated Coronary Stent Loaded With Mycophenolic Acid. Front Bioeng Biotechnol 2021; 9:650408. [PMID: 34778222 PMCID: PMC8585759 DOI: 10.3389/fbioe.2021.650408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 10/15/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Titanium is commonly used in blood-exposed medical devices because it has superior blood compatibility. Mycophenolic acid inhibits the proliferation of vascular smooth muscle cells. This study examined the effect of a non-polymer TiO2 thin film–coated stent with mycophenolic acid in a porcine coronary overstretch restenosis model. Methods: Thirty coronary arteries in 15 pigs were randomized into three groups in which the coronary arteries were treated with a TiO2 film–coated stent with mycophenolic acid (NTM, n = 10), everolimus-eluting stent with biodegradable polymer (EES, n = 10), or TiO2 film–coated stent (NT, n = 10). A histopathologic analysis was performed 28 days after the stenting. Results: There were no significant intergroup differences in injury score, internal elastic lamina area, or inflammation score. Percent area stenosis was significantly smaller in the NTM and EES groups than in the NT group (36.1 ± 13.63% vs. 31.6 ± 7.74% vs. 45.5 ± 18.96%, respectively, p = 0.0003). Fibrin score was greater in the EES group than in the NTM and NT groups [2.0 (range, 2.0–2.0) vs. 1.0 (range, 1.0–1.75) vs. 1.0 (range, 1.0–1.0), respectively, p < 0.0001]. The in-stent occlusion rate measured by micro-computed tomography demonstrated similar percent area stenosis rates on histology analysis (36.1 ± 15.10% in NTM vs. 31.6 ± 8.89% in EES vs. 45.5 ± 17.26% in NT, p < 0.05). Conclusion: The NTM more effectively reduced neointima proliferation than the NT. Moreover, the inhibitory effect of NTM on smooth muscle cell proliferation was not inferior to that of the polymer-based EES with lower fibrin deposition in this porcine coronary restenosis model.
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Affiliation(s)
- Jae Won Shim
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Sung Soo Kim
- Division of Cardiology, Chosun University Hospital, Gwangju, South Korea
| | - Hyun Kuk Kim
- Division of Cardiology, Chosun University Hospital, Gwangju, South Korea
| | - In Ho Bae
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Dae Sung Park
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea.,Research Institute of Medical Sciences, Chonnam National University, Gwangju, South Korea
| | | | - Jae Un Kim
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Han Byul Kim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Min Young Lee
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Joong Sun Kim
- College of Veterinary Medicine, Chonnam National University, Gwangju, South Korea
| | - Jung Ha Kim
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Bon-Sang Koo
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Kang-Jin Jeong
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Sun-Uk Kim
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Min Chul Kim
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Doo Sun Sim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Young Joon Hong
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Youngkeun Ahn
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Kyung Seob Lim
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Myung Ho Jeong
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
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Hertault A, Chai F, Maton M, Sobocinski J, Woisel P, Maurel B, Lyskawa J, Blanchemain N. In vivo evaluation of a pro-healing polydopamine coated stent through an in-stent restenosis rat model. Biomater Sci 2021; 9:212-220. [PMID: 33179639 DOI: 10.1039/d0bm01204a] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Drug-eluting stents have demonstrated efficiency in in-stent restenosis (ISR) but induced a risk of late acute thrombosis by delaying strut re-endothelialization. Polydopamine (PDA), a biocompatible polymer inspired from adhesive proteins of mussels, has been reported to promote endothelial cell (EC) proliferation while limiting SMC proliferation in vitro, thus suggesting the pro-healing potential. This study aimed at evaluating in vivo the impact of the pro-healing PDA-coated stent on ISR and on the quality of the strut re-endothelialization in a rat model. PDA-coated stents demonstrated a significant reduction in ISR in vivo compared to bare metal stents (ratio neointima/media = 0.48 (±0.26) versus 0.83 (±0.42), p < 0.001). Western blot analyses identified a trend towards an increased activation of p38 MAPK phosphorylation and its anti-proliferative effects on vascular SMC that could explain the results observed in morphological analyses. This bioinspired and biocompatible polydopamine layer could intrinsically limit ISR. In addition, according to its latent reactivity, PDA offers the possibility to immobilize some relevant drugs on the PDA-functionalized stent to provide potential synergistic effects.
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Affiliation(s)
- Adrien Hertault
- Univ. Lille, INSERM, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France.
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Park JK, Kim SS, Kim HK, Nah JW, Kim HB, Bae IH, Park DS, Shim JW, Lee MY, Kim JS, Koo BS, Jeong KJ, Jin YB, Kim SU, Lee SR, Na JY, Sim DS, Hong YJ, Lim KS, Jeong MH. Poly-l-lactide Polymer-Based Triple Drug-Eluting Stent with Abciximab, Alpha-Lipoic Acid and Sirolimus in Porcine Coronary Restenosis Model. Macromol Res 2020. [DOI: 10.1007/s13233-020-8004-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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PEGylated Polyethylenimine Derivative-Mediated Local Delivery of the shSmad3 Inhibits Intimal Thickening after Vascular Injury. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8483765. [PMID: 31467913 PMCID: PMC6699321 DOI: 10.1155/2019/8483765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 07/03/2019] [Indexed: 01/08/2023]
Abstract
Intimal hyperplasia is a complex process which contributes to several clinical problems such as atherosclerosis and postangioplasty restenosis. Inhibition of Smad3 expression inhibits intimal thickening. Our previous study has modified biscarbamate cross-linked polyethylenimine derivative (PEI-Et) through PEGylation thus obtained polyethylene glycol-graft-polyethylenimine derivative (PEG-Et 1:1), which has lower cytotoxicity and higher gene transfection efficiency compared with PEI-Et. In this study, PEG-Et 1:1 was employed in Smad3 shRNA (shSmad3) delivery for preventing intimal hyperplasia after vascular injury. It was observed that PEG-Et 1:1 could condense shSmad3 gene into nanoparticles with particle size of 115–168 nm and zeta potential of 3–6 mV. PEG-Et 1:1 displayed remarkably lower cytotoxicity, higher transfection efficiency, and shRNA silencing efficiency than PEI-Et and PEI 25 kDa in vascular smooth muscle cells (VSMCs). Moreover, PEG-Et 1:1/shSmad3 polyplex treatment significantly inhibited collagen, matrix metalloproteinase 1 (MMP1), MMP2 and MMP9 expression, and upregulated tissue inhibitor of metalloproteinase 1 (TIMP1) expression both in vitro and in vivo. Furthermore, intravascular delivery of shSmad3 with PEG-Et 1:1 polyplex efficiently reduced Smad3 expression and inhibited intimal thickening 14 days after vascular injury. Ultimately, this study indicated that PEG-Et 1:1-mediated local delivery of shSmad3 is a promising strategy for preventing intimal thickening.
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9
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Liu S, Yang Y, Jiang S, Tang N, Tian J, Ponnusamy M, Tariq MA, Lian Z, Xin H, Yu T. Understanding the role of non-coding RNA (ncRNA) in stent restenosis. Atherosclerosis 2018; 272:153-161. [PMID: 29609130 DOI: 10.1016/j.atherosclerosis.2018.03.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/08/2018] [Accepted: 03/21/2018] [Indexed: 02/02/2023]
Abstract
Coronary heart disease (CHD) is one of the leading disorders with the highest mortality rate. Percutaneous angioplasty and stent implantation are the currently available standard methods for the treatment of obstructive coronary artery disease. However, the stent being an exogenous substance causes several complications by promoting the proliferation of vascular smooth muscle cells, immune responses and neointima formation after implantation, leading to post-stent restenosis (ISR) and late thrombosis. The prevention of these adverse vascular events is important to achieve long-term proper functioning of the heart after stent implantation. Non-coding ribonucleic acids (ncRNAs) are RNA molecules not translated into proteins, theyhave a great potential in regulating endothelial cell and vascular smooth muscle function as well as inflammatory reactions. In this review, we outline the regulatory functions of different classes of ncRNA in cardiovascular disease and propose ncRNAs as new targets for stent restonosis treatment.
