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Li S, Xu Z, Wang Y, Chen L, Wang X, Zhou Y, Lei D, Zang G, Wang G. Recent advances of mechanosensitive genes in vascular endothelial cells for the formation and treatment of atherosclerosis. Genes Dis 2024; 11:101046. [PMID: 38292174 PMCID: PMC10825297 DOI: 10.1016/j.gendis.2023.06.016] [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: 02/18/2022] [Revised: 05/09/2023] [Accepted: 06/06/2023] [Indexed: 02/01/2024] Open
Abstract
Atherosclerotic cardiovascular disease and its complications are a high-incidence disease worldwide. Numerous studies have shown that blood flow shear has a huge impact on the function of vascular endothelial cells, and it plays an important role in gene regulation of pro-inflammatory, pro-thrombotic, pro-oxidative stress, and cell permeability. Many important endothelial cell mechanosensitive genes have been discovered, including KLK10, CCN gene family, NRP2, YAP, TAZ, HIF-1α, NF-κB, FOS, JUN, TFEB, KLF2/KLF4, NRF2, and ID1. Some of them have been intensively studied, whereas the relevant regulatory mechanism of other genes remains unclear. Focusing on these mechanosensitive genes will provide new strategies for therapeutic intervention in atherosclerotic vascular disease. Thus, this article reviews the mechanosensitive genes affecting vascular endothelial cells, including classical pathways and some newly screened genes, and summarizes the latest research progress on their roles in the pathogenesis of atherosclerosis to reveal effective therapeutic targets of drugs and provide new insights for anti-atherosclerosis.
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Affiliation(s)
- Shuyu Li
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, National and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Zichen Xu
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, National and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Yi Wang
- College of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China
| | - Lizhao Chen
- Department of Neurosurgery, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing 400042, China
| | - Xiangxiu Wang
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, National and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Yanghao Zhou
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, National and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Daoxi Lei
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, National and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Guangchao Zang
- College of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China
| | - Guixue Wang
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, National and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
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Yu Y, Xiong Y, Li T, Zhou J, Yan W, Xiong Y, Chen Y, Fu P. Risk factors for in-stent restenosis in maintenance hemodialysis patients with central venous occlusive disease and biomechanical assessment of stents. J Vasc Access 2024; 25:943-952. [PMID: 36540050 DOI: 10.1177/11297298221139640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES To investigate the risk factors and biomechanical mechanisms of in-stent restenosis (ISR) in central venous occlusive disease (CVOD). PATIENTS AND METHODS This retrospective study consecutively included 77 maintenance hemodialysis (MHD) patients with CVOD who received the first percutaneous transluminal angioplasty with stenting (PTS) due to symptomatic CVOD in a tertiary hospital. The mean age was 59.7 ± 14.0 years, and 51.9% of patients were male. The clinical characteristics, occurrence of ISR and patency rates were recorded. Finite element method was applied to assess the biomechanical properties of stents. RESULTS Among 77 patients with a mean CVS score of 8.0 ± 2.8, 20.8%, 62.3%, and 16.9% of patients had the main vein of CVOD in the subclavian vein, brachiocephalic vein, and superior vena cava, respectively. A total of 72 (93.5%) patients received successful PTS treatment, for which the stents implanted were mainly Fluency covered stent (48.6%) and SMART bare stent (31.9%). During 15 (10-24)-months of follow-up, ISR occurred in 36.1% of the 72 patients. The primary and assisted primary patency rates at 6, 12, and 18 months were 78%, 56%, 42% and 95%, 90%, 87%, respectively. A prolonged dialysis vintage was an independent risk factor for ISR, yet the stent type or the main vein location was not correlated with ISR. Among three laser-engraving stents, the SMART stent was the best in terms of flexibility, stress, and strain on stents but worst in stress or strain on vessels. The Luminexx stent was the best in radial force and worst in stress or strain on stents. The Vici stent was the best in stress and strain on vessels and worst in radial force and flexibility. CONCLUSIONS An unsatisfactory comprehensive biomechanical performance from configurations rooted in existing stents may account for the high incidence of ISR in CVOD.
