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DePietro DM, Trerotola SO. Choosing the right treatment for the right lesion, Part II: a narrative review of drug-coated balloon angioplasty and its evolving role in dialysis access maintenance. Cardiovasc Diagn Ther 2023; 13:233-259. [PMID: 36864970 PMCID: PMC9971313 DOI: 10.21037/cdt-22-497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023]
Abstract
Background and Objective Drug-coated balloons (DCBs) seek to inhibit restenosis in treated hemodialysis access lesions by delivering an anti-proliferative agent (paclitaxel) into the vessel wall. While DCBs have proven effective in the coronary and peripheral arterial vasculature, the evidence for their use in arteriovenous (AV) access has been less robust. In part two of this review, a comprehensive overview of DCB mechanisms, implementation, and design is provided, followed by an examination of the evidence basis for their use in AV access stenosis. Methods An electronic search was performed on PubMed and EMBASE to identify relevant randomized controlled trials (RCTs) comparing DCBs and plain balloon angioplasty from January 1, 2010 to June 30, 2022 published in English. As part of this narrative review, a review of DCB mechanisms of action, implementation, and design is provided, followed by a review of available RCTs and other studies. Key Content and Findings Numerous DCBs have been developed, each with unique properties, although the degree to which these differences impact clinical outcomes is unclear. Target lesion preparation, achieved by pre-dilation, and balloon inflation time have proven important factors in achieving optimal DCB treatment. Numerous RCTs have been performed, but have suffered from significant heterogeneity, and have often reported contrasting clinical results, making it difficult to draw conclusions on how to implement DCBs in daily practice. On the whole, it is likely there is a population of patients who benefit from DCB use, but it is unclear which patients benefit most and what device, technical, and procedural factors lead to optimal outcomes. Importantly, DCBs use appears safe in the end-stage renal disease (ESRD) population. Conclusions DCB implementation has been tempered by the lack of clear signal regarding the benefits of DCB use. As further evidence is obtained, it is possible that a precision-based approach to DCBs may shed light onto which patients will truly benefit from DCBs. Until that time, the evidence reviewed herein may serve to guide interventionalists in their decision making, knowing that DCBs appear safe when used in AV access and may provide some benefit in certain patients.
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Affiliation(s)
- Daniel M DePietro
- Division of Interventional Radiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Scott O Trerotola
- Division of Interventional Radiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Déglise S, Bechelli C, Allagnat F. Vascular smooth muscle cells in intimal hyperplasia, an update. Front Physiol 2023; 13:1081881. [PMID: 36685215 PMCID: PMC9845604 DOI: 10.3389/fphys.2022.1081881] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Arterial occlusive disease is the leading cause of death in Western countries. Core contemporary therapies for this disease include angioplasties, stents, endarterectomies and bypass surgery. However, these treatments suffer from high failure rates due to re-occlusive vascular wall adaptations and restenosis. Restenosis following vascular surgery is largely due to intimal hyperplasia. Intimal hyperplasia develops in response to vessel injury, leading to inflammation, vascular smooth muscle cells dedifferentiation, migration, proliferation and secretion of extra-cellular matrix into the vessel's innermost layer or intima. In this review, we describe the current state of knowledge on the origin and mechanisms underlying the dysregulated proliferation of vascular smooth muscle cells in intimal hyperplasia, and we present the new avenues of research targeting VSMC phenotype and proliferation.
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Adventitial injection of HA/SA hydrogel loaded with PLGA rapamycin nanoparticle inhibits neointimal hyperplasia in a rat aortic wire injury model. Drug Deliv Transl Res 2022; 12:2950-2959. [PMID: 35378720 DOI: 10.1007/s13346-022-01158-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 12/16/2022]
Abstract
Neointimal hyperplasia is a persistent complication after vascular interventions, and it is also the leading cause of vascular graft restenosis and failure after arterial interventions, so novel treatment methods are needed to treat this complication. We hypothesized that adventitial injection of HA/SA hydrogel loaded with PLGA rapamycin nanoparticle (hydrogel-PLGA-rapamycin) could inhibit neointimal hyperplasia in a rat aortic wire injury model. The HA/SA hydrogel was fabricated by the interaction of hyaluronic acid (HA), sodium alginate (SA), and CaCO3; and loaded with PLGA rapamycin nanoparticle or rhodamine uniformly. A SD rat aortic wire injury induced neointimal hyperplasia model was developed, the control group only received wire injury, the adventitial application group received 10 μL hydrogel-PLGA-rapamycin after wire injury, and the adventitial injection group received 10 μL hydrogel-PLGA-rapamycin injected into the aortic adventitia after wire injury. Tissues were harvested at day 21 and analyzed by histology and immunohistochemical staining. Hydrogel loaded with rhodamine can be successfully injected into the aortic adventitia and was encapsuled by the adventitia. The hydrogel could be seen beneath the adventitia after adventitial injection but was almost degraded at day 21. There was a significantly thinner neointima in the adventitial application group and adventitial injection group compared to the control group (p = 0.0009). There were also significantly fewer CD68+ (macrophages) cells (p = 0.0012), CD3+ (lymphocytes) cells (p = 0.0011), p-mTOR+ cells (p = 0.0019), PCNA+ cells (p = 0.0028) in the adventitial application and adventitial injection groups compared to the control group. The endothelial cells expressed arterial identity markers (Ephrin-B2 and dll-4) in all these three groups. Adventitial injection of hydrogel-PLGA-rapamycin can effectively inhibit neointimal hyperplasia after rat aortic wire injury. This may be a promising drug delivery method and therapeutic choice to inhibit neointimal hyperplasia after vascular interventions.
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Vallejo-Zamora JA, Vega-Cantu YI, Rodriguez C, Cordell GA, Rodriguez-Garcia A. Drug-Eluting, Bioresorbable Cardiovascular Stents─Challenges and Perspectives. ACS APPLIED BIO MATERIALS 2022; 5:4701-4717. [PMID: 36150217 DOI: 10.1021/acsabm.2c00551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Globally, the leading causes of natural death are attributed to coronary heart disease and type 1 and type 2 diabetes. High blood pressure levels, high cholesterol levels, smoking, and poor eating habits lead to the agglomeration of plaque in the arteries, reducing the blood flow. The implantation of devices used to unclog vessels, known as stents, sometimes results in a lack of irrigation due to the excessive proliferation of endothelial tissue within the blood vessels and is known as restenosis. The use of drug-eluting stents (DESs) to deliver antiproliferative drugs has led to the development of different encapsulation techniques. However, due to the potency of the drugs used in the initial stent designs, a chronic inflammatory reaction of the arterial wall known as thrombosis can cause a myocardial infarction (MI). One of the most promising drugs to reduce this risk is everolimus, which can be encapsulated in lipid systems for controlled release directly into the artery. This review aims to discuss the current status of stent design, fabrication, and functionalization. Variables such as the mechanical properties, metals and their alloys, drug encapsulation and controlled elution, and stent degradation are also addressed. Additionally, this review covers the use of polymeric surface coatings on stents and the recent advances in layer-by-layer coating and drug delivery. The advances in nanoencapsulation techniques such as liposomes and micro- and nanoemulsions and their functionalization in bioresorbable, drug-eluting stents are also highlighted.
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Affiliation(s)
- Julio A Vallejo-Zamora
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, Nuevo León64849, Mexico
| | - Yadira I Vega-Cantu
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, Nuevo León64849, Mexico
| | - Ciro Rodriguez
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, Nuevo León64849, Mexico
- Laboratorio Nacional de Manufactura Aditiva y Digital (MADIT), Apodaca, Nuevo León66629, Mexico
| | - Geoffrey A Cordell
- Natural Products, Inc., Evanston, Illinois60201, United States
- College of Pharmacy, University of Florida, Gainesville, Florida32610, United States
| | - Aida Rodriguez-Garcia
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, Nuevo León64849, Mexico
- Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Instituto de Biotecnología, Ciudad Universitaria, Ave. Pedro de Alba S/N, San Nicolás de los Garza, Nuevo León66455, Mexico
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InSilc Computational Tool for In Silico Optimization of Drug-Eluting Bioresorbable Vascular Scaffolds. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5311208. [PMID: 36105243 PMCID: PMC9467806 DOI: 10.1155/2022/5311208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
Stents made by different manufacturers must meet the requirements of standard in vitro mechanical tests performed under different physiological conditions in order to be validated. In addition to in vitro research, there is a need for in silico numerical simulations that can help during the stent prototyping phase. In silico simulations have the ability to give the same stent responses as well as the potential to reduce costs and time needed to carry out experimental tests. The goal of this paper is to show the achievements of the computational platform created as a result of the EU-funded project InSilc, used for numerical testing of most standard tests for validation of preproduction bioresorbable vascular scaffolds (BVSs). Within the platform, an ad hoc simulation protocol has been developed based on the finite element (FE) analysis program PAK and user interface software CAD Field and Solid. Two different designs of two different stents have been numerically simulated using this integrated tool, and the results have been demonstrated. The following standard tests have been performed: longitudinal tensile strength, local compression, kinking, and flex 1-3. Strut thickness and additional pocket holes (slots) in two different scaffolds have been used as representative parameters for comparing the mechanical characteristics of the stents (AB-BVS vs. AB-BVS-thinner and PLLA-prot vs. PLLA-plot-slot). The AB-BVS-thinner prototype shows better overall stress distribution than the AB-BVS, while the PLLA-prot shows better overall stress distribution in comparison to the PLLA-plot-slot. In all cases, the values of the maximum effective stresses are below 220 MPa—the value obtained by in vitro experiment. Despite the presented results, additional considerations should be included before the proposed software can be used as a validation tool for stent prototyping.
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Talimi R, Rabbani S, Mehryab F, Haeri A. Perivascular application of sirolimus multilayer nanofibrous mat for prevention of vascular stenosis: Preparation, In vitro characterization, and In vivo efficacy evaluation. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Macabrey D, Longchamp A, Déglise S, Allagnat F. Clinical Use of Hydrogen Sulfide to Protect Against Intimal Hyperplasia. Front Cardiovasc Med 2022; 9:876639. [PMID: 35479275 PMCID: PMC9035533 DOI: 10.3389/fcvm.2022.876639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/18/2022] [Indexed: 12/27/2022] Open
Abstract
Arterial occlusive disease is the narrowing of the arteries via atherosclerotic plaque buildup. The major risk factors for arterial occlusive disease are age, high levels of cholesterol and triglycerides, diabetes, high blood pressure, and smoking. Arterial occlusive disease is the leading cause of death in Western countries. Patients who suffer from arterial occlusive disease develop peripheral arterial disease (PAD) when the narrowing affects limbs, stroke when the narrowing affects carotid arteries, and heart disease when the narrowing affects coronary arteries. When lifestyle interventions (exercise, diet…) fail, the only solution remains surgical endovascular and open revascularization. Unfortunately, these surgeries still suffer from high failure rates due to re-occlusive vascular wall adaptations, which is largely due to intimal hyperplasia (IH). IH develops in response to vessel injury, leading to inflammation, vascular smooth muscle cells dedifferentiation, migration, proliferation and secretion of extra-cellular matrix into the vessel’s innermost layer or intima. Re-occlusive IH lesions result in costly and complex recurrent end-organ ischemia, and often lead to loss of limb, brain function, or life. Despite decades of IH research, limited therapies are currently available. Hydrogen sulfide (H2S) is an endogenous gasotransmitter derived from cysteine metabolism. Although environmental exposure to exogenous high H2S is toxic, endogenous H2S has important vasorelaxant, cytoprotective and anti-inflammatory properties. Its vasculo-protective properties have attracted a remarkable amount of attention, especially its ability to inhibit IH. This review summarizes IH pathophysiology and treatment, and provides an overview of the potential clinical role of H2S to prevent IH and restenosis.
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Affiliation(s)
- Diane Macabrey
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Alban Longchamp
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Sébastien Déglise
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Florent Allagnat
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
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Sivapragasam N, Matchar DB, Zhuang KD, Patel A, Pua U, Win HH, Chandramohan S, Venkatanarasimha N, Chua JME, Tan GWL, Irani FG, Leong S, Tay KH, Chong TT, Tan BS. Cost-Effectiveness of Drug-Coated Balloon Angioplasty Versus Conventional Balloon Angioplasty for Treating Below-the-Knee Arteries in Chronic Limb-Threatening Ischemia: The SINGA-PACLI Trial. Cardiovasc Intervent Radiol 2022; 45:1663-1669. [PMID: 35237860 DOI: 10.1007/s00270-022-03073-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/27/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Drug-coated balloon angioplasty (DCBA) has been studied as a potentially superior option compared to conventional percutaneous transluminal angioplasty (PTA) in treating below-the-knee (BTK) arteries in chronic limb-threatening ischemia (CLTI). The aim of this study is to examine the cost-effectiveness of DCBA versus PTA in BTK arteries based on a randomized controlled trial. MATERIAL AND METHODS A prospective economic study was embedded in a randomized controlled trial of 138 patients with CLTI. Resource use and health outcomes were assessed at baseline, and at 3, 6 and 12 months post-intervention. Costs were calculated from a societal perspective and health outcomes measured using quality-adjusted life years with probabilistic sensitivity analysis performed to account for subject heterogeneity. RESULTS Compared with participants randomized to receive PTA, participants randomized to DCBA gained an average baseline-adjusted quality-adjusted life years (QALYs) of .012 while average total costs were USD$1854 higher; this translates to an incremental cost-effectiveness ratio (ICER) of US$154,500 additional cost per QALY gained. However, the estimate of ICER had substantial variance with only 48% of bootstrap ICERs meeting a benchmark threshold of US$57,705 (the average gross domestic product (GDP) per capita of Singapore). CONCLUSION The use of DCBA in BTK arteries in CLTI patients was not cost-effective compared with PTA. LEVEL OF EVIDENCE 2, Randomized trial.