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Affiliation(s)
- Shaoyan Liu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, 266000, People's Republic of China
| | - Yanyan Yang
- Institue for Translational Medicine, Qingdao University, 266021, People's Republic of China
| | - Shaoyan Jiang
- Department of Cardiology, The Affiliated Cardiovascular Hospital of Qingdao University, 266000, People's Republic of China
| | - Ningning Tang
- Institue for Translational Medicine, Qingdao University, 266021, People's Republic of China
| | - Jiawei Tian
- Department of Emergency, The Affiliated Hospital of Qingdao University, 266000, People's Republic of China
| | - Murugavel Ponnusamy
- Institue for Translational Medicine, Qingdao University, 266021, People's Republic of China
| | - Muhammad Akram Tariq
- Department of Biomolecular Engineering, Jack Baskin School of Engineering, University of California, Santa Cruz, CA, United states
| | - Zhexun Lian
- Department of Cardiology, The Affiliated Hospital of Qingdao University, 266000, People's Republic of China
| | - Hui Xin
- Department of Cardiology, The Affiliated Hospital of Qingdao University, 266000, People's Republic of China.
| | - Tao Yu
- Institue for Translational Medicine, Qingdao University, 266021, People's Republic of China.
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Krishnagopal A, Reddy A, Sen D. Stent-mediated gene and drug delivery for cardiovascular disease and cancer: A brief insight. J Gene Med 2018; 19. [PMID: 28370939 DOI: 10.1002/jgm.2954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 03/23/2017] [Accepted: 03/28/2017] [Indexed: 12/17/2022] Open
Abstract
This review concisely recapitulates the different existing modes of stent-mediated gene/drug delivery, their considerable advancement in clinical trials and a rationale for other merging new technologies such as nanotechnology and microRNA-based therapeutics, in addition to addressing the limitations in each of these perpetual stent platforms. Over the past decade, stent-mediated gene/drug delivery has materialized as a hopeful alternative for cardiovascular disease and cancer in contrast to routine conventional treatment modalities. Regardless of the phenomenal recent developments achieved by coronary interventions and cancer therapies that employ gene and drug-eluting stents, practical hurdles still remain a challenge. The present review highlights the limitations that each of the existing stent-based gene/drug delivery system encompasses and therefore provides a vision for the future with respect to discovering an ideal stent therapeutic platform that would circumvent all the practical hurdles witnessed with the existing technology. Further study of the improvisation of next-generation drug-eluting stents has helped to overcome the issue of restenosis to some extent. However, current stent formulations fall short of the anticipated clinically meaningful outcomes and there is an explicit need for more randomized trials aiming to further evaluate stent platforms in favour of enhanced safety and clinical value. Gene-eluting stents may hold promise in contributing new ideas for stent-based prevention of in-stent restenosis through genetic interventions by capitalizing on a wide variety of molecular targets. Therefore, the central consideration directs us toward finding an ideal stent therapeutic platform that would tackle all of the gaps in the existing technology.
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Affiliation(s)
| | - Aakash Reddy
- Cellular and Molecular Therapeutics Laboratory, Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), VIT University, Vellore, Tamil Nadu, India
| | - Dwaipayan Sen
- Cellular and Molecular Therapeutics Laboratory, Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), VIT University, Vellore, Tamil Nadu, India
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Han CM, Park KS, Joung YK. Recent alternative approaches of vascular drug-eluting stents. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2017. [DOI: 10.1007/s40005-017-0378-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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12
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Sim DS, Jeong MH. Development of Novel Drug-Eluting Stents for Acute Myocardial Infarction. Chonnam Med J 2017; 53:187-195. [PMID: 29026706 PMCID: PMC5636757 DOI: 10.4068/cmj.2017.53.3.187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 06/02/2017] [Accepted: 06/11/2017] [Indexed: 11/06/2022] Open
Abstract
Delayed arterial healing at culprit sites after drug-eluting stent (DES) placement for acute myocardial infarction (AMI) is associated with increased risk of late stent thrombosis. The Korea Acute Myocardial Infarction Registry was established in commemoration of the 50th anniversary of Korea Circulation Society. Between November 2005 and December 2016, more than 62,000 patients were registered from 50 primary percutaneous coronary intervention (PCI) centers in Korea. DES in AMI may be safe and effective, however, there is concern about increased stent thrombosis after DES implantation in AMI patients, requiring longer-term dual anti-platelet therapy to reduce the risk of late stent thrombosis. Device innovation is needed to overcome issues such as stent thrombosis and restenosis by using new coating materials with biocompatible polymers, different coating methods using non-polymer techniques, bioabsorbable stents and pro-healing stents. In this review article, we describe the current usage of DES in AMI in Korea and introduce novel DES uses in development for patients with AMI. We have developed many types of DES in our research laboratory. Abciximab-coated stents inhibited platelet thrombi and restenosis. Furthermore, anti-oxidants (carvedilol, probucol and alpha-lipoic acid) were used for stent coating. Currently we are developing novel DESs using polymer-free and natural binding techniques, peptide coating stents, gene-and-drug delivery, bioabsorbable stents using 3D printing, endothelial progenitor cell capturing stents to promote reendothelialization and reduce stent thrombosis. New DESs in development may be safe and effective in preventing late stent thrombosis and restenosis in patients with AMI.
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Affiliation(s)
- Doo Sun Sim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
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13
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Fisher RK, Mattern-Schain SI, Best MD, Kirkpatrick SS, Freeman MB, Grandas OH, Mountain DJH. Improving the efficacy of liposome-mediated vascular gene therapy via lipid surface modifications. J Surg Res 2017; 219:136-144. [PMID: 29078873 DOI: 10.1016/j.jss.2017.05.111] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/28/2017] [Accepted: 05/25/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND We have previously defined mechanisms of intimal hyperplasia that could be targets for molecular therapeutics aimed at vascular pathology. However, biocompatible nanocarriers are needed for effective delivery. Cationic liposomes (CLPs) have been demonstrated as effective nanocarriers in vitro. However, in vivo success has been hampered by cytotoxicity. Recently, neutral PEGylated liposomes (PLPs) have been modified with cell-penetrating peptides (CPPs) to enhance cellular uptake. We aim to establish CPP-modified neutral liposomes as viable molecular nanocarriers in vascular smooth muscle cells. METHODS CLPs, PLPs, and CPP-modified PLPs (R8-PLPs) were assembled with short interfering RNA (siRNA) via ethanol injection. Characterization studies determined liposomal morphology, size, and charge. siRNA encapsulation efficiency was measured via RiboGreen assay. Vascular smooth muscle cells were exposed to equal lipid/siRNA across all groups. Rhodamine-labeled liposomes were used to quantify cell association via fluorometry, live/dead dual stain was used to measure cytotoxicity, and gene silencing was measured by quantitative polymerase chain reaction. RESULTS R8-PLPs exhibited increased encapsulation efficiency equivalent to CLPs. PLPs and R8-PLP-5 mol% and R8-PLP-10 mol% had no cytotoxic effect. CLPs demonstrated significant cytotoxicity. R8-PLP-5 mol% and R8-PLP-10 mol% exhibited increased cell association versus PLPs. R8-PLP-10 mol% resulted in significant gene silencing, in a manner dependent on lipid-to-siRNA load capacity. CONCLUSIONS The negligible cytotoxicity and enhanced cellular association and gene silencing capacity exhibited by R8-PLPs reveal this class of liposomes as a candidate for future applications. Further modifications for optimizing R8-PLPs are still warranted to improve efficacy, and in vivo studies are needed for translational development. However, this could prove to be an optimal nanocarrier for vascular gene therapeutics.