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Affiliation(s)
- Yang Yu
- Kidney Research Laboratory, Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Interventional Therapy Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuqin Xiong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tao Li
- College of Mechanical Engineering, Sichuan University, Chengdu, China
| | - Jingyuan Zhou
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Weijie Yan
- Division of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Xiong
- College of Mechanical Engineering, Sichuan University, Chengdu, China
| | - Yu Chen
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Ping Fu
- Kidney Research Laboratory, Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
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Sun X, Zhang C, Ma Y, He Y, Zhang X, Wu J. Association between diabetes mellitus and primary restenosis following endovascular treatment: a comprehensive meta-analysis of randomized controlled trials. Cardiovasc Diabetol 2024; 23:132. [PMID: 38650038 PMCID: PMC11036687 DOI: 10.1186/s12933-024-02201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 03/14/2024] [Indexed: 04/25/2024] Open
Abstract
IMPORTANCE Diabetes mellitus (DM) is thought to be closely related to arterial stenotic or occlusive disease caused by atherosclerosis. However, there is still no definitive clinical evidence to confirm that patients with diabetes have a higher risk of restenosis. OBJECTIVE This meta-analysis was conducted to determine the effect of DM on restenosis among patients undergoing endovascular treatment, such as percutaneous transluminal angioplasty (PTA) or stenting. DATA SOURCES AND STUDY SELECTION The PubMed/Medline, EMBASE and Cochrane Library electronic databases were searched from 01/1990 to 12/2022, without language restrictions. Trials were included if they satisfied the following eligibility criteria: (1) RCTs of patients with or without DM; (2) lesions confined to the coronary arteries or femoral popliteal artery; (3) endovascular treatment via PTA or stenting; and (4) an outcome of restenosis at the target lesion site. The exclusion criteria included the following: (1) greater than 20% of patients lost to follow-up and (2) a secondary restenosis operation. DATA EXTRACTION AND SYNTHESIS Two researchers independently screened the titles and abstracts for relevance, obtained full texts of potentially eligible studies, and assessed suitability based on inclusion and exclusion criteria.. Disagreements were resolved through consultation with a third researcher. Treatment effects were measured by relative ratios (RRs) with 95% confidence intervals (CIs) using random effects models. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. MAIN OUTCOMES AND MEASURES The main observation endpoint was restenosis, including > 50% stenosis at angiography, or TLR of the primary operation lesion during the follow-up period. RESULTS A total of 31,066 patients from 20 RCTs were included. Patients with DM had a higher risk of primary restenosis after endovascular treatment (RR = 1.43, 95% CI: 1.25-1.62; p = 0.001). CONCLUSIONS AND RELEVANCE This meta-analysis of all currently available RCTs showed that patients with DM are more prone to primary restenosis after endovascular treatment.
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Affiliation(s)
- Xiaolei Sun
- Department of General Surgery (Vascular Surgery), Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
- Department of Interventional Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
- Laboratory of Nucleic Acids in Medicine for National High-Level Talents, Nucleic Acid Medicine of Luzhou Key Laboratory, Southwest Medical University, Luzhou, 646000, China.
- Key Laboratory of Medical Electrophysiology, Ministry of Education and Medical Electrophysiological Key Laboratory of Sichuan Province, Collaborative Innovation Center for Prevention and Treatment of Cardiovascular Disease of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, 646000, China.
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, 646000, China.
- School of Cardiovascular Medicine and Sciences, Faculty of Life Science and Medicine, King's College London British Heart Foundation Centre of Research Excellence, King's College London, London, SE5 9NU, UK.
| | - Cheng Zhang
- Department of General Surgery, Center of Vascular and Interventional Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University &The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, 610031, China
| | - Yarong Ma
- Department of Ophthalmology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Yanzheng He
- Department of General Surgery (Vascular Surgery), Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Xiaodong Zhang
- Chongqing Clinical Research Center for Reproductive Medicine, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
| | - Jianbo Wu
- Department of Pharmacology, Basic Medicine Research Innovation Center for Cardiometabolic Diseases, Ministry of Education, and Laboratory for Cardiovascular Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, 646000, China.
- Key Laboratory of Medical Electrophysiology, Ministry of Education and Medical Electrophysiological Key Laboratory of Sichuan Province, Collaborative Innovation Center for Prevention and Treatment of Cardiovascular Disease of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, 646000, China.
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, 646000, China.