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Affiliation(s)
- Nirmali Sivapragasam
- Programme in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - David B Matchar
- Programme in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Kun Da Zhuang
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Ankur Patel
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Uei Pua
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore, 308433, Singapore
| | - Hlaing Hlaing Win
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Sivanathan Chandramohan
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Nanda Venkatanarasimha
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Jasmine M E Chua
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Glenn Wei Leong Tan
- Department of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore, 308433, Singapore
| | - Farah G Irani
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Sum Leong
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Kiang Hiong Tay
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
| | - Tze Tec Chong
- Department of Vascular Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Bien Soo Tan
- Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Programme, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore, 169608, Singapore
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Macabrey D, Deslarzes-Dubuis C, Longchamp A, Lambelet M, Ozaki CK, Corpataux JM, Allagnat F, Déglise S. Hydrogen Sulphide Release via the Angiotensin Converting Enzyme Inhibitor Zofenopril Prevents Intimal Hyperplasia in Human Vein Segments and in a Mouse Model of Carotid Artery Stenosis. Eur J Vasc Endovasc Surg 2021; 63:336-346. [PMID: 34916111 DOI: 10.1016/j.ejvs.2021.09.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/01/2021] [Accepted: 09/17/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hypertension is a major risk factor for intimal hyperplasia (IH) and re-stenosis following vascular and endovascular interventions. Preclinical studies suggest that hydrogen sulphide (H2S), an endogenous gasotransmitter, limits re-stenosis. While there is no clinically available pure H2S releasing compound, the sulfhydryl containing angiotensin converting enzyme inhibitor zofenopril is a source of H2S. Here, it was hypothesised that zofenopril, due to H2S release, would be superior to other non-sulfhydryl containing angiotensin converting enzyme inhibitors (ACEi) in reducing intimal hyperplasia. METHODS Spontaneously hypertensive male Cx40 deleted mice (Cx40-/-) or wild type (WT) littermates were randomly treated with enalapril 20 mg or zofenopril 30 mg. Discarded human vein segments and primary human smooth muscle cells (SMCs) were treated with the active compound enalaprilat or zofenoprilat. IH was evaluated in mice 28 days after focal carotid artery stenosis surgery and in human vein segments cultured for seven days ex vivo. Human primary smooth muscle cell (SMC) proliferation and migration were studied in vitro. RESULTS Compared with control animals (intima/media thickness 2.3 ± 0.33 μm), enalapril reduced IH in Cx40-/- hypertensive mice by 30% (1.7 ± 0.35 μm; p = .037), while zofenopril abrogated IH (0.4 ± 0.16 μm; p < .002 vs. control and p > .99 vs. sham operated Cx40-/- mice). In WT normotensive mice, enalapril had no effect (0.9665 ± 0.2 μm in control vs. 1.140 ± 0.27 μm; p > .99), while zofenopril also abrogated IH (0.1623 ± 0.07 μm; p < .008 vs. control and p > .99 vs. sham operated WT mice). Zofenoprilat, but not enalaprilat, also prevented IH in human vein segments ex vivo. The effect of zofenopril on carotid and SMCs correlated with reduced SMC proliferation and migration. Zofenoprilat inhibited the mitogen activated protein kinase and mammalian target of rapamycin pathways in SMCs and human vein segments. CONCLUSION Zofenopril provides extra beneficial effects compared with non-sulfhydryl ACEi in reducing SMC proliferation and re-stenosis, even in normotensive animals. These findings may hold broad clinical implications for patients suffering from vascular occlusive diseases and hypertension.
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Affiliation(s)
- Diane Macabrey
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Céline Deslarzes-Dubuis
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Alban Longchamp
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Martine Lambelet
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Charles K Ozaki
- Department of Surgery and the Heart and Vascular Centre, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jean-Marc Corpataux
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Florent Allagnat
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Sébastien Déglise
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
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Liposomal Nanocarriers Designed for Sub-Endothelial Matrix Targeting under Vascular Flow Conditions. Pharmaceutics 2021; 13:pharmaceutics13111816. [PMID: 34834231 PMCID: PMC8618675 DOI: 10.3390/pharmaceutics13111816] [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: 09/27/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022] Open
Abstract
Vascular interventions result in the disruption of the tunica intima and the exposure of sub-endothelial matrix proteins. Nanoparticles designed to bind to these exposed matrices could provide targeted drug delivery systems aimed at inhibiting dysfunctional vascular remodeling and improving intervention outcomes. Here, we present the progress in the development of targeted liposomal nanocarriers designed for preferential collagen IV binding under simulated static vascular flow conditions. PEGylated liposomes (PLPs), previously established as effective delivery systems in vascular cells types, served as non-targeting controls. Collagen-targeting liposomes (CT-PLPs) were formed by conjugating established collagen-binding peptides to modified lipid heads via click chemistry (CTL), and inserting them at varying mol% either at the time of PLP assembly or via micellar transfer. All groups included fluorescently labeled lipid species for imaging and quantification. Liposomes were exposed to collagen IV matrices statically or via hemodynamic flow, and binding was measured via fluorometric analyses. CT-PLPs formed with 5 mol% CTL at the time of assembly demonstrated the highest binding affinity to collagen IV under static conditions, while maintaining a nanoparticle characterization profile of ~50 nm size and a homogeneity polydispersity index (PDI) of ~0.2 favorable for clinical translation. When liposomes were exposed to collagen matrices within a pressurized flow system, empirically defined CT-PLPs demonstrated significant binding at shear stresses mimetic of physiological through pathological conditions in both the venous and arterial architectures. Furthermore, when human saphenous vein explants were perfused with liposomes within a closed bioreactor system, CT-PLPs demonstrated significant ex vivo binding to diseased vascular tissue. Ongoing studies aim to further develop CT-PLPs for controlled targeting in a rodent model of vascular injury. The CT-PLP nanocarriers established here show promise as the framework for a spatially controlled delivery platform for future application in targeted vascular therapeutics.
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Milosevic M, Anic M, Nikolic D, Geroski V, Milicevic B, Kojic M, Filipovic N. Application of in silico Platform for the Development and Optimization of Fully Bioresorbable Vascular Scaffold Designs. FRONTIERS IN MEDICAL TECHNOLOGY 2021; 3:724062. [PMID: 35047953 PMCID: PMC8757700 DOI: 10.3389/fmedt.2021.724062] [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: 06/11/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022] Open
Abstract
Bioresorbable vascular scaffolds (BVS), made either from polymers or from metals, are promising materials for treating coronary artery disease through the processes of percutaneous transluminal coronary angioplasty. Despite the opinion that bioresorbable polymers are more promising for coronary stents, their long-term advantages over metallic alloys have not yet been demonstrated. The development of new polymer-based BVS or optimization of the existing ones requires engineers to perform many very expensive mechanical tests to identify optimal structural geometry and material characteristics. in silico mechanical testing opens the possibility for a fast and low-cost process of analysis of all the mechanical characteristics and also provides the possibility to compare two or more competing designs. In this study, we used a recently introduced material model of poly-l-lactic acid (PLLA) fully bioresorbable vascular scaffold and recently empowered numerical InSilc platform to perform in silico mechanicals tests of two different stent designs with different material and geometrical characteristics. The result of inflation, radial compression, three-point bending, and two-plate crush tests shows that numerical procedures with true experimental constitutive relationships could provide reliable conclusions and a significant contribution to the optimization and design of bioresorbable polymer-based stents.
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Affiliation(s)
- Miljan Milosevic
- Bioengineering Research and Development Center, BioIRC, Kragujevac, Serbia
- Institute for Information Technologies, University of Kragujevac, Kragujevac, Serbia
- Faculty of Information Technologies, Belgrade Metropolitan University, Belgrade, Serbia
| | - Milos Anic
- Bioengineering Research and Development Center, BioIRC, Kragujevac, Serbia
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | - Dalibor Nikolic
- Bioengineering Research and Development Center, BioIRC, Kragujevac, Serbia
- Institute for Information Technologies, University of Kragujevac, Kragujevac, Serbia
| | - Vladimir Geroski
- Bioengineering Research and Development Center, BioIRC, Kragujevac, Serbia
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | - Bogdan Milicevic
- Bioengineering Research and Development Center, BioIRC, Kragujevac, Serbia
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | - Milos Kojic
- Bioengineering Research and Development Center, BioIRC, Kragujevac, Serbia
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, United States
- Serbian Academy of Sciences and Arts, Belgrade, Serbia
| | - Nenad Filipovic
- Bioengineering Research and Development Center, BioIRC, Kragujevac, Serbia
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
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Zhou R, Yu J, Gu Z, Zhang Y. Microneedle-mediated therapy for cardiovascular diseases. Drug Deliv Transl Res 2021; 12:472-483. [PMID: 34637115 DOI: 10.1007/s13346-021-01073-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
Cardiovascular diseases remain a leading cause of global disease burden. To date, the limited drug delivery efficacy confines the therapeutic effect in most conventional approaches, such as intramyocardial injections and vascular devices, due to short-term drug release and low retention within the disease sites. As a typical transdermal medical device with a minimally invasive manner and controlled/sustained drug release pattern, microneedles have gained momentum in the field of cardiovascular therapy, from which several cardiovascular diseases have been benefited to the ultimate therapeutic effects. In this concise review, strategies based on the microneedles for the treatments of cardiovascular diseases are introduced, mainly focus on hypertension, atherosclerosis, thrombus, and myocardial diseases. The limitations at the present stage and perspectives of the next-generation microneedles for cardiovascular therapy are also discussed.
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Affiliation(s)
- Ruyi Zhou
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Jicheng Yu
- Zenomics Inc., Los Angeles, CA, 90095, USA
| | - Zhen Gu
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China. .,Department of General Surgery, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, 310016, China. .,Zhejiang Laboratory of Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou, 311121, China. .,MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China.
| | - Yuqi Zhang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China. .,Department of Burns and Wound Center, College of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
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Patel A, Irani FG, Pua U, Tay KH, Chong TT, Leong S, Chan ESY, Tan GWL, Burgmans MC, Zhuang KD, Quek LHH, Kwan J, Damodharan K, Gogna A, Tan BP, Too CW, Chan SXJM, Chng SP, Yuan W, Tan BS. Randomized Controlled Trial Comparing Drug-coated Balloon Angioplasty versus Conventional Balloon Angioplasty for Treating Below-the-Knee Arteries in Critical Limb Ischemia: The SINGA-PACLI Trial. Radiology 2021; 300:715-724. [PMID: 34227886 DOI: 10.1148/radiol.2021204294] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background There is a paucity of randomized trials demonstrating superior efficacy of drug-coated balloon angioplasty (DCBA) compared with conventional percutaneous transluminal angioplasty (PTA) for below-the-knee arterial disease in patients with -critical limb ischemia. Purpose To compare DCBA versus PTA for below-the-knee lesions in participants with critical limb ischemia through 12 months. Materials and Methods In this prospective, randomized, two-center, double-blind superiority study, participants with critical limb ischemia with rest pain or tissue loss with atherosclerotic disease in the native below-the-knee arteries were randomly assigned (in a one-to-one ratio) to DCBA or PTA after stratification for diabetes and renal failure between November 2013 and October 2017. The primary efficacy end point was angiographic primary patency at 6 months analyzed on an intention-to-treat basis. Secondary end points through 12 months were composed of major adverse events including death and major amputations, wound healing, limb salvage, clinically driven target-lesion revascularization, and amputation-free survival. Primary and binary secondary end points, analyzed by using generalized-linear model and time-to-event analyses, were estimated with Kaplan-Meier survival curves and hazard ratios (Cox regression). Results Seventy participants (mean age, 61 years ± 10 [standard deviation]; 43 men) in the DCBA group and 68 (mean age, 64 years ± 10; 50 men) in the PTA group were evaluated. The percentage of patients with angiographic primary patency at 6 months was 43% (30 of 70) in the DCBA group and 38% (26 of 68) in the PTA group (P = .48). Through 12 months, the percentage of deaths was similar: 21% in the DCBA group and 16% in the PTA group (P = .43). Amputation-free survival rate assessed with Kaplan-Meier curves differed through 12 months: 59% (41 of 70) in the DCBA group compared with 78% (53 of 68) in the PTA group (P = .01). Conclusion In participants with critical limb ischemia, the drug-coated balloon angioplasty group and the conventional percutaneous transluminal angioplasty group had similar primary patency rates at 6 months after treatment of below-the-knee arteries. Amputation-free survival rates through 12 months were higher in the percutaneous transluminal angioplasty group. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Ankur Patel
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Farah G Irani
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Uei Pua
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Kiang Hiong Tay
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Tze Tec Chong
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Sum Leong
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Edwin Shih-Yen Chan
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Glenn Wei Leong Tan
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Mark C Burgmans
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Kun Da Zhuang
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Lawrence Han Hwee Quek
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Justin Kwan
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Karthikeyan Damodharan
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Apoorva Gogna
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Bien Peng Tan
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Chow Wei Too
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Shaun X Ju Min Chan
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Siew Ping Chng
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Wei Yuan
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
| | - Bien Soo Tan
- From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.)