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Affiliation(s)
- Richard K Fisher
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | | | - Michael D Best
- Department of Chemistry, University of Tennessee, Knoxville, Tennessee
| | - Stacy S Kirkpatrick
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Michael B Freeman
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Oscar H Grandas
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Deidra J H Mountain
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
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14
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Long-term preclinical evaluation of bioabsorbable polymer-coated drug-eluting stent in a porcine model. Macromol Res 2017. [DOI: 10.1007/s13233-017-5067-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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15
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Koenig O, Nothdurft D, Perle N, Neumann B, Behring A, Degenkolbe I, Walker T, Schlensak C, Wendel HP, Nolte A. An Atelocollagen Coating for Efficient Local Gene Silencing by Using Small Interfering RNA. MOLECULAR THERAPY-NUCLEIC ACIDS 2017; 6:290-301. [PMID: 28325296 PMCID: PMC5363512 DOI: 10.1016/j.omtn.2017.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 01/13/2023]
Abstract
In the last decades, many efforts have been made to counteract adverse effects after stenting atherosclerotic coronary arteries. A breakthrough in better vascular wall regeneration was noted in the new era of drug-eluting stents. A novel personalized approach is the development of gene-eluting stents promising an alteration in gene expression involved in regeneration. We investigated a coating system consisting of the polymer atelocollagen (ATCOL) and a specific small interfering RNA (siRNA) for intercellular adhesion molecule-1 (ICAM-1) found on the surface of defective endothelial cells (ECs). We demonstrated very high cell viability, in which EA.hy926 grew on 0.008% or 0.032% ATCOL layers. Additionally, hemocompatibility assays proved the biocompatibility of this coating. The highest transfection efficiency with EA.hy926 was achieved with 5 μg siRNA immobilized in ATCOL after 2 days. The release of fluorescent-labeled siRNA was about 9 days. Long-term knockdown of ICAM-1 was analyzed by flow cytometry, revealing that the coating with 0.008% ATCOL and 5 μg siICAM-1 provoked gene silencing up to 8 days. 5′-RNA ligase-mediated rapid amplification of cDNA ends PCR (RLM-RACE-PCR) demonstrated the specificity of our established ATCOL gene-silencing coating, meaning that our coating is well suited for further investigations in in vivo studies. Herein, we would like to demonstrate that our ATCOL is well-suited for better artery wall regeneration after stent implantation.
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Affiliation(s)
- Olivia Koenig
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
| | - Dimitrios Nothdurft
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
| | - Nadja Perle
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
| | - Bernd Neumann
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
| | - Andreas Behring
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
| | - Ilka Degenkolbe
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
| | - Tobias Walker
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
| | - Christian Schlensak
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
| | - Hans Peter Wendel
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany.
| | - Andrea Nolte
- Department of Thoracic, Cardiac, and Vascular Surgery, University Hospital Tuebingen, Tuebingen, 72076 Baden-Wuerttemberg, Germany
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16
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Lekshmi KM, Che HL, Cho CS, Park IK. Drug- and Gene-eluting Stents for Preventing Coronary Restenosis. Chonnam Med J 2017; 53:14-27. [PMID: 28184335 PMCID: PMC5299126 DOI: 10.4068/cmj.2017.53.1.14] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/17/2016] [Accepted: 08/18/2016] [Indexed: 12/19/2022] Open
Abstract
Coronary artery disease (CAD) has been reported to be a major cause of death worldwide. Current treatment methods include atherectomy, coronary angioplasty (as a percutaneous coronary intervention), and coronary artery bypass. Among them, the insertion of stents into the coronary artery is one of the commonly used methods for CAD, although the formation of in-stent restenosis (ISR) is a major drawback, demanding improvement in stent technology. Stents can be improved using the delivery of DNA, siRNA, and miRNA rather than anti-inflammatory/anti-thrombotic drugs. In particular, genes that could interfere with the development of plaque around infected regions are conjugated on the stent surface to inhibit neointimal formation. Despite their potential benefits, it is necessary to explore the various properties of gene-eluting stents. Furthermore, multifunctional electronic stents that can be used as a biosensor and deliver drug- or gene-based on physiological condition will be a very promising way to the successful treatment of ISR. In this review, we have discussed the molecular mechanism of restenosis, the use of drug- and gene-eluting stents, and the possible roles that these stents have in the prevention and treatment of coronary restenosis. Further, we have explained how multifunctional electronic stents could be used as a biosensor and deliver drugs based on physiological conditions.
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Affiliation(s)
- Kamali Manickavasagam Lekshmi
- Department of Biomedical Sciences and BK21 PLUS Centre for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Korea
| | - Hui-Lian Che
- Department of Biomedical Sciences and BK21 PLUS Centre for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Korea.; Heart Research Centre, Chonnam National University Hospital, Gwangju, Korea
| | - Chong-Su Cho
- Department of Agricultural Biotechnology and Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea
| | - In-Kyu Park
- Department of Biomedical Sciences and BK21 PLUS Centre for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Korea
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17
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Preparation of a Microporous Polyurethane Film with Negative Surface Charge for siRNA Delivery via Stent. INT J POLYM SCI 2017. [DOI: 10.1155/2017/2841682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Polyurethane (PU) and polyethylene glycol (PEG) were used to prepare a porous stent-covering material for the controlled delivery of small interfering RNA (siRNA). Microporous polymer films were prepared using a blend of polyurethane and water-soluble polyethylene glycol by the solution casting method; the PEG component was extracted in water to make the film microporous. This film was dipped in 2% poly(methyl methacrylate-co-methacrylic acid) solution to coat the polymer film with the anionic polyelectrolyte. The chemical components of the film surface were characterized by Fourier Transform Infrared (FTIR) spectroscopy and its structural morphology was examined by scanning electron microscopy (SEM). The effect of the negatively charged surface after attachment of a fluorescein isothiocyanate- (FITC-) labeled siRNA-polyethyleneimine complex onto the microporous polyurethane film and the controlled release of the complex from the film was investigated by fluorescence microscopy. Fluorescence microscopy showed the PU surface with intense fluorescence by the aggregates of the FITC-labeled-siRNA-PEI complex (measuring up to few microns in size); additionally, the negatively charged PU surface revealed broad and diffuse fluorescence. These results suggest that the construction of negatively charged microporous polyurethane films is feasible and could be applied for enhancing the efficiency of siRNA delivery via a stent-covering polyurethane film.
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18
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Jang S, Jeong MH, Lim KS, Bae IH, Park JK, Park DS, Shim JW, Kim JH, Kim HK, Sim DS, Hong YJ, Ahn Y, Kang JC. Effect of Stents Coated with Artemisinin or Dihydroartemisinin in a Porcine Coronary Restenosis Model. Korean Circ J 2016; 47:115-122. [PMID: 28154599 PMCID: PMC5287173 DOI: 10.4070/kcj.2016.0278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/09/2016] [Accepted: 08/23/2016] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives Artemisinin and dihydroartemisinin are drugs used to treat malaria. These drugs suppress inflammatory reactions. The aim of this study was to examine the anti-intima hyperplasia effect of a novel drug-eluting stent with artemisinin or dihydroartemisinin in a porcine coronary restenosis model. Materials and Methods Pigs were randomized into four groups; in the first, the coronary arteries (20 pigs, a total of 40 coronary arteries, with 10 coronary arteries in each group) was implanted with bare metal stents (BMS, n=10); the second group was given polymer-coated stents (PCS, n=10); the third group was treated with artemisinin-eluting stents (AES, n=10); and the fourth group was given dihydroartemisinin-eluting stents (DAES, n=10). Histopathologic analysis was performed 28 days after stenting. Results The injury and fibrin scores among the four groups were not significantly different. However, the internal elastic lamina, lumen area, and neointima area were significantly different. Moreover, the percent area of stenosis (46.2±18.66% in BMS vs. 89.4±10.92% in PCS vs. 83.3±17.07% in AES vs. 36.7±11.20% in DAES, p<0.0001) and inflammation score (1.0 [range: 1.0-1.0] vs. 3.0 [range: 2.25-3.0] vs. 3.0 [range: 1.0-3.0] vs. 2.0 [range: 1.75-3.0] in BMS, PCS, AES, and DAES, respectively; p<0.001) were markedly decreased in the DAES group compared to the PCS group. Conclusion DES, which uses a natural substance, dihydroartemisinin, showed a neointima and inflammatory suppressive effect in a porcine coronary restenosis model.