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Giakoumi M, Stephanou PS, Kokkinidou D, Papastefanou C, Anayiotos A, Kapnisis K. A Predictive Toxicokinetic Model for Nickel Leaching from Vascular Stents. ACS Biomater Sci Eng 2024; 10:2534-2551. [PMID: 38525821 PMCID: PMC11005016 DOI: 10.1021/acsbiomaterials.3c01436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
In vitro testing methods offer valuable insights into the corrosion vulnerability of metal implants and enable prompt comparison between devices. However, they fall short in predicting the extent of leaching and the biodistribution of implant byproducts under in vivo conditions. Physiologically based toxicokinetic (PBTK) models are capable of quantitatively establishing such correlations and therefore provide a powerful tool in advancing nonclinical methods to test medical implants and assess patient exposure to implant debris. In this study, we present a multicompartment PBTK model and a simulation engine for toxicological risk assessment of vascular stents. The mathematical model consists of a detailed set of constitutive equations that describe the transfer of nickel ions from the device to peri-implant tissue and circulation and the nickel mass exchange between blood and the various tissues/organs and excreta. Model parameterization was performed using (1) in-house-produced data from immersion testing to compute the device-specific diffusion parameters and (2) full-scale animal in situ implantation studies to extract the mammalian-specific biokinetic functions that characterize the time-dependent biodistribution of the released ions. The PBTK model was put to the test using a simulation engine to estimate the concentration-time profiles, along with confidence intervals through probabilistic Monte Carlo, of nickel ions leaching from the implanted devices and determine if permissible exposure limits are exceeded. The model-derived output demonstrated prognostic conformity with reported experimental data, indicating that it may provide the basis for the broader use of modeling and simulation tools to guide the optimal design of implantable devices in compliance with exposure limits and other regulatory requirements.
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Affiliation(s)
- Matheos Giakoumi
- Department
of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol 3036, Cyprus
| | - Pavlos S. Stephanou
- Department
of Chemical Engineering, Cyprus University
of Technology, Limassol 3036, Cyprus
| | - Despoina Kokkinidou
- Department
of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol 3036, Cyprus
| | | | - Andreas Anayiotos
- Department
of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol 3036, Cyprus
| | - Konstantinos Kapnisis
- Department
of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol 3036, Cyprus
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5
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Qi W, Ooi A, Grayden DB, Opie NL, John SE. Haemodynamics of stent-mounted neural interfaces in tapered and deformed blood vessels. Sci Rep 2024; 14:7212. [PMID: 38532013 DOI: 10.1038/s41598-024-57460-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
The endovascular neural interface provides an appealing minimally invasive alternative to invasive brain electrodes for recording and stimulation. However, stents placed in blood vessels have long been known to affect blood flow (haemodynamics) and lead to neointimal growth within the blood vessel. Both the stent elements (struts and electrodes) and blood vessel wall geometries can affect the mechanical environment on the blood vessel wall, which could lead to unfavourable vascular remodelling after stent placement. With increasing applications of stents and stent-like neural interfaces in venous blood vessels in the brain, it is necessary to understand how stents affect blood flow and tissue growth in veins. We explored the haemodynamics of a stent-mounted neural interface in a blood vessel model. Results indicated that blood vessel deformation and tapering caused a substantial change to the lumen geometry and the haemodynamics. The neointimal proliferation was evaluated in sheep implanted with an endovascular neural interface. Analysis showed a negative correlation with the mean Wall Shear Stress pattern. The results presented here indicate that the optimal stent oversizing ratio must be considered to minimise the haemodynamic impact of stenting.
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Affiliation(s)
- Weijie Qi
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia.