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Lee HI, Rhim WK, Kang EY, Choi B, Kim JH, Han DK. A Multilayer Functionalized Drug-Eluting Balloon for Treatment of Coronary Artery Disease. Pharmaceutics 2021; 13:614. [PMID: 33922861 PMCID: PMC8146216 DOI: 10.3390/pharmaceutics13050614] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 12/22/2022] Open
Abstract
Drug-eluting balloons (DEBs) have been mostly exploited as an interventional remedy for treating atherosclerosis instead of cardiovascular stents. However, the therapeutic efficacy of DEB is limited due to their low drug delivery capability to the disease site. The aim of our study was to load drugs onto a balloon catheter with preventing drug loss during transition time and maximizing drug transfer from the surface of DEBs to the cardiovascular wall. For this, a multilayer-coated balloon catheter, composed of PVP/Drug-loaded liposome/PVP, was suggested. The hydrophilic property of 1st layer, PVP, helps to separate drug layer in hydrophilic blood vessel, and the 2nd layer with Everolimus (EVL)-loaded liposome facilitates drug encapsulation and sustained release to the targeted lesions during inflation time. Additionally, a 3rd layer with PVP can protect the inner layer during transition time for preventing drug loss. The deionized water containing 20% ethanol was utilized to hydrate EVL-loaded liposome for efficient coating processes. The coating materials showed negligible toxicity in the cells and did not induce pro-inflammatory cytokine in human coronary artery smooth muscle cells (HCASMCs), even in case of inflammation induction through LPS. The results of hemocompatibility for coating materials exhibited that protein adsorption and platelet adhesion somewhat decreased with multilayer-coated materials as compared to bare Nylon tubes. The ex vivo experiments to confirm the feasibility of further applications of multilayer-coated strategy as a DEB system demonstrated efficient drug transfer of approximately 65% in the presence of the 1st layer, to the tissue in 60 s after treatment. Taken together, a functional DEB platform with such a multilayer coating approach would be widely utilized for percutaneous coronary intervention (PCI).
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Affiliation(s)
| | | | | | | | | | - Dong-Keun Han
- Department of Biomedical Science, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam 13488, Gyenggi, Korea; (H.-I.L.); (W.-K.R.); (E.-Y.K.); (B.C.); (J.-H.K.)
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15
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Lin S, Dong P, Zhou C, Dallan LAP, Zimin VN, Pereira GTR, Lee J, Gharaibeh Y, Wilson DL, Bezerra HG, Gu L. Degradation modeling of poly-l-lactide acid (PLLA) bioresorbable vascular scaffold within a coronary artery. NANOTECHNOLOGY REVIEWS 2020; 9:1217-1226. [PMID: 34012762 PMCID: PMC8130847 DOI: 10.1515/ntrev-2020-0093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In this work, a strain-based degradation model was implemented and validated to better understand the dynamic interactions between the bioresorbable vascular scaffold (BVS) and the artery during the degradation process. Integrating the strain-modulated degradation equation into commercial finite element codes allows a better control and visualization of local mechanical parameters. Both strut thinning and discontinuity of the stent struts within an artery were captured and visualized. The predicted results in terms of mass loss and fracture locations were validated by the documented experimental observations. In addition, results suggested that the heterogeneous degradation of the stent depends on its strain distribution following deployment. Degradation is faster at the locations with higher strains and resulted in the strut thinning and discontinuity, which contributes to the continuous mass loss, and the reduced contact force between the BVS and artery. A nonlinear relationship between the maximum principal strain of the stent and the fracture time was obtained, which could be transformed to predict the degradation process of the BVS in different mechanical environments. The developed computational model provided more insights into the degradation process, which could complement the discrete experimental data for improving the design and clinical management of the BVS.
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Affiliation(s)
- Shengmao Lin
- School of Civil Engineering and Architecture, Xiamen University of Technology, Xiamen, Fujian, 361024, China
| | - Pengfei Dong
- Department of Biomedical and Chemical Engineering, Florida Institute of Technology, Melbourne, FL 32901, United States of America
| | - Changchun Zhou
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Luis Augusto P Dallan
- Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States of America
| | - Vladislav N Zimin
- Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States of America
| | - Gabriel T R Pereira
- Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States of America
| | - Juhwan Lee
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - Yazan Gharaibeh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - David L Wilson
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - Hiram G Bezerra
- Interventional Cardiology Center, Heart and Vascular Institute, University of South Florida, Tampa, FL 33606, United States of America
| | - Linxia Gu
- Department of Biomedical and Chemical Engineering, Florida Institute of Technology, Melbourne, FL 32901, United States of America
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16
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Wang S, Guo X, Ren L, Wang B, Hou L, Zhou H, Gao Q, Gao Y, Wang L. Targeting and deep-penetrating delivery strategy for stented coronary artery by magnetic guidance and ultrasound stimulation. ULTRASONICS SONOCHEMISTRY 2020; 67:105188. [PMID: 32473543 DOI: 10.1016/j.ultsonch.2020.105188] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/30/2020] [Accepted: 05/24/2020] [Indexed: 05/13/2023]
Abstract
Stent placement is an effective treatment for atherosclerosis, but is suffered from in-stent restenosis (ISR) caused by stent mechanical damage. Conventional ISR treatment such as drug-eluting stents (DES) is challenged by the low therapeutic efficacy and severe complications, unchangeable drug dosage for individuals, and limited drug penetration in the vascular tissue. We hypothesize that magnetic targeting and deep-penetrating delivery strategy by magnetic guidance and ultrasound stimulation might be an effective approach for ISR treatment. In the present study, antiproliferative drug (paclitaxel, PTX) loaded poly (lactide-co-glycolide) (PLGA) nanoparticles (PLGA-PTX) were embedded within the shells of the magnetic nanoparticle coated microbubbles (MMB-PLGA-PTX). Once being targeted to the stent under a magnetic field, a low intensity focused ultrasound (LIFU) is applied to activate stable microbubble oscillations, thereby triggering the release of PLGA-PTX. The generated mechanical force and microstreaming facilitate the penetration of released PLGA-PTX into the thickened vascular tissue and enhance their internalization by smooth muscle cells (SMCs), thereby reducing the clearance by blood flow. In an ex vivo experiment, magnetic targeting improved the accumulation amount of MMB-PLGA-PTX by 10 folds, while the LIFU facilitated the penetration of released PLGA-PTX into the tunica media region of the porcine coronary artery, resulting in prolonged retention time at the stented vascular tissue. With the combination effects, this strategy holds great promise in the precision delivery of antiproliferative drugs to the stented vascular tissue for ISR treatment.
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Affiliation(s)
- Siyu Wang
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Xixi Guo
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Lili Ren
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Bo Wang
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Lixin Hou
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Hao Zhou
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Qinchang Gao
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Yu Gao
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China.
| | - Lianhui Wang
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergistic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China.
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Yang Q, Lei D, Huang S, Yang Y, Jiang C, Shi H, Chen W, Zhao Q, You Z, Ye X. A novel biodegradable external stent regulates vein graft remodeling via the Hippo-YAP and mTOR signaling pathways. Biomaterials 2020; 258:120254. [PMID: 32805499 DOI: 10.1016/j.biomaterials.2020.120254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/15/2020] [Accepted: 07/20/2020] [Indexed: 01/10/2023]
Abstract
Coronary artery bypass graft (CABG) has been confirmed to effectively improve the prognosis of coronary artery disease, which is a major public health concern worldwide. As the most frequently used conduits in CABG, saphenous vein grafts have the disadvantage of being susceptible to restenosis due to intimal hyperplasia. To meet the urgent clinical demand, adopting external stents (eStents) and illuminating the potential mechanisms underlying their function are important for preventing vein graft failure. Here, using 4-axis printing technology, we fabricated a novel biodegradable and flexible braided eStent, which exerts excellent inhibitory effect on intimal hyperplasia. The stented grafts downregulate Yes-associated protein (YAP), indicating that the eStent regulates vein graft remodeling via the Hippo-YAP signaling pathway. Further, as a drug-delivery vehicle, a rapamycin (RM)-coated eStent was designed to amplify the inhibitory effect of eStent on intimal hyperplasia through the synergistic effects of the Hippo and mammalian target of rapamycin (mTOR) signaling pathways. Overall, this study uncovers the underlying mechanisms of eStent function and identifies a new therapeutic target for the prevention of vein graft restenosis.
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Affiliation(s)
- Qi Yang
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Dong Lei
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Belt and Road Joint Laboratory of Advanced Fiber and Low-dimension Materials (Donghua University), College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China
| | - Shixing Huang
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Yang Yang
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China
| | - Chenyu Jiang
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Hongpeng Shi
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Wenyi Chen
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Belt and Road Joint Laboratory of Advanced Fiber and Low-dimension Materials (Donghua University), College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China
| | - Qiang Zhao
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
| | - Zhengwei You
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Belt and Road Joint Laboratory of Advanced Fiber and Low-dimension Materials (Donghua University), College of Materials Science and Engineering, Donghua University, Shanghai, 201620, China.
| | - Xiaofeng Ye
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
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18
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Lee K, Lee J, Lee SG, Park S, Yang DS, Lee JJ, Khademhosseini A, Kim JS, Ryu W. Microneedle drug eluting balloon for enhanced drug delivery to vascular tissue. J Control Release 2020; 321:174-183. [DOI: 10.1016/j.jconrel.2020.02.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 10/25/2022]
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Targeting and imaging of monocyte-derived macrophages in rat's injured artery following local delivery of liposomal quantum dots. J Control Release 2020; 318:145-157. [DOI: 10.1016/j.jconrel.2019.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/26/2019] [Accepted: 12/08/2019] [Indexed: 12/27/2022]
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20
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Longchamp A, Kaur K, Macabrey D, Dubuis C, Corpataux JM, Déglise S, Matson JB, Allagnat F. Hydrogen sulfide-releasing peptide hydrogel limits the development of intimal hyperplasia in human vein segments. Acta Biomater 2019; 97:374-384. [PMID: 31352106 PMCID: PMC6801028 DOI: 10.1016/j.actbio.2019.07.042] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022]
Abstract
Currently available interventions for vascular occlusive diseases suffer from high failure rates due to re-occlusive vascular wall adaptations, a process called intimal hyperplasia (IH). Naturally occurring hydrogen sulfide (H2S) works as a vasculoprotective gasotransmitter in vivo. However, given its reactive and hazardous nature, H2S is difficult to administer systemically. Here, we developed a hydrogel capable of localized slow release of precise amounts of H2S and tested its benefits on IH. The H2S-releasing hydrogel was prepared from a short peptide attached to an S-aroylthiooxime H2S donor. Upon dissolution in aqueous buffer, the peptide self-assembled into nanofibers, which formed a gel in the presence of calcium. This new hydrogel delivered H2S over the course of several hours, in contrast with fast-releasing NaHS. The H2S-releasing peptide/gel inhibited proliferation and migration of primary human vascular smooth muscle cells (VSMCs), while promoting proliferation and migration of human umbilical endothelial cells (ECs). Both NaHS and the H2S-releasing gel limited IH in human great saphenous vein segments obtained from vascular patients undergoing bypass surgery, with the H2S-releasing gel showing efficacy at a 5x lower dose than NaHS. These results suggest local perivascular H2S release as a new strategy to limit VSMC proliferation and IH while promoting EC proliferation, hence re-endothelialization. STATEMENT OF SIGNIFICANCE: Arterial occlusive disease is the leading cause of death in Western countries, yet current therapies suffer from high failure rates due to intimal hyperplasia (IH), a thickening of the vascular wall leading to secondary vessel occlusion. Hydrogen sulfide (H2S) is a gasotransmitter with vasculoprotective properties. Here we designed and synthesized a peptide-based H2S-releasing hydrogel and found that local application of the gel reduced IH in human vein segments obtained from patients undergoing bypass surgery. This work provides the first evidence of H2S efficacy against IH in human tissue, and the results show that the gel is more effective than NaHS, a common instantaneous H2S donor.