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Affiliation(s)
- Suyoung Jang
- Korea Cardiovascular Stent Research Institute, Jangsung, Korea.; Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Korea Cardiovascular Stent Research Institute, Jangsung, Korea.; Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.; Regeneromics Research Center, Chonnam National University, Gwangju, Gwangju, Korea
| | - Kyung Seob Lim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - In Ho Bae
- Korea Cardiovascular Stent Research Institute, Jangsung, Korea.; Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Jun-Kyu Park
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Dae Sung Park
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Jae Won Shim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Jung Ha Kim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Hyun Kuk Kim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Doo Sun Sim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Jung Chaee Kang
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
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19
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Fishbein I, Alferiev IS, Chorny M, Levy RJ. Gene Delivery from Stents for Prevention of In-Stent Restenosis. EUROPEAN MEDICAL JOURNAL 2016. [DOI: 10.33590/emj/10314517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
The increasing sophistication of vascular stent design, especially devices that combine mechanical support with local drug delivery to the vascular wall, has resulted in major progress in the management of coronary and peripheral artery disease. This progress is reflected in expanded anatomical and clinical indications for stent angioplasty, with complementary reduction in bypass surgery rates and decreased need for target-lesion revascularisation. Nevertheless, even with second-generation drug-eluting stents (DES), the most common cause of stent failure, in-stent restenosis, while <10%, generates high numbers of cases due to the large scale of stent use (there are >1 million stent angioplasty procedures yearly in the USA alone). Gene-eluting stents (GES), the next generation of stent devices now in the preclinical phase of development, have evolved over the past two decades around the concept of localised vessel wall delivery of gene vectors attached to the stent struts. GES potentially provide several important advantages over DES, such as prolonged or even permanent anti-restenotic effect, capacity to deliver dissimilar impact on smooth muscle cells and endothelium, and fine-tuning of transgene expression and pharmacological effect with systemically administered therapeutics. Furthermore, GES can be used for treating non-occlusive lesions with the aim of slowing the underlying atherosclerotic process in the vessel wall. GES research at this time is concerned with achieving effective and safe transgene overexpression in the stented arteries, optimal vector choice, and proper techniques for vector immobilisation on the stent struts.
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Affiliation(s)
- Ilia Fishbein
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ivan S. Alferiev
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael Chorny
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert J. Levy
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania, Philadelphia, Pennsylvania, USA
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20
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Lee SY, Bae IH, Park DS, Jang EJ, Shim JW, Lim KS, Park JK, Sim DS, Jeong MH. Comparison of dextran-based sirolimus-eluting stents and PLA-based sirolimus-eluting stents in vitro and in vivo. J Biomed Mater Res A 2016; 105:301-310. [PMID: 27615559 DOI: 10.1002/jbm.a.35898] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 08/09/2016] [Accepted: 09/07/2016] [Indexed: 11/09/2022]
Abstract
The aim of this study was to compare dextran and Poly(l-lactide) (PLLA) polymer stent coatings as mediators for sirolimus (SRL) drug elution in a porcine coronary model. The bare metal stent (BMS) surface was first coated with a layer of SRL and then either dextran (DSS, a natural polymer) or PLA (PSS, a synthetic polymer). The release velocity of SRL was slightly faster in DSS than PSS over the first 7 days (78.5% and 62.3%, respectively, n = 10, p < 0.05) and continued to 28 days in both groups. The contact angle was dramatically decreased in DSS (38.7° ± 1.24) compared to BMS and PSS groups (72.7° ± 5.32 and 81.1º ± 1.70, respectively, n = 10, p < 0.05). Smooth muscle cell migration was arrested in both the DSS and PSS-treated groups compared to that in the nontreated group (4.2% ± 0.31, 5.8% ± 0.60, 80.0% ± 4.4, respectively, n = 10, p < 0.05). In the animal study, there were no significant differences in the injury score, the internal elastic lamina, and the lumen area among the groups. However, percent area stenosis was significantly decreased in the SRL-containing group (27.5% ± 2.52 in DSS and 27.9% ± 3.30 in PSS) compared to BMS (35.9% ± 3.51, p < 0.05). The fibrin score was higher in the PSS (2.9 ± 0.31) than BMS (2.1 ± 0.12) and DSS (2.5 ± 0.66). The inflammation score in the DSS (0.7 ± 0.21) was similar to that in the BMS (0.7 ± 0.12), which was dramatically lower than that PSS (1.5 ± 0.18, p < 0.005). Immunofluorescence analysis revealed that endothelialization was increased and inflammation prevented in the DSS. These results suggest that dextran may be useful for the fabrication of drug eluting stent as an alternative existing synthetic polymer. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 301-310, 2017.
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Affiliation(s)
- So-Youn Lee
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea.,Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - In-Ho Bae
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea.,Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - Dae Sung Park
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea.,Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - Eun-Jae Jang
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea.,Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - Jae-Won Shim
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea.,Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - Kyung Seob Lim
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea
| | - Jun-Kyu Park
- Department of Polymer Science and Engineering, Sunchon National University, Suncheon, 540-950, Republic of Korea
| | - Doo Sun Sim
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea.,Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea.,Department of Cardiology, Chonnam National University Hospital, Gwangju, 501-757, Republic of Korea
| | - Myung Ho Jeong
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea.,Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea.,Department of Cardiology, Chonnam National University Hospital, Gwangju, 501-757, Republic of Korea
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21
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Lim KS, Park JK, Jeong MH, Bae IH, Nah JW, Park DS, Sim JW, Kim JH, Lee SY, Jang EJ, Jang S, Kim HK, Sim DS, Kim IS, Hong YJ, Ahn Y, Kang JC. Optimal coating method for a dual-layer stent with sirolimus and alpha-lipoic acid in a porcine coronary restenosis model. Macromol Res 2016. [DOI: 10.1007/s13233-016-4082-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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22
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The use of polymer-based nanoparticles and nanostructured materials in treatment and diagnosis of cardiovascular diseases: Recent advances and emerging designs. Prog Polym Sci 2016. [DOI: 10.1016/j.progpolymsci.2016.01.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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23
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Lim KS, Park JK, Jeong MH, Bae IH, Nah JW, Park DS, Kim JM, Kim JH, Lee SY, Jang EJ, Jang S, Kim HK, Sim DS, Park KH, Hong YJ, Ahn Y, Kang JC. Effect of stents coated with a combination of sirolimus and alpha-lipoic acid in a porcine coronary restenosis model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:66. [PMID: 26886814 DOI: 10.1007/s10856-015-5622-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/05/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate antiproliferative sirolimus- and antioxidative alpha-lipoic acid (ALA)-eluting stents using biodegradable polymer [poly-L-lactic acid (PLA)] in a porcine coronary overstretch restenosis model. Forty coronary arteries of 20 pigs were randomized into four groups in which the coronary arteries had a bare metal stent (BMS, n = 10), ALA-eluting stent with PLA (AES, n = 10), sirolimus-eluting stent with PLA (SES, n = 10), or sirolimus- and ALA-eluting stent with PLA (SAS, n = 10). A histopathological analysis was performed 28 days after the stenting. The ALA and sirolimus released slowly over 30 days. There were no significant differences between groups in the injury or inflammation score; however, there were significant differences in the percent area of stenosis (56.2 ± 11.78% in BMS vs. 51.5 ± 12.20% in AES vs. 34.7 ± 7.23% in SES vs. 28.7 ± 7.30% in SAS, P < 0.0001) and fibrin score [1.0 (range 1.0-1.0) in BMS vs. 1.0 (range 1.0-1.0) in AES vs. 2.0 (range 2.0-2.0) in SES vs. 2.0 (range 2.0-2.0) in SAS, P < 0.0001] between the four groups. The percent area of stenosis based on micro-computed tomography corresponded with the restenosis rates based on histopathological stenosis in different proportions in the four groups (54.8 ± 7.88% in BMS vs. 50.4 ± 14.87% in AES vs. 34.5 ± 7.22% in SES vs. 28.9 ± 7.22% in SAS, P < 0.05). SAS showed a better neointimal inhibitory effect than BMS, AES, and SES at 1 month after stenting in a porcine coronary restenosis model. Therefore, SAS with PLA can be a useful drug combination for coronary stent coating to suppress neointimal hyperplasia.