| | - Andrew Ooi
- Department of Mechanical Engineering, The University of Melbourne, Parkville, Australia
| | - David B Grayden
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia
- Graeme Clark Institute, The University of Melbourne, Parkville, Australia
| | - Nicholas L Opie
- Vascular Bionics Laboratory, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Sam E John
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia
- Graeme Clark Institute, The University of Melbourne, Parkville, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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Zhao Y, Yang Y, Guo L, Shen D, Dong Z, Lin Y, Liu H, Wei Y, Zhang B. Effect of ticagrelor versus clopidogrel after implantation of drug-eluting stents guided by either intravascular ultrasound or angiography in patients with acute coronary syndrome-propensity score matching analysis. BMC Cardiovasc Disord 2024; 24:58. [PMID: 38238660 PMCID: PMC10795401 DOI: 10.1186/s12872-023-03659-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/05/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The effect of different dual antiplatelet therapies on thrombotic events on the background of intravascular ultrasound (IVUS) guidance is unclear. We investigated whether ticagrelor can provide any additional benefit to clopidogrel in reducing thrombotic events in acute coronary syndrome (ACS) treated with drug- eluting stent (DES), when guided by IVUS or not. METHODS A total of 5,666 ACS patients who underwent DES implantation and who were discharged on dual antiplatelet therapy were enrolled and grouped according to the use of IVUS or not. Each group was subdivided into two subgroups according to the type of P2Y12 inhibitor used after discharge. Propensity score matching (PSM) was used between the IVUS and no-IVUS groups. Covariate adjustment of Cox proportional hazards model was used between the ticagrelor and clopidogrel groups. Thrombotic event at 12 months was compared in groups separately. RESULTS After PSM, 12-month follow-up data were available for 1,174 patients. Major adverse cardiac events (MACE) were less frequent in the IVUS-guided group (2.2% vs. 4.3%, P = 0.081) with a trend toward statistical significance. Comparison of antiplatelet regimens revealed significantly fewer major adverse cardiac and cerebrovascular events (MACCE) with ticagrelor in the entire PSM cohort and angiography-guided subgroup (2.9% vs. 5.7%, P = 0.035; 3.1% vs. 6.4%, P = 0.020, respectively). Among patients in the IVUS-guided group the outcome was comparable (2.5% vs. 4.4%, P = 0.312). Ticagrelor was associated with increasing bleeding incidence in the entire PSM cohort (1.3% vs. 3.3%, P = 0.030), mainly due to Bleeding Academic Research Consortium type 2 bleeding (0.7% vs. 2.6%, P = 0.010). The results were consistent after covariate adjustment of Cox proportional hazards model. CONCLUSION The comparison of ischemic benefit between ticagrelor and clopidogrel was similar in patients receiving IVUS guidance during stent implantation, probably due to the precise implantation of IVUS. Multicenter, randomized studies should be performed to validate this conclusion.
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Affiliation(s)
- Yinan Zhao
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yuxin Yang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Lei Guo
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Dapeng Shen
- Department of Cardiology, Fuxin center Hospital, Fuxin, 123099, China
| | - Zhichao Dong
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yajuan Lin
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Hao Liu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yushan Wei
- Department of Scientific research, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
| | - Bo Zhang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
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Kokkinidou D, Kaliviotis E, Shammas C, Anayiotos A, Kapnisis K. An in vivo investigation on the effects of stent implantation on hematological and hemorheological parameters. Clin Hemorheol Microcirc 2024; 87:39-53. [PMID: 38143339 DOI: 10.3233/ch-231921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND Even though cardiovascular stenting is widely used for the treatment of coronary artery disease, information on how it can affect the hematological and hemorheological profile is scarce in the literature. Most of the work on this issue is based on theoretical or computational fluid dynamics models, lacking in-depth in vitro and in vivo experimental verification. OBJECTIVE This work investigates, in an in vivo setting, the effects of stenting and the implantation time-course on hematological and hemorheological parameters that could potentially compromise the device's functionality and longevity. METHODS Custom-made self-expanding nitinol stents were implanted in the common carotid artery of male CD1 mice. Whole blood samples were collected from control (non-stented) and stented animals at 5 and 10 weeks post-implantation. Hematological measurements and blood viscosity, red blood cell aggregation, and deformability were performed using standard techniques. RESULTS Implant-induced changes were observed in some of the hematological and hemorheological indices. Blood viscosity seems to have been negatively affected by an increased hematocrit and reduced RBC deformability, at 10 weeks post-implantation, despite a slight decrease in RBC aggregation. CONCLUSIONS Although the alterations observed may be the result of the peri-implant inflammatory response, the physiological consequences due to hemorheological changes need to be further investigated.