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Affiliation(s)
- Alban Longchamp
- Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Kuljeet Kaur
- Virginia Tech, Department of Chemistry, Macromolecules Innovation Institute and Virginia Tech Center for Drug Discovery, Blacksburg, VA, USA
| | - Diane Macabrey
- Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Celine Dubuis
- Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Jean-Marc Corpataux
- Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Sébastien Déglise
- Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - John B Matson
- Virginia Tech, Department of Chemistry, Macromolecules Innovation Institute and Virginia Tech Center for Drug Discovery, Blacksburg, VA, USA.
| | - Florent Allagnat
- Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
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Hajibandeh S, Hajibandeh S, Antoniou SA, Torella F, Antoniou GA. Treatment strategies for in-stent restenosis in peripheral arterial disease: a systematic review. Interact Cardiovasc Thorac Surg 2019; 28:253-261. [PMID: 30052955 DOI: 10.1093/icvts/ivy233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 06/15/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Our purpose was to investigate the outcomes of different treatment strategies for in-stent restenosis (ISR) in patients with peripheral arterial disease of the lower limbs. METHODS We performed a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. We searched MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials comparing different treatments for ISR in peripheral arterial disease. Recurrent ISR and freedom from target lesion revascularization were defined as the primary outcome measures. We performed an indirect comparison meta-analysis of different treatments. RESULTS We identified 4 randomized controlled trials that fulfilled our inclusion criteria enrolling a total of 491 patients and another 4 ongoing trials. Each of the included trials reported 1 of the 4 comparisons: drug-coated balloon angioplasty versus standard balloon angioplasty; treatment with heparin-bonded Viabahn endoprosthesis versus standard balloon angioplasty; excimer laser atherectomy plus standard balloon angioplasty versus standard balloon angioplasty alone; and peripheral cutting balloon angioplasty versus standard balloon angioplasty. The risk of recurrent ISR at 12 months was significantly higher with standard balloon angioplasty than with drug-coated balloon angioplasty (P = 0.004). There was no significant difference in the risk of recurrent ISR at 6 months between cutting balloon angioplasty and standard balloon angioplasty (P = 0.73). Freedom from target lesion revascularization at 12 months was significantly higher with drug-coated balloon angioplasty (P < 0.001) and treatment with the heparin-bonded Viabahn endoprosthesis (P < 0.001) than with standard balloon angioplasty. Freedom from target lesion revascularization at 6 months was also significantly higher with excimer laser atherectomy plus standard balloon angioplasty than with standard balloon angioplasty (P = 0.003). Tested indirect comparisons revealed large confidence intervals and no statistically significant difference between treatments. CONCLUSIONS The results from individual trials suggest that drug-coated balloon angioplasty, treatment with the heparin-bonded Viabahn endoprosthesis and adjuvant excimer laser atherectomy confer improved outcomes compared with standard balloon angioplasty. Ongoing clinical trials may elucidate uncertainties in the optimal management of ISR in this setting.
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Affiliation(s)
- Shahab Hajibandeh
- Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Shahin Hajibandeh
- Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Stavros A Antoniou
- Department of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Francesco Torella
- Liverpool Vascular and Endovascular Service, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - George A Antoniou
- Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK.,Division of Cardiovascular Sciences, School of Medical Sciences, University of Manchester, Manchester, UK
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Zhang J, Chen J, Yang J, Xu C, Hu Q, Wu H, Cai W, Guo Q, Gao W, He C, Yang C, Yang J. Suv39h1 downregulation inhibits neointimal hyperplasia after vascular injury. Atherosclerosis 2019; 288:76-84. [PMID: 31330382 DOI: 10.1016/j.atherosclerosis.2019.06.909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 05/09/2019] [Accepted: 06/19/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS Neointimal hyperplasia resulting from pathological vascular smooth muscle cells (VSMCs) activation is a common pathophysiological basis for numerous proliferative vascular diseases, such as restenosis. Suv39h1, an important transcription suppressor, may be involved in this process. Herein, we investigated the role of Suv39h1 in pathological intimal hyperplasia and its possible mechanisms in vitro and in vivo. METHODS An adenovirus vector for Suv39h1 overexpression and a lentiviral vector for its downregulation were constructed and used to transfect cultured VSMCs in vitro. The functional changes in VSMCs stimulated by angiotensin II (Ang II) were observed and the possible mechanism was investigated. Additionally, rat carotid arteries with balloon injury were locally transfected with these viral vectors and changes in neointima formation, proliferating cell nuclear antigen (Pcna) expression and collagen deposition were examined. RESULTS Upon Ang II stimulation, the expression of Suv39h1 and inhibitor of DNA binding 3 (Id3) was significantly increased. Suv39h1 downregulation inhibited Ang II-stimulated migration and proliferation of VSMCs, antagonized the production of Id3 and promoted p21 and p27Kip1 expression. In contrast, Suv39h1 overexpression had the opposite effects. Suv39h1 regulated the transcription of p21 and p27Kip1 by controlling H3K9me3 in the proximal promoter regions. Consistent with the VSMCs results, Suv39h1 and Id3 expression was significantly increased in blood vessels after balloon injury. Suv39h1 downregulation inhibited intimal hyperplasia, and attenuated Pcna expression and collagen synthesis in the intima, while Suv39h1 overexpression had the opposite effects. CONCLUSIONS Suv39h1 downregulation effectively inhibited neointimal hyperplasia after vascular injury.
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Affiliation(s)
- Jing Zhang
- Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China; Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China
| | - Jing Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jun Yang
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China
| | - Changwu Xu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qi Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hui Wu
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China
| | - Wanyin Cai
- Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China
| | - Qing Guo
- Department of Ophthalmology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China
| | - Wenqi Gao
- Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China
| | - Chao He
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China
| | - Chaojun Yang
- Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China
| | - Jian Yang
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, 443003, China.
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Flores AM, Ye J, Jarr KU, Hosseini-Nassab N, Smith BR, Leeper NJ. Nanoparticle Therapy for Vascular Diseases. Arterioscler Thromb Vasc Biol 2019; 39:635-646. [PMID: 30786744 PMCID: PMC6436996 DOI: 10.1161/atvbaha.118.311569] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Nanoparticles promise to advance strategies to treat vascular disease. Since being harnessed by the cancer field to deliver safer and more effective chemotherapeutics, nanoparticles have been translated into applications for cardiovascular disease. Systemic exposure and drug-drug interactions remain a concern for nearly all cardiovascular therapies, including statins, antithrombotic, and thrombolytic agents. Moreover, off-target effects and poor bioavailability have limited the development of completely new approaches to treat vascular disease. Through the rational design of nanoparticles, nano-based delivery systems enable more efficient delivery of a drug to its therapeutic target or even directly to the diseased site, overcoming biological barriers and enhancing a drug's therapeutic index. In addition, advances in molecular imaging have led to the development of theranostic nanoparticles that may simultaneously act as carriers of both therapeutic and imaging payloads. The following is a summary of nanoparticle therapy for atherosclerosis, thrombosis, and restenosis and an overview of recent major advances in the targeted treatment of vascular disease.
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Affiliation(s)
- Alyssa M. Flores
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine., Hanover, NH
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Jianqin Ye
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine., Hanover, NH
| | - Kai-Uwe Jarr
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine., Hanover, NH
| | - Niloufar Hosseini-Nassab
- Department of Radiology, Stanford University School of Medicine, Michigan State University, East Lansing, MI, USA
| | - Bryan R. Smith
- Department of Biomedical Engineering and Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA
| | - Nicholas J. Leeper
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine., Hanover, NH
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA
- Stanford Cardiovascular Institute, Stanford, CA 94305, USA
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Elmariah S, Ansel GM, Brodmann M, Doros G, Fuller S, Gray WA, Pinto DS, Rosenfield KA, Mauri L. Design and rationale of a randomized noninferiority trial to evaluate the SurVeil drug-coated balloon in subjects with stenotic lesions of the femoropopliteal artery - the TRANSCEND study. Am Heart J 2019; 209:88-96. [PMID: 30685679 DOI: 10.1016/j.ahj.2018.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 12/15/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Drug-coated balloons (DCBs), developed to reduce restenosis after percutaneous intervention in peripheral arterial disease (PAD), have been shown to be safe and efficacious, particularly in treating PAD affecting the femoropopliteal segment. The SurVeil DCB uses an excipient intended to optimize both the uniformity and transfer of paclitaxel to the vessel wall, allowing for efficient drug loading and lower systemic exposure than currently available DCBs, Heretofore, clinical outcomes have not previously been compared to other DCBs. STUDY DESIGN AND OBJECTIVES This prospective, multicenter, international, randomized, single-blind, trial will compare 1:1 the SurVeil DCB with the IN.PACT Admiral DCB for treatment of patients with Rutherford classification 2 to 4 due to femoral and/or popliteal arterial disease. The trial will randomize 446 subjects (with reference vessel diameter 4-7 mm and total lesion length ≤180 mm). Subjects will be followed for 60 months. The primary efficacy endpoint is 1 year primary patency, defined as composite freedom from clinically-driven target-lesion revascularization (TLR) and binary restenosis (core lab-adjudicated duplex ultrasound peak systolic velocity ratio ≥2.4, or ≥50% stenosis via angiography). The primary safety endpoint is composite freedom from device- and procedure-related death through 30 days and freedom from target limb major amputation and clinically-driven target vessel revascularization through 12 months. The primary analysis is a test of noninferiority of the SurVeil vs. IN.PACT Admiral on the primary efficacy and safety endpoints according to absolute deltas of 15.0% and 10.0%, respectively. CONCLUSION The Randomized And Controlled Noninferiority Trial to Evaluate Safety and Clinical Efficacy of the SurVeil DCB in the Treatment of Subjects with Stenotic Lesions of the Femoropopliteal Artery Compared to the Medtronic IN.PACT Admiral (TRANSCEND) study will assess safety and efficacy of the SurVeil DCB relative to a commonly used DCB.
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Zhao J, Yang M, Wu X, Yang Z, Jia P, Sun Y, Li G, Xie L, Liu B, Liu H. Effects of paclitaxel intervention on pulmonary vascular remodeling in rats with pulmonary hypertension. Exp Ther Med 2019; 17:1163-1170. [PMID: 30679989 PMCID: PMC6327549 DOI: 10.3892/etm.2018.7045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 03/23/2018] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to investigate the effects of paclitaxel (PTX), at a non-cytotoxic concentration, on pulmonary vascular remodeling (PVR) in rats with pulmonary hypertension (PAH), and to explore the mechanisms underlying the PTX-mediated reversal of PVR in PAH. A total of 36 rats were divided into control group (n=12), model group (n=12) receiving a subcutaneous injection of monocrotaline (60 mg/kg) in the back on day 7 following left pneumonectomy and PTX group (n=12) with PTX (2 mg/kg) injection via the caudal vein 3 weeks following establishing the model. The degree of PVR among all groups, as well as the expression levels of Ki67, p27Kip1 and cyclin B1, were compared. The mean pulmonary artery pressure, right ventricular hypertrophy index [right ventricle/(left ventricle + septum) ratio] and the thickness of the pulmonary arterial tunica media in the model group were 58.34±2.01 mmHg, 0.64±0.046 and 65.3±3.3%, respectively, which were significantly higher when compared with 23.30±1.14 mmHg, 0.32±0.028 and 16.2±1.3% in the control group, respectively (P<0.01). The mean pulmonary artery pressure, right ventricular hypertrophy index and thickness of the pulmonary arterial tunica media in the PTX group were 42.35±1.53 mmHg, 0.44±0.029 and 40.5±2.6%, respectively, which were significantly lower when compared with the model group (P<0.01). Compared with the control group, the expression levels of Ki67 and cyclin B1 in the model group were significantly increased (P<0.01), while p27Kip1 expression was significantly reduced (P<0.01). Following PTX intervention, the expression levels of Ki67 and cyclin B1 were significantly reduced when compared with the model group (P<0.01), while p27Kip1 expression was significantly increased (P<0.01). The results of the present study suggest that PTX, administered at a non-cytotoxic concentration, may reduce PAH in rats, and prevent the effects of PVR in PAH. These effects of PTX may be associated with increased expression of p27Kip1 and decreased expression of cyclin B1.