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Affiliation(s)
- Kyung Seob Lim
- Korea Cardiovascular Stent Institute, Jangsung, Korea
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Jun-Kyu Park
- Department of Polymer Science and Engineering, Sunchon National University, Sunchon, Korea
| | - Myung Ho Jeong
- Korea Cardiovascular Stent Institute, Jangsung, Korea.
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea.
- Regeneromics Research Center, Chonnam National University, Gwangju, Korea.
| | - In-Ho Bae
- Korea Cardiovascular Stent Institute, Jangsung, Korea
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Jae-Woon Nah
- Department of Polymer Science and Engineering, Sunchon National University, Sunchon, Korea
| | - Dae Sung Park
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Jong Min Kim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Jung Ha Kim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - So Youn Lee
- Korea Cardiovascular Stent Institute, Jangsung, Korea
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Eun Jae Jang
- Korea Cardiovascular Stent Institute, Jangsung, Korea
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Suyoung Jang
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Hyun Kuk Kim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Doo Sun Sim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Keun-Ho Park
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Young Joon Hong
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Youngkeun Ahn
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
| | - Jung Chaee Kang
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Cardiovascular Research Center, Chonnam National University Hospital, 671, Dong-gu, Gwangju, 501-757, Korea
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Che HL, Bae IH, Lim KS, Uthaman S, Song IT, Lee H, Lee D, Kim WJ, Ahn Y, Park IK, Jeong MH. Novel Fabrication of MicroRNA Nanoparticle-Coated Coronary Stent for Prevention of Post-Angioplasty Restenosis. Korean Circ J 2016; 46:23-32. [PMID: 26798382 PMCID: PMC4720846 DOI: 10.4070/kcj.2016.46.1.23] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/08/2015] [Accepted: 07/16/2015] [Indexed: 12/05/2022] Open
Abstract
Background and Objectives MicroRNA 145 is known to be responsible for cellular proliferation, and its enhanced expression reportedly inhibits the retardation of vascular smooth muscle cell growth specifically. In this study, we developed a microRNA 145 nanoparticle immobilized, hyaluronic acid (HA)-coated stent. Materials and Methods For the gene therapy, we used disulfide cross-linked low molecular polyethylenimine as the carrier. The microRNA 145 was labeled with YOYO-1 and the fluorescent microscopy images were obtained. The release of microRNA 145 from the stent was measured with an ultra violet spectrophotometer. The downstream targeting of the c-Myc protein and green fluorescent protein was determined by Western blotting. Finally, we deployed microRNA 145/ssPEI nanoparticles immobilized on HA-coated stents in the balloon-injured external iliac artery in a rabbit restenosis model. Results Cellular viability of the nanoparticle-immobilized surface tested using A10 vascular smooth muscle cells showed that MSN exhibited negligible cytotoxicity. In addition, microRNA 145 and downstream signaling proteins were identified by western blots with smooth muscle cell (SMC) lysates from the transfected A10 cell, as the molecular mechanism for decreased SMC proliferation that results in the inhibition of in-stent restenosis. MicroRNA 145 released from the stent suppressed the growth of the smooth muscle at the peri-stent implantation area, resulting in the prevention of restenosis at the post-implantation. We investigated the qualitative analyses of in-stent restenosis in the rabbit model using micro-computed tomography imaging and histological staining. Conclusion MicroRNA 145-eluting stent mitigated in-stent restenosis efficiently with no side effects and can be considered a successful substitute to the current drug-eluting stent.
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Affiliation(s)
- Hui-Lian Che
- Department of Biomedical Sciences and BK21 PLUS Center for Creative Biomedical Scientists, Gwangju, Korea
- Heart Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - In-Ho Bae
- Heart Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Seob Lim
- Heart Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Saji Uthaman
- Department of Biomedical Sciences and BK21 PLUS Center for Creative Biomedical Scientists, Gwangju, Korea
| | - In Taek Song
- The Graduate School of Nanoscience and Technology and Department of Chemistry, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Haeshin Lee
- The Graduate School of Nanoscience and Technology and Department of Chemistry, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Duhwan Lee
- Center for Self-assembly and Complexicity, Department of Chemistry, Pohang University of Science and Technology, Pohang, Korea
| | - Won Jong Kim
- Center for Self-assembly and Complexicity, Department of Chemistry, Pohang University of Science and Technology, Pohang, Korea
| | - Youngkeun Ahn
- Heart Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - In-Kyu Park
- Department of Biomedical Sciences and BK21 PLUS Center for Creative Biomedical Scientists, Gwangju, Korea
| | - Myung-Ho Jeong
- Heart Research Center, Chonnam National University Hospital, Gwangju, Korea
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Yu Y, Wise SG, Celermajer DS, Bilek MMM, Ng MKC. Bioengineering stents with proactive biocompatibility. Interv Cardiol 2015. [DOI: 10.2217/ica.15.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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26
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The Effects of Cu-doped TiO2 Thin Films on Hyperplasia, Inflammation and Bacteria Infection. APPLIED SCIENCES-BASEL 2015. [DOI: 10.3390/app5041016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Jang EJ, Bae IH, Park DS, Lee SY, Lim KS, Park JK, Shim JW, Sim DS, Jeong MH. Effect of a novel peptide, WKYMVm- and sirolimus-coated stent on re-endothelialization and anti-restenosis. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:251. [PMID: 26438653 DOI: 10.1007/s10856-015-5585-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 09/25/2015] [Indexed: 06/05/2023]
Abstract
The drug-eluting stent still has limitations such as thrombosis and inflammation. These limitations often occur in the absence of endothelialization. This study investigated the effects of WKYMVm- and sirolimus-coated stents on re-endothelialization and anti-restenosis. The WKYMVm peptide, specially synthesized for homing endothelial colony-forming cells, was coated onto a bare-metal stent with hyaluronic acid through a simple dip-coating method (designated HA-Pep). Thereafter, sirolimus was consecutively coated to onto the HA-Pep (designated Pep/SRL). The cellular response to stents by human umbilical-vein endothelial cells and vascular smooth-muscle cells was examined by XTT assay. Stents were implanted into rabbit iliac arteries, isolated 6 weeks post-implantation, and then subjected to histological analysis. The peptide was well attached to the surface of the stents and the sirolimus coating made the surface smooth. The release pattern for sirolimus was similar to that of commercial sirolimus-coated stents (57.2% within 7 days, with further release for up to 28 days). Endothelial-cell proliferation was enhanced in the HA-Pep group after 7 days of culture (38.2 ± 7.62%, compared with controls). On the other hand, the proliferation of smooth-muscle cells was inhibited in the Pep/SRL group after 7 days of culture (40.7 ± 6.71%, compared with controls). In an animal study, the restenosis rates for the Pep/SRL group (13.5 ± 4.50%) and commercial drug-eluting stents (Xience Prime™; 9.2 ± 7.20%) were lower than those for bare-metal stents (25.2 ± 4.52%) and HA-Pep stents (26.9 ± 3.88%). CD31 staining was incomplete for the bare-metal and Xience Prime™ groups. On the other hand, CD31 staining showed a consecutive linear pattern in the HA-Pep and Pep/SRL groups, suggesting that WKYMVm promotes endothelialization. These results indicate that the WKYMVm coating could promote endothelial healing, and consecutive coatings of WKYMVm and sirolimus onto bare-metal stents have a potential role in re-endothelialization and neointimal suppression.