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Affiliation(s)
- D Kokkinidou
- Department of Mechanical Engineering and Material Science and Engineering, Cyprus University of Technology, Limassol, Cyprus
| | - E Kaliviotis
- Department of Mechanical Engineering and Material Science and Engineering, Cyprus University of Technology, Limassol, Cyprus
| | - C Shammas
- BIOANALYSIS Clinical Laboratory, Limassol, Cyprus
| | - A Anayiotos
- Department of Mechanical Engineering and Material Science and Engineering, Cyprus University of Technology, Limassol, Cyprus
| | - K Kapnisis
- Department of Mechanical Engineering and Material Science and Engineering, Cyprus University of Technology, Limassol, Cyprus
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Krajnik A, Nimmer E, Brazzo JA, Biber JC, Drewes R, Tumenbayar BI, Sullivan A, Pham K, Krug A, Heo Y, Kolega J, Heo SJ, Lee K, Weil BR, Kim DH, Gupte SA, Bae Y. Survivin regulates intracellular stiffness and extracellular matrix production in vascular smooth muscle cells. APL Bioeng 2023; 7:046104. [PMID: 37868708 PMCID: PMC10590228 DOI: 10.1063/5.0157549] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023] Open
Abstract
Vascular dysfunction is a common cause of cardiovascular diseases characterized by the narrowing and stiffening of arteries, such as atherosclerosis, restenosis, and hypertension. Arterial narrowing results from the aberrant proliferation of vascular smooth muscle cells (VSMCs) and their increased synthesis and deposition of extracellular matrix (ECM) proteins. These, in turn, are modulated by arterial stiffness, but the mechanism for this is not fully understood. We found that survivin is an important regulator of stiffness-mediated ECM synthesis and intracellular stiffness in VSMCs. Whole-transcriptome analysis and cell culture experiments showed that survivin expression is upregulated in injured femoral arteries in mice and in human VSMCs cultured on stiff fibronectin-coated hydrogels. Suppressed expression of survivin in human VSMCs significantly decreased the stiffness-mediated expression of ECM components related to arterial stiffening, such as collagen-I, fibronectin, and lysyl oxidase. By contrast, expression of these ECM proteins was rescued by ectopic expression of survivin in human VSMCs cultured on soft hydrogels. Interestingly, atomic force microscopy analysis showed that suppressed or ectopic expression of survivin decreases or increases intracellular stiffness, respectively. Furthermore, we observed that inhibiting Rac and Rho reduces survivin expression, elucidating a mechanical pathway connecting intracellular tension, mediated by Rac and Rho, to survivin induction. Finally, we found that survivin inhibition decreases FAK phosphorylation, indicating that survivin-dependent intracellular tension feeds back to maintain signaling through FAK. These findings suggest a novel mechanism by which survivin potentially modulates arterial stiffness.
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Affiliation(s)
- Amanda Krajnik
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Erik Nimmer
- Department of Biomedical Engineering, School of Engineering and Applied Sciences, University at Buffalo, Buffalo, New York 14260, USA
| | - Joseph A. Brazzo
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - John C. Biber
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Rhonda Drewes
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Bat-Ider Tumenbayar
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Andra Sullivan
- Department of Biomedical Engineering, School of Engineering and Applied Sciences, University at Buffalo, Buffalo, New York 14260, USA
| | - Khanh Pham
- Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Alanna Krug
- Department of Biomedical Engineering, School of Engineering and Applied Sciences, University at Buffalo, Buffalo, New York 14260, USA
| | | | - John Kolega
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Su-Jin Heo
- Department of Orthopedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | | | - Brian R. Weil
- Department of Physiology and Biophysics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Deok-Ho Kim
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205, USA
| | - Sachin A. Gupte
- Department of Pharmacology, New York Medical College, Valhalla, New York 10595, USA
| | - Yongho Bae
- Author to whom correspondence should be addressed:
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Xu L, He C, Yang S, Zhu Y, Wang P, Wu S, Guo F, Wang Y. Phase-transited lysozyme nanofilm with co-immobilized copper ion and heparin as cardiovascular stent multifunctional coating. Colloids Surf B Biointerfaces 2023; 230:113530. [PMID: 37683323 DOI: 10.1016/j.colsurfb.2023.113530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Abstract
Cardiovascular metal stents have shown potential in the treatment of coronary artery disease using percutaneous coronary intervention. However, thrombosis, endothelialization, and new atherosclerosis after stent implantation remain unsolved problems. Herein, a multifunctional coating material based on phase-transited lysozyme was developed to promote stent endothelialization and simultaneously reduce thrombus events by embedding moieties of heparin and co-immobilized copper ions for in-situ catalyzing nitric oxide (NO) generation. The lysozyme-based biomimetic coating is compatible with blood and enables facile loading and sustainable release of copper ions to produce NO with donors via catalytic reaction. The novel coating strategy displayed several bio-effects of anti-thrombosis; it synergistically promoted endothelial cell growth and inhibited smooth muscle cell growth. Thus, this systemic in vitro study will provide a foundation for developing multifunctional cardiovascular stents in clinical settings.