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Affiliation(s)
- Jian Zhao
- Department of Pediatric Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Meifang Yang
- School of Nursing, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xindan Wu
- Department of Pediatrics, Chengdu Women and Children's Central Hospital, Chengdu, Sichuan 610091, P.R. China
| | - Zhangya Yang
- Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, P.R. China
| | - Peng Jia
- Department of Pediatric Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Yuqin Sun
- Department of Pediatric Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Gang Li
- Department of Pediatric Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Liang Xie
- Department of Pediatric Cardiology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Bin Liu
- Department of Pediatric Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Hanmin Liu
- Department of Pediatric Cardiology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
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Cocciolone AJ, Johnson E, Shao JY, Wagenseil JE. Elastic fiber fragmentation increases transmural hydraulic conductance and solute transport in mouse arteries. J Biomech Eng 2018; 141:2718211. [PMID: 30516242 DOI: 10.1115/1.4042173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Indexed: 01/15/2023]
Abstract
Transmural advective transport of solute and fluid was investigated in mouse carotid arteries with either a genetic knockout of Fibulin-5 (Fbln5-/-) or treatment with elastase to determine the influence of a disrupted elastic fiber matrix on wall transport properties. Fibulin-5 is an important director of elastic fiber assembly. Arteries from Fbln5-/- mice have a loose, non-continuous elastic fiber network and were hypothesized to have reduced resistance to advective transport. Experiments were carried out ex vivo at physiological pressure and axial stretch. Hydraulic conductance (Lp ) was measured to be 4.99·10-6 ± 8.94·10-7, 3.18·-5 ± 1.13·10-5 (P < 0.01), and 3.57·10-5 ± 1.77·10-5 (P < 0.01) mm·s-1·mmHg-1 for wild-type, Fbln5-/-, and elastase-treated carotids, respectively. Solute fluxes of 4, 70, and 150 kDa FITC-dextran were statistically increased in Fbln5-/- compared to wild-type by a factor of 4, 22, and 3 respectively. 70 kDa FITC-dextran solute flux was similarly increased in elastase-treated carotids by a factor of 27. Solute uptake by Fbln5-/- carotids was decreased compared to wild-type for all investigated dextran sizes after 60 minutes of transmural transport. These changes in transport properties of elastic fiber compromised arteries have important implications for the kinetics of biomolecules and pharmaceuticals in arterial tissue following elastic fiber degradation due to aging or vascular disease.
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Affiliation(s)
| | - Elizabeth Johnson
- Mechanical Engineering and Materials Science, Washington University, St. Louis, MO, USA
| | - Jin-Yu Shao
- Mechanical Engineering and Materials Science, Washington University, St. Louis, MO, USA
| | - Jessica E Wagenseil
- Department of Mechanical Engineering and Materials Science, Washington University, One Brookings Dr., CB 1185, St. Louis, MO 63130
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Lee WC, Hsueh SK, Chen CJ, Yang CH, Fang CY, Wu CJ, Fang HY. The Comparison of Clinical Outcomes After Drug-Eluting Balloon and Drug-Eluting Stent Use for Left Main Bifurcation In-Stent Restenosis. Int Heart J 2018; 59:935-940. [PMID: 30101849 DOI: 10.1536/ihj.17-540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Increasing evidence is available for the use of percutaneous coronary intervention (PCI) in selected patients with unprotected left main (LM) bifurcation coronary lesions. However, little data have been reported on recurrent in-stent restenosis (ISR) for LM bifurcation lesions. The aim of this study was to evaluate the efficacy of a drug-eluting balloon (DEB) for LM bifurcation ISR compared with that of a drug-eluting stent (DES).Between December 2011 and December 2015, 104 patients who underwent PCI for unprotected LM bifurcation ISR were enrolled. We separated the patients into 2 groups: (1) those underwent PCI with further DEB and (2) those underwent PCI with further DES. Clinical outcomes were analyzed.Patients' average age was 67.14 ± 7.65 years, and the percentage of male patients was 76.0%. A total of 75 patients were enrolled in the DEB group, and another 29 patients were enrolled in the DES group. Similar target lesion revascularization (TLR) rate and recurrent myocardial infarction (MI) rate were noted for both groups. A significantly higher cardiovascular mortality rate was found in the DES group (10.7% versus 0%, P = 0.020), and a higher all-cause mortality rate was noted in the DES group (21.4% versus 6.8%, P = 0.067).It is feasible to use DEB for LM bifurcation ISR. When comparing DEB with DES, similar TLR rates were found, but lower recurrent MI and lower cardiovascular death were noted for DEB treatment.
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Affiliation(s)
- Wei-Chieh Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Shu-Kai Hsueh
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Chien-Jen Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Cheng-Hsu Yang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Chih-Yuan Fang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Chiung-Jen Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Hsiu-Yu Fang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
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Qian K, Feng L, Sun Y, Xiong B, Ding Y, Han P, Chen H, Chen X, Du L, Wang Y. Overexpression of Salusin- α Inhibits Vascular Intimal Hyperplasia in an Atherosclerotic Rabbit Model. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8973986. [PMID: 30105261 PMCID: PMC6076935 DOI: 10.1155/2018/8973986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 06/27/2018] [Indexed: 11/18/2022]
Abstract
Inhibiting vascular endothelial foam is the focus of clinical attention. Using SonoVue (an ultrasound contrast agent), the salusin-α gene was transfected into the arterial intima of an atherosclerotic rabbit model induced by a high-fat diet in this study. Subsequently the model of blood lipid indexes, the pathological structure of the intima, and changes in molecules regulating atherosclerosis were investigated. The high-density lipoprotein C and apolipoprotein A values in the salusin-α gene overexpression (P) group were higher than those in the salusin-α gene interference (RP) group (P < 0.05), whereas the total cholesterol, low-density lipoprotein C, and apolipoprotein B values were reversed. Rabbits in the P group showed significantly thinner vascular intimal thickness than that of other experimental groups (P < 0.05). The expression of positive regulators of atherosclerosis (ABCA1, ABCG1) was higher in the P group than that in the RP group (P < 0.05), and the opposite effect was observed for negative regulators (ACAT1, CD36). Thus, our results showed that the overexpression of salusin-α gene inhibited the proliferation of the vascular intima, thereby throwing some light on understanding the mechanism how salusin-α gene expression interfered with the foaming of vascular intimal cells.
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Affiliation(s)
- Kun Qian
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Li Feng
- Endoscopy Center, Minhang Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yujie Sun
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Bowen Xiong
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Yi Ding
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Panting Han
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Hailun Chen
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Xiao Chen
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Ling Du
- Endoscopy Center, Minhang Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuxue Wang
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
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Fang CY, Fang HY, Chen CJ, Yang CH, Wu CJ, Lee WC. Comparison of clinical outcomes after drug-eluting balloon and drug-eluting stent use for in-stent restenosis related acute myocardial infarction: a retrospective study. PeerJ 2018; 6:e4646. [PMID: 29682422 PMCID: PMC5910788 DOI: 10.7717/peerj.4646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/29/2018] [Indexed: 11/20/2022] Open
Abstract
Background Good results of drug-eluting balloon (DEB) use are achieved in in-stent restenosis (ISR) lesions, small vessel disease, long lesions, and bifurcations. However, few reports exist about DEB use in acute myocardial infarction (AMI) with ISR. This study’s aim was to evaluate the efficacy of DEB for AMI with ISR. Methods Between November 2011 and December 2015, 117 consecutive patients experienced AMI including ST-segment elevation MI, and non-ST-segment elevation MI due to ISR, and received percutaneous coronary intervention (PCI). We divided our patients into two groups: (1) PCI with further DEB, and (2) PCI with further drug-eluting stent (DES). Clinical outcomes such as target lesion revascularization, target vessel revascularization, recurrent MI, stroke, cardiovascular mortality, and all-cause mortality were analyzed. Results The patients’ average age was 68.37 ± 11.41 years; 69.2% were male. A total of 75 patients were enrolled in the DEB group, and 42 patients were enrolled in the DES group. The baseline characteristics between the two groups were the same without statistical differences except for gender. Peak levels of cardiac biomarker, pre- and post-PCI cardiac function were similar between two groups. The major adverse cardiac cerebral events rate (34.0% vs. 35.7%; p = 0.688) and cardiovascular mortality rate (11.7% vs. 12.8%; p = 1.000) were similar in both groups. Conclusions DEB is a reasonable strategy for AMI with ISR. Compared with DES, DEB is an alternative strategy which yielded acceptable short-term outcomes and similar 1-year clinical outcomes.
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Affiliation(s)
- Chih-Yuan Fang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsiu-Yu Fang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Jen Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsu Yang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chiung-Jen Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Chieh Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Farah S. Protective Layer Development for Enhancing Stability and Drug-Delivery Capabilities of DES Surface-Crystallized Coatings. ACS APPLIED MATERIALS & INTERFACES 2018; 10:9010-9022. [PMID: 29436817 DOI: 10.1021/acsami.7b18733] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Carrier-free drug-eluting stents (DES)-based crystalline coatings are gaining prominence because of their function, skipping many limitations and clinical complications of the currently marketed DES. However, their usage has been humbled by inflexibility of the crystalline coating and limited mechanical and physical properties. This study reports for the first time the development of a protective top coating for enhancing the merits and delivery capabilities of the crystalline coating. Flexible and water-soluble polysaccharide top coating was developed and applied onto rapamycin (RM) crystalline carpet. The top coating prevented crystalline coating delamination during stent crimping and expansion without affecting its release profile. Crystalline coating strata and its interfaces with the metallic substrate and top coating were fully studied and characterized. The crystalline top-coated stents showed significant physical, mechanical, and chemical stability enhancement with ∼2% RM degradation after 1 year under different storage conditions. Biocompatibility study of the top-coated stents implanted subcutaneously for 1 month into SD rats did not provoke any safety concerns. Incorporating RM into the top coating to develop a bioactive protective coating for multilayer release purposes was also investigated. The developed protective coating had wide applicability and may be further implemented for various drugs and implantable medical devices.
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Affiliation(s)
- Shady Farah
- Institute of Drug Research, School of Pharmacy-Faculty of Medicine, Center for Nanoscience and Nanotechnology and The Alex Grass Center for Drug Design and Synthesis , The Hebrew University of Jerusalem , Jerusalem 91120 , Israel
- David H. Koch Institute for Integrative Cancer Research , Massachusetts Institute of Technology , 500 Main Street , Cambridge , Massachusetts 02139 , United States
- Department of Chemical Engineering , Massachusetts Institute of Technology , 77 Massachusetts Avenue , Cambridge , Massachusetts 02139 , United States
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31
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Bukka M, Rednam PJ, Sinha M. Drug-eluting balloon: design, technology and clinical aspects. ACTA ACUST UNITED AC 2018; 13:032001. [PMID: 29227279 DOI: 10.1088/1748-605x/aaa0aa] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A drug-eluting balloon is a non-stent technology in which the effective homogenous delivery of anti-proliferative drugs is processed by the vessel wall through an inflated balloon. This is done to restore luminal vascularity in order to treat atherosclerosis, in-stent restenosis and reduce the risk of late thrombosis without implanting a permanent foreign object. The balloon technology relies on the concept of targeted drug delivery, which helps in the rapid healing of the vessel wall and prevents the proliferation of smooth muscle cells. Several drug eluting devices in the form of coated balloons are currently in clinical use, namely DIOR®, PACCOCATH®, SeQuent®Please and IN.PACT™. The device varies in terms of the material used for making the balloon, the coating techniques, the choice of coated drug and the release pattern of the drug at the site. This review gives an insight into the evolution, rationale and comparison of the marketed drug-eluting balloons. Here, different coating techniques have been analysed for the application and critical analysis of available DEB technologies, and a technical comparison has been done.
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Affiliation(s)
- Meenasree Bukka
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research, Ahmedabad (NIPER-A) Palaj, Opp. Air Force Station, Gandhinagar-382355, Gujarat, India
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Farah S, Domb AJ. Crystalline paclitaxel coated DES with bioactive protective layer development. J Control Release 2018; 271:107-117. [PMID: 29289571 DOI: 10.1016/j.jconrel.2017.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 11/29/2017] [Accepted: 12/27/2017] [Indexed: 01/01/2023]
Abstract
Drug eluting stents (DES) based on polymeric-carriers currently lead the market, however, reports on clinical complications encourage the development of safer and more effective DES. We recently reported on carrier-free DES based on rapamycin crystalline coating as a potential therapeutic solution. Here, we report for the first time surface crystallization of paclitaxel (PT) onto metallic stents. The physicochemical principles of crystallization and key process parameters were extensively studied for fabrication of controllable and homogeneous crystalline coatings on stent scaffolds. Stents loaded with nearly 100μg PT were chosen as a potential therapeutic device with a multilayer coating of 4-7μm thickness. In vitro PT release from these coated stents shows constant release for at least 28days with 10% cumulatively released. The effect of fast dissolving top coating on the physical stability of the coated stent was determined. The top coating enhances the mechanical stability of the crystalline coating during deployment and expansion simulations. Also, incorporating PT in the protective top coating for developing bioactive top coating for multilayer controlled release purpose was intensively studied. This process has wide applications that can be further implemented for other drugs for effective local drug delivery from implantable medical devices.
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Affiliation(s)
- Shady Farah
- Institute of Drug Research, School of Pharmacy-Faculty of Medicine, Center for Nanoscience and Nanotechnology and The Alex Grass Center for Drug Design and Synthesis, The Hebrew University of Jerusalem, 91120, Israel.
| | - Abraham J Domb
- Institute of Drug Research, School of Pharmacy-Faculty of Medicine, Center for Nanoscience and Nanotechnology and The Alex Grass Center for Drug Design and Synthesis, The Hebrew University of Jerusalem, 91120, Israel.