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Affiliation(s)
- Eun-Jae Jang
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea
- Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - In-Ho Bae
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea
- Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - Dae Sung Park
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea
- Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - So-Youn Lee
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea
- Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - Kyung Seob Lim
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea
| | - Jun-Kyu Park
- Department of Polymer Science and Engineering, Sunchon National University, Suncheon, 540-950, Republic of Korea
| | - Jae-Won Shim
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea
- Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
| | - Doo Sun Sim
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea
- Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 501-757, Republic of Korea
| | - Myung Ho Jeong
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, 501-757, Republic of Korea.
- Korea Cardiovascular Stent Research Institute, Jangsung, 501-893, Republic of Korea.
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 501-757, Republic of Korea.
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Bools LM, Fisher RK, Grandas OH, Kirkpatrick SS, Arnold JD, Goldman MH, Freeman MB, Mountain DJH. Comparative analysis of polymers for short interfering RNA delivery in vascular smooth muscle cells. J Surg Res 2015; 199:266-73. [PMID: 26272685 DOI: 10.1016/j.jss.2015.07.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 07/08/2015] [Accepted: 07/13/2015] [Indexed: 12/31/2022]
Abstract
UNLABELLED The use of short interfering RNA (siRNA) to degrade messenger RNA in the cell cytoplasm and transiently attenuate intracellular proteins shows promise in the inhibition of vascular pathogenesis. However, a critical obstacle for therapeutic application is a safe and effective delivery system. Biodegradable polymers are promising alternative molecular carriers for genetic material. Here, we aim to perform a comparative analysis of poly(B-amino ester) (PBAE) and polyethylenimine (PEI) polymers in their efficacy for vascular smooth muscle cell transfection using siRNA against the glyceraldehyde 3-phosphate dehydrogenase (GAPDH) housekeeping gene as our test target. METHODS Human aortic smooth muscle cells (HASMC) were transfected in vitro with polymers conjugated to GAPDH or negative control (NC) siRNAs. Increasing siRNA:polymer ratios were tested for optimal transfection efficiency. DharmaFECT2 chemical transfection complexes were used for comparative analysis. Live/dead dual stain was used to measure cell viability, and GAPDH gene silencing was measured by quantitative polymerase chain reaction normalized to 18S. RESULTS The highest rate of PEI-mediated silencing was achieved with a 9μL polymer:220 pmol/mL siRNA conjugate (16 ± 2% expression versus NC; n = 6). Comparable PBAE-mediated silencing could be achieved with a 1.95μL polymer:100 pmol/mL siRNA conjugate (10 ± 1% expression versus NC; n = 5). Transfection using PEIs resulted in silencing equivalent to other methods but with less efficiency and increased cell toxicity at 24h polymer exposure. Decreasing PEI exposure time to 4 h resulted in similar silencing efficacy (21 ± 9% expression versus NC, n = 6) with an improved toxicity profile. CONCLUSIONS Polymeric bioconjugates transfected HASMCs in a manner similar to chemical complexes, with comparable cell toxicity and silencing efficiency. PEI bioconjugates demonstrated silencing equivalent to PBAE bioconjugates, although less efficient in terms of required polymer concentrations. Given the cost-to-benefit difference between the assayed polymers, and PEI's ability to transfect HASMCs within a short duration of exposure with an improved toxicity profile, this study shows that PEI bioconjugates are a potential transfection agent for vascular tissue. Future studies will expand on this method of gene therapy to validate delivery of gene-specific inhibitors aimed at attenuating smooth muscle cell proliferation, adhesion, and migration. These studies will lay the framework for our future experimental plans to expand on this method of gene therapy for in vivo transfection in animal models of vascular disease.
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Affiliation(s)
- Lindsay M Bools
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Richard K Fisher
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Oscar H Grandas
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Stacy S Kirkpatrick
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Joshua D Arnold
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Mitchell H Goldman
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Michael B Freeman
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Deidra J H Mountain
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
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29
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Kim NY, Lim KS, Jeong MH, Bae IH, Park JK, Nah JW, Park DS, Lee SY, Jang EJ, Kim JM, Kim JH, Kee HJ, Cho SN, Sim DS, Park KH, Hong YJ, Oh SG, Kim SH, Ahn Y, Kang JC. Reliable femoral chronic total occlusion model using a thin biodegradable polymer coated copper stent in a porcine model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:172. [PMID: 25804307 DOI: 10.1007/s10856-015-5506-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 02/09/2015] [Indexed: 06/04/2023]
Abstract
Chronic total occlusions (CTOs) are common in patients with peripheral arterial disease (PAD). This study aimed to examine the feasibility and reliability of a CTO induced by a thin biodegradable polymer (polyglycolic acid) coated copper stent in a porcine femoral artery. Novel thin biodegradable polymer coated copper stents (9 mm long) were crimped on an angioplasty balloon (4.5 mm diameter × 12 mm length) and inserted into the femoral artery. Histopathologic analysis was performed 35 days after stenting. In five of six stented femoral arteries, severe in-stent restenosis and total occlusion with collateral circulation were observed without adverse effects such as acute stent thrombosis, leg necrosis, or death at 5 weeks. Fibrous tissue deposition, small vascular channels, calcification, and inflammatory cells were observed in hematoxylin-eosin, Carstair's, and von Kossa tissue stains; these characteristics were similar to pathological findings associated with CTOs in humans. The neointima volume measured by micro-computed tomography was 93.9 ± 4.04 % in the stented femoral arteries. CTOs were reliably induced by novel thin biodegradable polymer coated copper stents in porcine femoral arteries. Successful induction of CTOs may provide a practical understanding of their formation and application of an interventional device for CTO treatment.
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Affiliation(s)
- Nan Yeol Kim
- Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea
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Formulation of glutathione responsive anti-proliferative nanoparticles from thiolated Akt1 siRNA and disulfide-crosslinked PEI for efficient anti-cancer gene therapy. Colloids Surf B Biointerfaces 2014; 126:322-7. [PMID: 25576812 DOI: 10.1016/j.colsurfb.2014.12.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 11/04/2014] [Accepted: 12/11/2014] [Indexed: 12/24/2022]
Abstract
In this study, thiol-modified siRNA (SH-siRNA) was delivered by bioreducible polyethylenimine (ssPEI), to enhance physicochemical properties of polyplexes and function of siRNA through disulfide bonding between SH-siRNA and ssPEI. The ssPEI was utilized to deliver Akt1 SH-siRNA for suppression of Akt1 mRNA and blockage of Akt1 protein translation, resulting in reduced cellular proliferation and the induction of apoptosis. Disulfide bondings between the ssPEI and SH-siRNA through thiol groups in both were confirmed by DTT treatment. Complexation between ssPEI and Akt1SH-siRNA was enhanced and reduced surface charge of ssPEI/Akt1SH-siRNA complexes with smaller average particle sizes even at lower N/P ratios was obtained compared with PEI/Akt1siRNA ones. Cellular uptake of ssPEI/Akt1SH-siRNA complexes in CT-26 mouse colon cancer cells was also enhanced. The ssPEI/Akt1SH-siRNA complexes reduced proliferation and increased apoptosis of mouse colon cancer cells in vitro. In an in vivo mouse tumor model, the complexes reduced tumor proliferation and downregulation of Akt1 compared to controls.