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Wang Y, Zhao D, Sheng J, Lu P. Local honokiol application inhibits intimal thickening in rabbits following carotid artery balloon injury. Mol Med Rep 2017; 17:1683-1689. [PMID: 29257208 PMCID: PMC5780111 DOI: 10.3892/mmr.2017.8076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 07/24/2017] [Indexed: 01/10/2023] Open
Abstract
Honokiol is a natural bioactive product with anti-tumor, anti-inflammatory, anti-oxidative, anti-angiogenic and neuroprotective properties. The present study aimed to investigate the effects of honokiol treatment on intimal thickening following vascular balloon injury. The current study determined that perivascular honokiol application reduced intimal thickening in rabbits 14 days after carotid artery injury, it may inhibit vascular smooth muscle cell (VSMCs) proliferation and reduce collagen deposition in local arteries. The findings of the presents study also suggested that honikiol may increase the mRNA expression levels of matrix metalloproteinase‑1 (MMP‑1), MMP‑2 and MMP‑9 and decrease tissue inhibitor of metalloproteinase‑1 (TIMP‑1) mRNA expression in the rabbit arteries. Additionally, perivascular honokiol application inhibited intimal thickening, possibly via inhibition of the phosphorylation of SMAD family member 2/3.
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Affiliation(s)
- Yu Wang
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Danyang Zhao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Jing Sheng
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Ping Lu
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
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Baek S, Lee KP, Cui L, Ryu Y, Hong JM, Kim J, Jung SH, Bae YM, Won KJ, Kim B. Low-power laser irradiation inhibits PDGF-BB-induced migration and proliferation via apoptotic cell death in vascular smooth muscle cells. Lasers Med Sci 2017; 32:2121-2127. [PMID: 28983687 DOI: 10.1007/s10103-017-2338-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/22/2017] [Indexed: 10/18/2022]
Abstract
Vascular restenosis after injury of blood vessel has been implicated in various responses including apoptosis, migration, and proliferation in vascular smooth muscle cells (VSMCs) stimulated by diverse growth factors underlying platelet-derived growth factor (PDGF). Previous studies evaluated the effects of low-power laser (LPL) irradiation over various wavelength ranges on VSMC events in normal and pathologic states. However, whether VSMC responses are affected by LPL irradiation remains unclear. The purpose of this study is to explore the effects of LPL (green diode laser 532-nm pulsed wave of 300 mW at a spot diameter of 1 mm) irradiation on the responses, apoptosis, migration, and proliferation of VSMCs. The effect of LPL irradiation was tested on VSMCs through cytotoxicity, proliferation, migration, and apoptotic assays. Aortic ring assay was used to assess the effect of LPL irradiation on aortic sprout outgrowth. Protein expression levels were determined by western blotting. LPL irradiation did not affect VSMC viability but slightly attenuated PDGF-BB-induced proliferation in VSMCs. In addition, LPL irradiation inhibited PDGF-BB-evoked migration of VSMCs. Aortic sprout outgrowth in response to PDGF-BB was diminished in cells treated with LPL. In contrast, LPL irradiation evoked apoptosis in VSMCs in the presence of PDGF-BB. Similarly, activation of caspase-3 and Bax, as well as p38 mitogen-activated protein kinase (MAPK), in VSMCs treated with PDGF-BB was enhanced by exposure to LPL. These findings indicate that LPL irradiation induces vascular apoptosis via p38 MAPK activation and simultaneously inhibits VSMC proliferation and migration in response to PDGF-BB.
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Affiliation(s)
- Suji Baek
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Kang Pa Lee
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Long Cui
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Yunkyoung Ryu
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Jung Min Hong
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Junghwan Kim
- Department of Physical Therapy, College of Public Health & Welfare, Yongin University, Yongin, 17092, South Korea
| | - Seung Hyo Jung
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Young Min Bae
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Kyung Jong Won
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea.
| | - Bokyung Kim
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea.
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Mei L, He Y, Wang H, Jin Y, Wang S, Jin C. Human hepatocyte growth factor inhibits early neointima formation in rabbit abdominal aortae following ultrasound-guided balloon injury. Mol Med Rep 2017; 16:5203-5210. [PMID: 28849185 PMCID: PMC5647058 DOI: 10.3892/mmr.2017.7229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 06/08/2017] [Indexed: 12/20/2022] Open
Abstract
The present study investigated the effects of in vivo gene transfer of human hepatocyte growth factor (hHGF) on neointima formation in rabbit abdominal aortae following ultrasound‑guided balloon injury. New Zealand white rabbits were randomly divided into four groups: endothelium injury alone (EI), endothelium injury with control vector transfection (EI‑V), endothelium injury with hHGF transfection (EI‑HGF), and hHGF transfection alone without endothelium injury (HGF). Endothelial injury was established by scraping the abdominal aortic wall using a balloon catheter under the guidance of a transabdominal ultrasound. hHGF gene transfer was performed 7 days following injury. hHGF mRNA and protein expression levels were determined at 3, 7, 14 and 21 days following transfection. Neointima formation was assessed by histopathological analysis at 14 and 28 days following injury. hHGF mRNA and protein expression levels were detected in the target abdominal aortae in EI‑HGF and HGF groups with the greatest levels observed 3 days following transfection, and their levels dropped below detection limits at 21 days following transfection. hHGF was not detectable in the EI and EI‑V groups throughout the experiment. The neointimal area and the neointima to media ratio in the EI‑HGF group were significantly decreased compared with those in the EI or EI‑V group at 14 days following injury. However, no differences were observed at 28 days following injury. The present study demonstrated that in vivo hHGF gene transfer inhibits the early formation of neointima in balloon‑injured rabbit abdominal aortae.
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Affiliation(s)
- Li Mei
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
- Department of Ultrasound, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yu He
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Ying Jin
- Department of Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Shuai Wang
- Department of Pathology, Cancer Hospital of Jilin, Changchun, Jilin 130012, P.R. China
| | - Chunxiang Jin
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
- Correspondence to: Professor Chunxiang Jin, Department of Ultrasound, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, Jilin 130033, P.R. China, E-mail:
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de Oliveira MG, Doro FG, Tfouni E, Krieger MH. Phenotypic switching prevention and proliferation/migration inhibition of vascular smooth muscle cells by the ruthenium nitrosyl complex trans-[Ru(NO)Cl(cyclam](PF 6 ) 2. ACTA ACUST UNITED AC 2017; 69:1155-1165. [PMID: 28590566 DOI: 10.1111/jphp.12755] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 05/07/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Vascular smooth muscle cell (VSMC) migration and proliferation at sites of vascular injury are both critical steps in the development of intimal hyperplasia (IH). Local delivery of nitric oxide (NO) largely prevents these events. Among the NO donors, tetraazamacrocyclic nitrosyl complexes, such as trans-[Ru(NO)Cl(cyclam)](PF6 )2 (cyclamNO), gained attention for their features, which include the possibility of being embedded in solid matrices, and ability to participate in a nitrite/NO catalytic conversion cycle. METHODS Methods used to evaluate cyclamNO activity: safety margin by NR and MTT; cell proliferation by 3H-thymidine incorporation and proliferating cell nuclear antigen (PCNA) expression; antimigratory properties by transwell and wound healing; prevention of cell phenotypic switching under platelet-derived growth factor type BB (PDGF-BB) stimuli by analysis of alpha smooth muscle actin (α-SMA) expression. KEY FINDINGS Cell proliferation and migration induced by PDGF-BB were significantly inhibited by cyclamNO. The ~60% reduction on expression of contractile protein α-SMA induced by PDGF-BB revealed VSMC phenotypic switching which is significantly prevented by cyclamNO. Compared to the NO donor sodium nitroprusside, cyclamNO showed to be significantly less cytotoxic. CONCLUSIONS With great potential to maintain VSMC functionality and prevent IH-associated events, cyclamNO might be a promissory drug for several applications in cardiovascular medicine, as in stents.
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Affiliation(s)
- Mariana G de Oliveira
- Laboratório de Cardiovascular, Departamento de Anatomia, Biologia Celular e Fisiologia, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fabio G Doro
- Departamento de Química Geral e Inorgânica, Instituto de Química, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Elia Tfouni
- Departamento de Química, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Marta H Krieger
- Laboratório de Cardiovascular, Departamento de Anatomia, Biologia Celular e Fisiologia, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
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Mylonaki I, Allémann É, Saucy F, Haefliger JA, Delie F, Jordan O. Perivascular medical devices and drug delivery systems: Making the right choices. Biomaterials 2017; 128:56-68. [PMID: 28288349 DOI: 10.1016/j.biomaterials.2017.02.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/13/2017] [Accepted: 02/26/2017] [Indexed: 12/31/2022]
Abstract
Perivascular medical devices and perivascular drug delivery systems are conceived for local application around a blood vessel during open vascular surgery. These systems provide mechanical support and/or pharmacological activity for the prevention of intimal hyperplasia following vessel injury. Despite abundant reports in the literature and numerous clinical trials, no efficient perivascular treatment is available. In this review, the existing perivascular medical devices and perivascular drug delivery systems, such as polymeric gels, meshes, sheaths, wraps, matrices, and metal meshes, are jointly evaluated. The key criteria for the design of an ideal perivascular system are identified. Perivascular treatments should have mechanical specifications that ensure system localization, prolonged retention and adequate vascular constriction. From the data gathered, it appears that a drug is necessary to increase the efficacy of these systems. As such, the release kinetics of pharmacological agents should match the development of the pathology. A successful perivascular system must combine these optimized pharmacological and mechanical properties to be efficient.
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Affiliation(s)
- Ioanna Mylonaki
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - Éric Allémann
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - François Saucy
- Department of Vascular Surgery, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland
| | - Jacques-Antoine Haefliger
- Department of Vascular Surgery, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland
| | - Florence Delie
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - Olivier Jordan
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland.
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A Biodegradable Microneedle Cuff for Comparison of Drug Effects through Perivascular Delivery to Balloon-Injured Arteries. Polymers (Basel) 2017; 9:polym9020056. [PMID: 30970733 PMCID: PMC6432118 DOI: 10.3390/polym9020056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 01/25/2017] [Accepted: 02/03/2017] [Indexed: 12/25/2022] Open
Abstract
Restenosis at a vascular anastomosis site is a major cause of graft failure and is difficult to prevent by conventional treatment. Perivascular drug delivery has advantages as drugs can be diffused to tunica media and subintima while minimizing the direct effect on endothelium. This in vivo study investigated the comparative effectiveness of paclitaxel, sirolimus, and sunitinib using a perivascular biodegradable microneedle cuff. A total of 31 New Zealand white rabbits were used. Rhodamine was used to visualize drug distribution (n = 3). Sirolimus- (n = 7), sunitinib- (n = 7), and paclitaxel-loaded (n = 7) microneedle cuffs were placed at balloon-injured abdominal aortae and compared to drug-free cuffs (n = 7). Basic histological structures were not affected by microneedle devices, and vascular wall thickness of the device-only group was similar to that of normal artery. Quantitative analysis revealed significantly decreased neointima formation in all drug-treated groups (p < 0.001). However, the tunica media layer of the paclitaxel-treated group was significantly thinner than that of other groups and also showed the highest apoptotic ratio (p < 0.001). Proliferating cell nuclear antigen (PCNA)-positive cells were significantly reduced in all drug-treated groups. Sirolimus or sunitinib appeared to be more appropriate for microneedle devices capable of slow drug release because vascular wall thickness was minimally affected.
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Tacrolimus-Eluting Suture Inhibits Neointimal Hyperplasia: An Experimental In Vivo Study in Rats. Eur J Vasc Endovasc Surg 2017; 53:431-437. [PMID: 28065442 DOI: 10.1016/j.ejvs.2016.11.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 11/30/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVE/BACKGROUND Neointimal hyperplasia (NIH) remains one of the leading causes of graft failure after vascular anastomoses. Cytotoxic drugs, such as rapamycin and tacrolimus, have been shown to inhibit the development of NIH. In this study, the aim was to test the impact of a sustained releasing tacrolimus-chitosan-eluting suture on the development of NIH in a rat model. METHODS After tacrolimus-chitosan coating of a 7/0 polyvinylidene difluoride (PVDF) Trofilen® suture, the tacrolimus concentration on the coated suture and in vitro release trials were performed spectrophotometrically. Twelve Wistar rats were included. After midline laparotomy, a 7-8 mm longitudinal aortotomy in the infrarenal aorta was made and then closed by a bare 7/0 PVDF (group C, n = 6) and a 7/0 tacrolimus-chitosan coated PVDF suture (0.65 μg/cm tacrolimus [0.9 wt%] + 1.82 μg/cm chitosan [2.28 wt%]) (group T, n = 6). After 1 month, rats were sacrificed and aortotomy sites were examined histologically by ratio of intimal area (including neointima) and immunohistochemically by α-smooth muscle actin (ASMA) and proliferating cell nuclear antigen (PCNA) immunostaining. The PCNA positive cells were indexed to total cell number and expressed as percentage. RESULTS In vitro tacrolimus release tests for a 7/0 tacrolimus-chitosan coated PVDF suture were confirmed for 1 month without an initial burst release. Endothelialisation over the aortotomy line occurred in both groups. The area of neointima was significantly reduced in group T compared with group C (ratio 0.22 ± 0.12 vs. 0.42 ± 0.11; p = .017) 1 month post-operatively. Likewise, the percentage of PCNA immunostaining significantly decreased in group C compared with group T (3.83 ± 2.85% vs. 11.17 ± 7.78%; p = .026). The cells constituting NIH were positive for ASMA immunostaining. CONCLUSIONS Tacrolimus-chitosan-eluting suture is shown to be an effective way to reduce NIH without interfering with normal endothelialisation.
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Kayssi A, Al‐Atassi T, Oreopoulos G, Roche‐Nagle G, Tan KT, Rajan DK. Drug-eluting balloon angioplasty versus uncoated balloon angioplasty for peripheral arterial disease of the lower limbs. Cochrane Database Syst Rev 2016; 2016:CD011319. [PMID: 27490003 PMCID: PMC8504434 DOI: 10.1002/14651858.cd011319.pub2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Atherosclerotic peripheral arterial disease (PAD) can lead to disabling ischemia and limb loss. Treatment modalities have included risk factor optimization through life-style modifications and medications, or operative approaches using both open and minimally invasive techniques, such as balloon angioplasty. Drug-eluting balloon (DEB) angioplasty has emerged as a promising alternative to uncoated balloon angioplasty for the treatment of this difficult disease process. By ballooning and coating the inside of atherosclerotic vessels with cytotoxic agents, such as paclitaxel, cellular mechanisms responsible for atherosclerosis and neointimal hyperplasia are inhibited and its devastating complications are prevented or postponed. DEBs are considerably more expensive than uncoated balloons, and their efficacy in improving patient outcomes is unclear. OBJECTIVES To assess the efficacy of drug-eluting balloons (DEBs) compared with uncoated, nonstenting balloon angioplasty in people with symptomatic lower-limb peripheral arterial disease (PAD). SEARCH METHODS The Cochrane Vascular Trials Search Co-ordinator (TSC) searched the Specialised Register (last searched December 2015) and Cochrane Register of Studies (CRS) (2015, Issue 11). The TSC searched trial databases for details of ongoing and unpublished studies. SELECTION CRITERIA We included all randomized controlled trials that compared DEBs with uncoated, nonstenting balloon angioplasty for intermittent claudication (IC) or critical limb ischemia (CLI). DATA COLLECTION AND ANALYSIS Two review authors (AK, TA) independently selected the appropriate trials and performed data extraction, assessment of trial quality, and data analysis. The senior review author (DKR) adjudicated any disagreements. MAIN RESULTS Eleven trials that randomized 1838 participants met the study inclusion criteria. Seven of the trials included femoropopliteal arterial lesions, three included tibial arterial lesions, and one included both. The trials were carried out in Europe and in the USA and all used the taxane drug paclitaxel in the DEB arm. Nine of the 11 trials were industry-sponsored. Four companies manufactured the DEB devices (Bard, Bavaria Medizin, Biotronik, and Medtronic). The trials examined both anatomic and clinical endpoints. There was heterogeneity in the frequency of stent deployment and the type and duration of antiplatelet therapy between trials. Using GRADE assessment criteria, the quality of the evidence presented was moderate for the outcomes of target lesion revascularization and change in Rutherford category, and high for amputation, primary vessel patency, binary restenosis, death, and change in ankle-brachial index (ABI). Most participants were followed up for 12 months, but one trial reported outcomes at five years.There were better outcomes for DEBs for up to two years in primary vessel patency (odds ratio (OR) 1.47, 95% confidence interval (CI) 0.22 to 9.57 at six months; OR 1.92, 95% CI 1.45 to 2.56 at 12 months; OR 3.51, 95% CI 2.26 to 5.46 at two years) and at six months and two years for late lumen loss (mean difference (MD) -0.64 mm, 95% CI -1.00 to -0.28 at six months; MD -0.80 mm, 95% CI -1.44 to -0.16 at two years). DEB were also superior to uncoated balloon angioplasty for up to five years in target lesion revascularization (OR 0.28, 95% CI 0.17 to 0.47 at six months; OR 0.40, 95% CI 0.31 to 0.51 at 12 months; OR 0.28, 95% CI 0.18 to 0.44 at two years; OR 0.21, 95% CI 0.09 to 0.51 at five years) and binary restenosis rate (OR 0.44, 95% CI 0.29 to 0.67 at six months; OR 0.38, 95% CI 0.15 to 0.98 at 12 months; OR 0.26, 95% CI 0.10 to 0.66 at two years; OR 0.12, 95% CI 0.05 to 0.30 at five years). There was no significant difference between DEB and uncoated angioplasty in amputation, death, change in ABI, change in Rutherford category and quality of life (QoL) scores, or functional walking ability, although none of the trials were powered to detect a significant difference in these clinical endpoints. We carried out two subgroup analyses to examine outcomes in femoropopliteal and tibial interventions as well as in people with CLI (4 or greater Rutherford class), and showed no advantage for DEBs in tibial vessels at six and 12 months compared with uncoated balloon angioplasty. There was also no advantage for DEBs in CLI compared with uncoated balloon angioplasty at 12 months. AUTHORS' CONCLUSIONS Based on a meta-analysis of 11 trials with 1838 participants, there is evidence of an advantage for DEBs compared with uncoated balloon angioplasty in several anatomic endpoints such as primary vessel patency (high-quality evidence), binary restenosis rate (moderate-quality evidence), and target lesion revascularization (low-quality evidence) for up to 12 months. Conversely, there is no evidence of an advantage for DEBs in clinical endpoints such as amputation, death, or change in ABI, or change in Rutherford category during 12 months' follow-up. Well-designed randomized trials with long-term follow-up are needed to compare DEBs with uncoated balloon angioplasties adequately for both anatomic and clinical study endpoints before the widespread use of this expensive technology can be justified.
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Affiliation(s)
- Ahmed Kayssi
- University of TorontoDivision of Vascular SurgeryEaton North, 6th Floor, Room EN 6‐214200 Elizabeth StreetTorontoONCanadaM5G 2C4
| | - Talal Al‐Atassi
- University of Ottawa Heart InstituteDivision of Cardiac Surgery40 Ruskin StreetOttawaONCanadaK1Y 4W7
| | - George Oreopoulos
- University of TorontoDivision of Vascular SurgeryEaton North, 6th Floor, Room EN 6‐214200 Elizabeth StreetTorontoONCanadaM5G 2C4
| | - Graham Roche‐Nagle
- University of TorontoDivision of Vascular SurgeryEaton North, 6th Floor, Room EN 6‐214200 Elizabeth StreetTorontoONCanadaM5G 2C4
| | - Kong Teng Tan
- University of TorontoDivision of Vascular and Interventional RadiologyNCSB 1C‐572, 585 University AvenueTorontoONCanadaM5G 2N2
| | - Dheeraj K Rajan
- University of TorontoDivision of Vascular and Interventional RadiologyNCSB 1C‐572, 585 University AvenueTorontoONCanadaM5G 2N2
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Mylonaki I, Strano F, Deglise S, Allémann E, Alonso F, Corpataux JM, Dubuis C, Haefliger JA, Jordan O, Saucy F, Delie F. Perivascular sustained release of atorvastatin from a hydrogel-microparticle delivery system decreases intimal hyperplasia. J Control Release 2016; 232:93-102. [DOI: 10.1016/j.jconrel.2016.04.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 12/26/2022]
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Periadventitial drug delivery for the prevention of intimal hyperplasia following open surgery. J Control Release 2016; 233:174-80. [PMID: 27179635 DOI: 10.1016/j.jconrel.2016.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/02/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Intimal hyperplasia (IH) remains a major cause of poor patient outcomes after surgical revascularization to treat atherosclerosis. A multitude of drugs have been shown to prevent the development of IH. Moreover, endovascular drug delivery following angioplasty and stenting has been achieved with a marked diminution in the incidence of restenosis. Despite advances in endovascular drug delivery, there is currently no clinically available method of periadventitial drug delivery suitable for open vascular reconstructions. Herein we provide an overview of the recent literature regarding innovative polymer platforms for periadventitial drug delivery in preclinical models of IH as well as insights about barriers to clinical translation. METHODS A comprehensive PubMed search confined to the past 15years was performed for studies of periadventitial drug delivery. Additional searches were performed for relevant clinical trials, patents, meeting abstracts, and awards of NIH funding. RESULTS Most of the research involving direct periadventitial delivery without a drug carrier was published prior to 2000. Over the past 15years there have been a surge of reports utilizing periadventitial drug-releasing polymer platforms, most commonly bioresorbable hydrogels and wraps. These methods proved to be effective for the inhibition of IH in various animal models (e.g. balloon angioplasty, wire injury, and vein graft), but very few have advanced to clinical trials. There are a number of barriers that may account for this lack of translation. Promising new approaches including the use of nanoparticles will be described. CONCLUSIONS No periadventitial drug delivery system has reached clinical application. For periadventitial delivery, polymer hydrogels, wraps, and nanoparticles exhibit overlapping and complementary properties. The ideal periadventitial delivery platform would allow for sustained drug release yet exert minimal mechanical and inflammatory stresses to the vessel wall. A clinically applicable strategy for periadventitial drug delivery would benefit thousands of patients undergoing open vascular reconstruction each year.
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Cai J, Yuan H, Wang Q, Yang H, Al-Abed Y, Hua Z, Wang J, Chen D, Wu J, Lu B, Pribis JP, Jiang W, Yang K, Hackam DJ, Tracey KJ, Billiar TR, Chen AF. HMGB1-Driven Inflammation and Intimal Hyperplasia After Arterial Injury Involves Cell-Specific Actions Mediated by TLR4. Arterioscler Thromb Vasc Biol 2015; 35:2579-93. [PMID: 26515416 DOI: 10.1161/atvbaha.115.305789] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/02/2015] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Endoluminal vascular interventions such as angioplasty initiate a sterile inflammatory response resulting from local tissue damage. This response drives the development of intimal hyperplasia (IH) that, in turn, can lead to arterial occlusion. We hypothesized that the ubiquitous nuclear protein and damage-associated molecular pattern molecule, high-mobility group box 1 (HMGB1), is one of the endogenous mediators that activates processes leading to IH after endoluminal injury to the arterial wall. The aim of this study is to investigate whether approaches that reduce the levels of HMGB1 or inhibit its activity suppresses IH after arterial injury. APPROACH AND RESULTS Here, we show that HMGB1 regulates IH in a mouse carotid wire injury model. Induced genetic deletion or neutralization of HMGB1 prevents IH, monocyte recruitment, and smooth muscle cell growth factor production after endoluminal carotid artery injury. A specific inhibitor of HMGB1 myeloid differentiation factor 2-toll-like receptor 4 (TLR4) interaction, P5779, also significantly inhibits IH. HMGB1 deletion is mimicked in this model by global deletion of TLR4 and partially replicated by myeloid-specific deletion of TLR4 but not TLR2 or receptor for advanced glycation endproducts deletion. The specific HMGB1 isoform known to activate TLR4 signaling (disulfide HMGB1) stimulates smooth muscle cell to migrate and produce monocyte chemotactic protein 1/CCL2) via TLR4. Macrophages produce smooth muscle cell mitogens in response to disulfide HMGB1 also in a TLR4/myeloid differentiation primary response gene (88)/Trif-dependent manner. CONCLUSIONS These findings place HMGB1 and its receptor, TLR4 as critical regulators of the events that drive the inflammation leading to IH after endoluminal arterial injury and identify this pathway as a possible therapeutic target to limit IH to attenuate damage-associated molecular pattern molecule-mediated vascular inflammatory responses.
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Affiliation(s)
- Jingjing Cai
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Hong Yuan
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Qingde Wang
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Huan Yang
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Yousef Al-Abed
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Zhong Hua
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Jiemei Wang
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Dandan Chen
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Jinze Wu
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Ben Lu
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - John P Pribis
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Weihong Jiang
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Kan Yang
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - David J Hackam
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Kevin J Tracey
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Timothy R Billiar
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.)
| | - Alex F Chen
- From the Center of Clinical Pharmacology of the Third Xiangya Hospital (J.C., H.Y., Q.W., Z.H., J. Wu), the Center of Vascular Disease and Translational Medicine (A.F.C.), Department of Cardiology of the Third Xiangya Hospital (J.C., H.Y., W.J., K.Y.), and Department of Hematology of the Third Xiangya Hospital (B.L.), Central South University, Changsha, China; Department of Surgery, University of Pittsburgh School of Medicine, PA (J.C., Q.W., Z.H., J. Wang, D.C., J. Wu, J.P.P., D.J.H., T.R.B., A.F.C.); and Laboratory of Biomedical Science, the Feinstein Institute for Medical Research, Manhasset, New York (H.Y., Y.A.-A., K.J.T.).