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31
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Effect of polymer-free TiO2 stent coated with abciximab or alpha lipoic acid in porcine coronary restenosis model. J Cardiol 2014; 64:409-18. [DOI: 10.1016/j.jjcc.2014.02.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 01/21/2014] [Accepted: 02/06/2014] [Indexed: 11/21/2022]
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33
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Yin RX, Yang DZ, Wu JZ. Nanoparticle drug- and gene-eluting stents for the prevention and treatment of coronary restenosis. Theranostics 2014; 4:175-200. [PMID: 24465275 PMCID: PMC3900802 DOI: 10.7150/thno.7210] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 10/23/2013] [Indexed: 01/16/2023] Open
Abstract
Percutaneous coronary intervention (PCI) has become the most common revascularization procedure for coronary artery disease. The use of stents has reduced the rate of restenosis by preventing elastic recoil and negative remodeling. However, in-stent restenosis remains one of the major drawbacks of this procedure. Drug-eluting stents (DESs) have proven to be effective in reducing the risk of late restenosis, but the use of currently marketed DESs presents safety concerns, including the non-specificity of therapeutics, incomplete endothelialization leading to late thrombosis, the need for long-term anti-platelet agents, and local hypersensitivity to polymer delivery matrices. In addition, the current DESs lack the capacity for adjustment of the drug dose and release kinetics appropriate to the disease status of the treated vessel. The development of efficacious therapeutic strategies to prevent and inhibit restenosis after PCI is critical for the treatment of coronary artery disease. The administration of drugs using biodegradable polymer nanoparticles as carriers has generated immense interest due to their excellent biocompatibility and ability to facilitate prolonged drug release. Despite the potential benefits of nanoparticles as smart drug delivery and diagnostic systems, much research is still required to evaluate potential toxicity issues related to the chemical properties of nanoparticle materials, as well as to their size and shape. This review describes the molecular mechanism of coronary restenosis, the use of DESs, and progress in nanoparticle drug- or gene-eluting stents for the prevention and treatment of coronary restenosis.
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Lee JM, Lee J, Jeong H, Choe WS, Seo WW, Lim WH, Kim YC, Hur J, Lee SE, Yang HM, Cho HJ, Kim HS. Development of a rabbit model for a preclinical comparison of coronary stent types in-vivo. Korean Circ J 2013; 43:713-22. [PMID: 24363745 PMCID: PMC3866309 DOI: 10.4070/kcj.2013.43.11.713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/02/2013] [Accepted: 09/03/2013] [Indexed: 01/30/2023] Open
Abstract
Along with the development of innovative stent designs, preclinical trials in animal models are essential. Many animal models have been used and appear to yield comparable results to clinical trials despite substantial criticisms about their validity. Among the animal models, porcine coronary artery models have been the standard models for the preclinical evaluation of endovascular devices. However, rapid growth rate, high body weight potential, and the propensity to develop granulomatous inflammatory reactions are major limitations of the porcine coronary artery model. Compared with porcine coronary artery models, the comparative rabbit iliac artery model has the advantages of being small and easy to handle and relatively inexpensive. Furthermore, the rabbit model has been known to reliably reflect human restenosis histopathologically and have major advantages such as pairwise comparison, which makes each animal serve as its own control subject, therefore, maximizing its statistical power for comparative testing. However, despite the widespread use of this model, a systematic description of the procedure and harvest protocols has never been published. This article describes the surgical procedure, stent implantation procedure, method for tissue harvesting, and how measurements are performed. Although the results of animal models may not perfectly extrapolate to humans, the comparative rabbit iliac artery model may be a useful tool for assessing and comparing the efficacy of new coronary stents with conventional stent systems. This thorough description of the techniques required for vascular access, stent implantation, tissue preparation, and measurement, should aid investigators wishing to begin using the comparative rabbit iliac artery model.
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Affiliation(s)
- Joo Myung Lee
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Jaewon Lee
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Heewon Jeong
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Won Seok Choe
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Won-Woo Seo
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Woo-Hyun Lim
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Young-Chan Kim
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Jin Hur
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Sang Eun Lee
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Han-Mo Yang
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Hyun-Jai Cho
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea
| | - Hyo-Soo Kim
- Innovative Research Institute for Cell Therapy, Seoul National University Hospital, Seoul, Korea. ; World Class University Program, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea
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Abstract
Restenosis and stent thrombosis remain major concerns after percutaneous coronary intervention for the treatment of coronary artery disease. The present review was undertaken in order to highlight the various coronary stents that have been investigated in our Heart Research Center, and how far we have come from the first heparin-coated stent first used in the late 1990s. Thereafter, from the abciximab-coated stent to the current gene-delivery stent and other newer agents, our group has applied a range of techniques in this field. However, in groups similar to ours, the restenosis rates of such stents are still high for second-generation drug-eluting stents (DESs). Moreover, our nation imports almost all of these types of stents from other countries. Thus, we need to develop domestic coronary stents. Research into newer DESs are warranted in Korea so as to achieve improved safety and efficacy outcomes.
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Affiliation(s)
- Jae Yeong Cho
- Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea
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Koenig O, Walker T, Perle N, Zech A, Neumann B, Schlensak C, Wendel HP, Nolte A. New aspects of gene-silencing for the treatment of cardiovascular diseases. Pharmaceuticals (Basel) 2013; 6:881-914. [PMID: 24276320 PMCID: PMC3816708 DOI: 10.3390/ph6070881] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 06/15/2013] [Accepted: 07/11/2013] [Indexed: 01/17/2023] Open
Abstract
Coronary heart disease (CHD), mainly caused by atherosclerosis, represents the single leading cause of death in industrialized countries. Besides the classical interventional therapies new applications for treatment of vascular wall pathologies are appearing on the horizon. RNA interference (RNAi) represents a novel therapeutic strategy due to sequence-specific gene-silencing through the use of small interfering RNA (siRNA). The modulation of gene expression by short RNAs provides a powerful tool to theoretically silence any disease-related or disease-promoting gene of interest. In this review we outline the RNAi mechanisms, the currently used delivery systems and their possible applications to the cardiovascular system. Especially, the optimization of the targeting and transfection procedures could enhance the efficiency of siRNA delivery drastically and might open the way to clinical applicability. The new findings of the last years may show the techniques to new innovative therapies and could probably play an important role in treating CHD in the future.
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Affiliation(s)
- Olivia Koenig
- Clinical Research Laboratory, Dept. of Thoracic, Cardiac and Vascular Surgery, University Hospital Tuebingen, Calwerstr. 7/1, 72076 Tuebingen, Germany.
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Castleberry S, Wang M, Hammond PT. Nanolayered siRNA dressing for sustained localized knockdown. ACS NANO 2013; 7:5251-61. [PMID: 23672676 PMCID: PMC3873513 DOI: 10.1021/nn401011n] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The success of RNA interference (RNAi) in medicine relies on the development of technology capable of successfully delivering it to tissues of interest. Significant research has focused on the difficult task of systemic delivery of RNAi; however its local delivery could be a more easily realized approach. Localized delivery is of particular interest for many medical applications, including the treatment of localized diseases, the modulation of cellular response to implants or tissue engineering constructs, and the management of wound healing and regenerative medicine. In this work we present an ultrathin electrostatically assembled coating for localized and sustained delivery of short interfering RNA (siRNA). This film was applied to a commercially available woven nylon dressing commonly used for surgical applications and was demonstrated to sustain significant knockdown of protein expression in multiple cell types for more than one week in vitro. Significantly, this coating can be easily applied to a medically relevant device and requires no externally delivered transfection agents for effective delivery of siRNA. These results present promising opportunities for the localized administration of RNAi.