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Chen D, Tao X, Wang Y, Tian F, Wei Y, Chen G, Shen H, Wang Z, Yu Z, Li H, Chen G. Curcumin accelerates reendothelialization and ameliorates intimal hyperplasia in balloon-injured rat carotid artery via the upregulation of endothelial cell autophagy. Int J Mol Med 2015; 36:1563-71. [PMID: 26459716 PMCID: PMC4678154 DOI: 10.3892/ijmm.2015.2365] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 10/06/2015] [Indexed: 11/30/2022] Open
Abstract
Delayed reendothelialization and intimal hyperplasia (IH) contribute to the failure of vascular interventions. Curcumin (Cur) has been used for various types of diseases with antioxidant, antiproliferative and anti-inflammatory effects. However, investigations involving the application of Cur in inhibiting IH are limited. The aim of the present study was to evaluate the potential therapeutic effects of Cur and its underlying mechanisms on a rat model of carotid artery (CA) intimal injury. In vitro, an endothelial cell (EC) migration assay was conducted using cultured primary human umbilical vein endothelial cells (HUVECs) that were exposed to Cur. In vivo, CA angioplasty injury was used to generate a rat model of intimal injury. CAs were collected at 3 days, and 1 and 4 weeks after injury, respectively, for western blot analysis and double-immunofluorescence analyses, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling staining, oxidative stress indicator analysis and hematoxylin and eosin staining of the neointima. In vivo, Cur significantly enhanced the migration and healing of HUVECs and simultaneously promoted microtubule-associated protein light chain 3-II (LC3-II) expression when HUVECs were subjected to an artificial scratch. In vitro, endangium from the Cur-treated rats exhibited a significantly reduced number of apoptotic ECs and oxidative stress level compared to that of the sham group. In addition, Cur treatment markedly improved quantification of the LC3-II concomitant with the downregulation of p62 in the injured CA. At 1 week following injury, sizable neointimal lesions had developed, although prominent intima thickening was not observed. At 4 weeks, apparent hemadostenosis occurred resulting from the exorbitance IH. Cur treatment markedly reduced the thickness of the neointimal lesion. It is noteworthy that high-dose Cur may have exerted more significant effects than low-dose Cur. Cur can potentially become a therapeutic drug for angiostenosis by imparting a protective effect that accelerates reendothelialization and ameliorates IH and was mediated by its pro-autophagic effect.
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Affiliation(s)
- Dongdong Chen
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Xiaoyang Tao
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Yang Wang
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Fengxuan Tian
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Yongxin Wei
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Guilin Chen
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Haitao Shen
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Zhong Wang
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Zhengquan Yu
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Haiying Li
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Gang Chen
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
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Curaj A, Wu Z, Fokong S, Liehn EA, Weber C, Burlacu A, Lammers T, van Zandvoort M, Kiessling F. Noninvasive molecular ultrasound monitoring of vessel healing after intravascular surgical procedures in a preclinical setup. Arterioscler Thromb Vasc Biol 2015; 35:1366-73. [PMID: 25838431 DOI: 10.1161/atvbaha.114.304857] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 03/22/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Cardiovascular interventions induce damage to the vessel wall making antithrombotic therapy inevitable until complete endothelial recovery. Without a method to accurately determine the endothelial status, many patients undergo prolonged anticoagulation therapy, denying them any invasive medical procedures, such as surgical operations and dental interventions. Therefore, we aim to introduce molecular ultrasound imaging of the vascular cell adhesion molecule (VCAM)-1 using targeted poly-n-butylcyanoacrylate microbubbles (MB(VCAM-1)) as an easy accessible method to monitor accurately the reendothelialization of vessels. APPROACH AND RESULTS ApoE(-/-) mice were fed with an atherogenic diet for 1 and 12 weeks and subsequently, endothelial denudation was performed in the carotid arteries using a guidewire. Molecular ultrasound imaging was performed at different time points after denudation (1, 3, 7, and 14 days). An increased MB(VCAM-1) binding after 1 day, a peak after 3 days, and a decrease after 7 days was found. After 12 weeks of diet, MB(VCAM-1) binding also peaked after 3 days but remained high until 7 days, indicating a delay in endothelial recovery. Two-photon laser scanning microscopy imaging of double fluorescence staining confirmed the exposure of VCAM-1 on the superficial layer after arterial injury only during the healing phase. After complete reendothelialization, VCAM-1 expression persisted in the subendothelial layer but was not reachable for the MBV(CAM-1) anymore. CONCLUSION Molecular ultrasound imaging with MB(VCAM-1) is promising to assess vascular damage and to monitor endothelial recovery after arterial interventions. Thus, it may become an important diagnostic tool supporting the development of adequate therapeutic strategies to personalize anticoagulant and anti-inflammatory therapy after cardiovascular intervention.
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Affiliation(s)
- Adelina Curaj
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.)
| | - Zhuojun Wu
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.)
| | - Stanley Fokong
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.)
| | - Elisa A Liehn
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.)
| | - Christian Weber
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.)
| | - Alexandrina Burlacu
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.)
| | - Twan Lammers
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.)
| | - Marc van Zandvoort
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.).
| | - Fabian Kiessling
- From the Institute for Experimental Molecular Imaging (A.C., Z.W., S.F., T.L., F.K.), Institute for Molecular Cardiovascular Research (A.C., Z.W., E.A.L., M.v.Z.), University Clinic, RWTH Aachen University, Aachen, Germany; Institute of Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Munich, Germany (C.W.); DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Alliance), Munich, Germany (C.W.); Institute of Cellular Biology and Pathology "Nicolae Simionescu" of the Romanian Academy, Bucharest, Romania (A.B.); Department of Controlled Drug Delivery, University of Twente, AE Enschede, The Netherlands (T.L.); and Department of Genetics and Molecular Cell Biology, School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, The Netherlands (M.v.Z.).
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Nurminskaya M, Beazley KE, Smith EP, Belkin AM. Transglutaminase 2 promotes PDGF-mediated activation of PDGFR/Akt1 and β-catenin signaling in vascular smooth muscle cells and supports neointima formation. J Vasc Res 2015; 51:418-28. [PMID: 25612735 DOI: 10.1159/000369461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 10/25/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Phenotypic switch of vascular smooth muscle cells (VSMCs) accompanies neointima formation and associates with vascular diseases. Platelet-derived growth factor (PDGF)-induced activation of PDGFR/Akt1 and β-catenin signaling pathways in VSMCs has been implicated in vessel occlusion. Transglutaminase 2 (TG2) regulates these pathways and its levels are increased in the neointima. OBJECTIVE The aim of this study was to evaluate the role of TG2 in PDGF/β-catenin signaling cross-talk and assess its contribution to neointima. METHODS Aortic VSMCs from wild-type and TG2 knockout mice were tested in vitro for levels of VSMC markers, proliferation, migration and PDGF-induced activation of PDGFR/Akt1 and β-catenin pathways. Neointima in these mice was studied ex vivo in coronary vessels using a heart slice model and in vivo using a carotid artery ligation model. RESULTS Genetic deletion of TG2 attenuated the PDGF-induced phenotypic switch of aortic VSMCs, reduced their proliferation and migration rates, and inhibited PDGF-induced activation of PDGFR/Akt1 and β-catenin pathways in both ex vivo and in vivo neointima models. Importantly, genetic deletion of TG2 also markedly attenuated vessel occlusion. CONCLUSIONS TG2 promotes neointima formation by mediating the PDGF-induced activation of the PDGFR/Akt1 and β-catenin pathways in VSMCs. This study identifies TG2 as a potential therapeutic target for blocking neointima in blood vessels.
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Affiliation(s)
- Maria Nurminskaya
- Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, Baltimore, Md., USA
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Di Minno G, Spadarella G, Cafaro G, Petitto M, Lupoli R, Di Minno A, de Gaetano G, Tremoli E. Systematic reviews and meta-analyses for more profitable strategies in peripheral artery disease. Ann Med 2014; 46:475-89. [PMID: 25045928 PMCID: PMC4245179 DOI: 10.3109/07853890.2014.932618] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
In the peripheral arteries, a thrombus superimposed on atherosclerosis contributes to the progression of peripheral artery disease (PAD), producing intermittent claudication (IC), ischemic necrosis, and, potentially, loss of the limb. PAD with IC is often undiagnosed and, in turn, undertreated. The low percentage of diagnosis (∼30%) in this setting of PAD is of particular concern because of the potential worsening of PAD (amputation) and the high risk of adverse vascular outcomes (vascular death, coronary artery disease, stroke). A Medline literature search of the highest-quality systematic reviews and meta-analyses of randomized controlled trials documents that, due to risk of bias, imprecision, and indirectness, the overall quality of the evidence concerning diagnostic tools and antithrombotic interventions in PAD is generally low. Areas of research emerge from the information collected. Appropriate treatments for PAD patients will only derive from ad-hoc studies. Innovative imaging techniques are needed to identify PAD subjects at the highest vascular risk. Whether IC unresponsive to physical exercise and smoking cessation identifies those with a heritable predisposition to more severe vascular events deserves to be addressed. Devising ways to improve prevention of vascular events in patients with PAD implies a co-ordinated approach in vascular medicine.
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Affiliation(s)
- Giovanni Di Minno
- Department of Clinical Mediine and Surgery, Università degli Studi di Napoli , Naples , Italy
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Novel potential targets for prevention of arterial restenosis: insights from the pre-clinical research. Clin Sci (Lond) 2014; 127:615-34. [PMID: 25072327 DOI: 10.1042/cs20140131] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Restenosis is the pathophysiological process occurring in 10-15% of patients submitted to revascularization procedures of coronary, carotid and peripheral arteries. It can be considered as an excessive healing reaction of the vascular wall subjected to arterial/venous bypass graft interposition, endarterectomy or angioplasty. The advent of bare metal stents, drug-eluting stents and of the more recent drug-eluting balloons, have significantly reduced, but not eliminated, the incidence of restenosis, which remains a clinically relevant problem. Biomedical research in pre-clinical animal models of (re)stenosis, despite its limitations, has contributed enormously to the identification of processes involved in restenosis progression, going well beyond the initial dogma of a primarily proliferative disease. Although the main molecular and cellular mechanisms underlying restenosis have been well described, new signalling molecules and cell types controlling the progress of restenosis are continuously being discovered. In particular, microRNAs and vascular progenitor cells have recently been shown to play a key role in this pathophysiological process. In addition, the advanced highly sensitive high-throughput analyses of molecular alterations at the transcriptome, proteome and metabolome levels occurring in injured vessels in animal models of disease and in human specimens serve as a basis to identify novel potential therapeutic targets for restenosis. Molecular analyses are also contributing to the identification of reliable circulating biomarkers predictive of post-interventional restenosis in patients, which could be potentially helpful in the establishment of an early diagnosis and therapy. The present review summarizes the most recent and promising therapeutic strategies identified in experimental models of (re)stenosis and potentially translatable to patients subjected to revascularization procedures.
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Tang B, Dong X, Wei Z, Qiao H, Jiang H, Liu B, Sun X. Enhanced autophagy by everolimus contributes to the antirestenotic mechanisms in vascular smooth muscle cells. J Vasc Res 2014; 51:259-68. [PMID: 25196016 DOI: 10.1159/000365927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/08/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The present study aims to investigate the underlying mechanisms accounting for the activities of everolimus to inhibit the growth of vascular smooth muscle cells (VSMCs), which contributes to restenosis. METHODS Primary VSMCs were cultured in media containing smooth muscle growth supplements and incubated with testing agents. Cell proliferation, cell cycle distribution, apoptosis and autophagy, and the key molecules involved, were examined. RESULTS Everolimus inhibited the proliferation of VSMCs by inhibiting the activation of ribosomal protein S6 kinase and phosphorylation of eukaryotic translation initiation factor 4E-binding protein 1, and downregulating proliferating cellular nuclear antigen. Everolimus induced cell cycle arrest at the G1 phase by downregulating cyclin D1 and upregulating p27, and increased apoptosis by downregulating Bcl-2, upregulating Bad and activating capsase-3 and poly ADP ribose polymerase. Everolimus enhanced autophagy by increasing the conversion of microtubule-associated protein 1 light chain 3 (LC3)-I to LC3-II, and upregulating Beclin 1. Specific autophagy inhibitors, 3-methyladenine and bafilomycin A1, significantly attenuated the inhibition of cell proliferation, the increased apoptosis and the altered expression of the above key proteins induced by everolimus. CONCLUSIONS Enhanced autophagy by everolimus contributes to its antirestenotic activity and its abilities to inhibit cell proliferation and to induce apoptosis of VSMCs.
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Affiliation(s)
- Bo Tang
- Hepatosplenic Surgery Center, Department of General Surgery, Harbin Medical University, Harbin, China
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