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Affiliation(s)
- Steven Castleberry
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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Liao ZX, Hsiao CW, Ho YC, Chen HL, Sung HW. Disulfide bond-conjugated dual PEGylated siRNAs for prolonged multiple gene silencing. Biomaterials 2013; 34:6930-7. [PMID: 23769418 DOI: 10.1016/j.biomaterials.2013.05.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 05/23/2013] [Indexed: 02/06/2023]
Abstract
Many human diseases carry at least two independent gene mutations, further exacerbating clinical disorders. In this work, disulfide bond-conjugated dual PEGylated siRNAs were synthesized, capable of specifically targeting and silencing two genes simultaneously. To achieve efficient delivery, the conjugated siRNAs were formulated with the cationic chitosan together with an anionic polymer, poly(γ-glutamic acid) (γPGA), to form a ternary complex. Experimental results indicate that the incorporated γPGA could significantly enhance their intracellular delivery efficiency, allowing for reduction of the disulfide bond-conjugated PEGylated siRNAs delivered to the PEGylated siRNAs in the reductive cytoplasmic environment. The PEGylated siRNAs could more significantly increase their enzymatic tolerability, effectively silence multiple genes, and prolong the duration of their gene silencing capability than the unmodified siRNAs could. Silencing of different genes simultaneously significantly contributes to the efforts to treat multiple gene disorders, and prolonged duration of gene silencing can reduce the need for frequent administrations.
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Affiliation(s)
- Zi-Xian Liao
- Department of Chemical Engineering and Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan, ROC
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39
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Lim KS, Bae IH, Kim JH, Park DS, Kim JM, Kim JH, Sim DS, Hong YJ, Jeong MH. Mechanical and Histopathological Comparison between Commercialized and Newly Designed Coronary Bare Metal Stents in a Porcine Coronary Restenosis Model. Chonnam Med J 2013; 49:7-13. [PMID: 23678471 PMCID: PMC3651989 DOI: 10.4068/cmj.2013.49.1.7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 03/28/2013] [Accepted: 03/29/2013] [Indexed: 11/11/2022] Open
Abstract
The aim of this study was to compare the stent designed by Chonnam National University Hospital (designated as CNUH) with commercial cobalt-chromium coronary stent in a porcine coronary overstretch restenosis model. CNUH stent was subjected to mechanical performance tests. Pigs were randomized into two groups in which the coronary arteries (10 pigs, 10 coronaries in each group) had either CNUH stent or control commercial bare metal stent. Histopathologic analysis was assessed at 28 days after stenting. In mechanical performance tests, CNUH stent showed 2.65N, 35.1N, 0.52N, 1.94%, 4.29% in the flat plate radial compression, radial force, 3 point bending, Foreshortening and recoil test, respectively. There was no significant difference in the injury score, internal elastic lamina (IEL), lumen area, neointima area, percent area stenosis, inflammation score and fibrin score between the two groups (1.2±0.35, 4.1±0.41 mm2, 2.7±0.56 mm2, 1.6±0.47 mm2, 36.7±11.2%, 1.2±0.62, 0.2±0.34 in CNUH stent group vs. 1.2±0.38, 3.7±0.64 mm2, 2.5±0.49 mm2, 1.5±0.61 mm2, 36.3±12.17%, 1.1±0.12, 0.4±0.46 in commercial stent group, respectively). In the mechanical performance test, CNUH stent showed the moderated performance under the guideline of FDA. CNUH stent demonstrated similar histological reactions compared with commercial cobalt-chromium stent in a porcine coronary overstretch restenosis model.
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Affiliation(s)
- Kyung Seob Lim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
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Ma G, Wang Y, Fishbein I, Yu M, Zhang L, Alferiev IS, Yang J, Song C, Levy RJ. Anchoring of self-assembled plasmid DNA/anti-DNA antibody/cationic lipid micelles on bisphosphonate-modified stent for cardiovascular gene delivery. Int J Nanomedicine 2013; 8:1029-35. [PMID: 23687446 PMCID: PMC3655620 DOI: 10.2147/ijn.s40077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Indexed: 01/24/2023] Open
Abstract
Purpose: To investigate the anchoring of plasmid DNA/anti-DNA antibody/cationic lipid tri-complex (DAC
micelles) onto bisphosphonate-modified 316 L coronary stents for cardiovascular site-specific gene
delivery. Methods: Stents were first modified with polyallylamine bisphosphonate (PAA-BP), thereby enabling the
retention of a PAA-BP molecular monolayer that permits the anchoring (via vector-binding molecules)
of DAC micelles. DAC micelles were then chemically linked onto the PAA-BP-modified stents by using
N-succinimidyl-3-(2-pyridyldithiol)-propionate (SPDP) as a crosslinker. Rhodamine-labeled DNA was
used to assess the anchoring of DAC micelles, and radioactive-labeled antibody was used to evaluate
binding capacity and stability. DAC micelles (encoding green fluorescent protein) were tethered onto
the PAA-BP-modified stents, which were assessed in cell culture. The presence of a PAA-BP molecular
monolayer on the steel surface was confirmed by X-ray photoelectron spectroscopy and atomic force
microscope analysis. Results: The anchoring of DAC micelles was generally uniform and devoid of large-scale patches of defects.
Isotopic quantification confirmed that the amount of antibody chemically linked on the stents was
17-fold higher than that of the physical adsorbed control stents and its retention time was also
significantly longer. In cell culture, numerous green fluorescent protein-positive cells were found
on the PAA-BP modified stents, which demonstrated high localization and efficiency of gene
delivery. Conclusion: The DAC micelle-immobilized PAA-BP-modified stents were successful as a gene delivery system.
Gene delivery using DAC micelle-tethered stent-based PAA-BP functionalization should be suitable for
a wide array of single or multiple therapeutic gene strategies, and could be used on cardiovascular
metallic implants for achieving efficient gene therapy.
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Affiliation(s)
- Guilei Ma
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People's Republic of China
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41
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Fishbein I, Chorny M, Adamo RF, Forbes SP, Corrales RA, Alferiev IS, Levy RJ. Endovascular Gene Delivery from a Stent Platform: Gene- Eluting Stents. ACTA ACUST UNITED AC 2013. [PMID: 26225356 PMCID: PMC4516395 DOI: 10.4172/2329-9495.1000109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A synergistic impact of research in the fields of post-angioplasty restenosis, drug-eluting stents and vascular gene therapy over the past 15 years has shaped the concept of gene-eluting stents. Gene-eluting stents hold promise of overcoming some biological and technical problems inherent to drug-eluting stent technology. As the field of gene-eluting stents matures it becomes evident that all three main design modules of a gene-eluting stent: a therapeutic transgene, a vector and a delivery system are equally important for accomplishing sustained inhibition of neointimal formation in arteries treated with gene delivery stents. This review summarizes prior work on stent-based gene delivery and discusses the main optimization strategies required to move the field of gene-eluting stents to clinical translation.
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Affiliation(s)
- Ilia Fishbein
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA ; The University of Pennsylvania, USA
| | - Michael Chorny
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA ; The University of Pennsylvania, USA
| | - Richard F Adamo
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA
| | - Scott P Forbes
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA
| | - Ricardo A Corrales
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA
| | - Ivan S Alferiev
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA ; The University of Pennsylvania, USA
| | - Robert J Levy
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA ; The University of Pennsylvania, USA
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