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Affiliation(s)
- Lehua Xu
- The Institute for Translational Nanomedicine, Shanghai East Hospital, the Institute for Biomedical Engineering and Nano Science, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Chenlong He
- The Institute for Translational Nanomedicine, Shanghai East Hospital, the Institute for Biomedical Engineering and Nano Science, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Shusheng Yang
- Department of Laboratory Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200123, PR China
| | - Yunxia Zhu
- Department of Laboratory Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200123, PR China
| | - Peng Wang
- The Institute for Translational Nanomedicine, Shanghai East Hospital, the Institute for Biomedical Engineering and Nano Science, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Shengming Wu
- The Institute for Translational Nanomedicine, Shanghai East Hospital, the Institute for Biomedical Engineering and Nano Science, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Fangfang Guo
- The Institute for Translational Nanomedicine, Shanghai East Hospital, the Institute for Biomedical Engineering and Nano Science, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Yilong Wang
- The Institute for Translational Nanomedicine, Shanghai East Hospital, the Institute for Biomedical Engineering and Nano Science, School of Medicine, Tongji University, Shanghai 200092, PR China.
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10
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Ninno F, Tsui J, Balabani S, Díaz-Zuccarini V. A systematic review of clinical and biomechanical engineering perspectives on the prediction of restenosis in coronary and peripheral arteries. JVS Vasc Sci 2023; 4:100128. [PMID: 38023962 PMCID: PMC10663814 DOI: 10.1016/j.jvssci.2023.100128] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/10/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Restenosis is a significant complication of revascularization treatments in coronary and peripheral arteries, sometimes necessitating repeated intervention. Establishing when restenosis will happen is extremely difficult due to the interplay of multiple variables and factors. Standard clinical and Doppler ultrasound scans surveillance follow-ups are the only tools clinicians can rely on to monitor intervention outcomes. However, implementing efficient surveillance programs is hindered by health care system limitations, patients' comorbidities, and compliance. Predictive models classifying patients according to their risk of developing restenosis over a specific period will allow the development of tailored surveillance, prevention programs, and efficient clinical workflows. This review aims to: (1) summarize the state-of-the-art in predictive models for restenosis in coronary and peripheral arteries; (2) compare their performance in terms of predictive power; and (3) provide an outlook for potentially improved predictive models. Methods We carried out a comprehensive literature review by accessing the PubMed/MEDLINE database according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy consisted of a combination of keywords and included studies focusing on predictive models of restenosis published between January 1993 and April 2023. One author independently screened titles and abstracts and checked for eligibility. The rest of the authors independently confirmed and discussed in case of any disagreement. The search of published literature identified 22 studies providing two perspectives-clinical and biomechanical engineering-on restenosis and comprising distinct methodologies, predictors, and study designs. We compared predictive models' performance on discrimination and calibration aspects. We reported the performance of models simulating reocclusion progression, evaluated by comparison with clinical images. Results Clinical perspective studies consider only routinely collected patient information as restenosis predictors. Our review reveals that clinical models adopting traditional statistics (n = 14) exhibit only modest predictive power. The latter improves when machine learning algorithms (n = 4) are employed. The logistic regression models of the biomechanical engineering perspective (n = 2) show enhanced predictive power when hemodynamic descriptors linked to restenosis are fused with a limited set of clinical risk factors. Biomechanical engineering studies simulating restenosis progression (n = 2) are able to capture its evolution but are computationally expensive and lack risk scoring for individual patients at specific follow-ups. Conclusions Restenosis predictive models, based solely on routine clinical risk factors and using classical statistics, inadequately predict the occurrence of restenosis. Risk stratification models with increased predictive power can be potentially built by adopting machine learning techniques and incorporating critical information regarding vessel hemodynamics arising from biomechanical engineering analyses.
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Affiliation(s)
- Federica Ninno
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
- Wellcome-EPSRC Centre for Interventional Surgical Sciences, London, United Kingdom
| | - Janice Tsui
- Department of Vascular Surgery, Royal Free Hospital NHS Foundation Trust, London, United Kingdom
- Division of Surgery & Interventional Science, Department of Surgical Biotechnology, Faculty of Medical Sciences, University College London, Royal Free Campus, London, United Kingdom
| | - Stavroula Balabani
- Wellcome-EPSRC Centre for Interventional Surgical Sciences, London, United Kingdom
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Vanessa Díaz-Zuccarini
- Wellcome-EPSRC Centre for Interventional Surgical Sciences, London, United Kingdom
- Department of Mechanical Engineering, University College London, London, United Kingdom
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11
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Pelliccia F, Zimarino M, Niccoli G, Morrone D, De Luca G, Miraldi F, De Caterina R. In-stent restenosis after percutaneous coronary intervention: emerging knowledge on biological pathways. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead083. [PMID: 37808526 PMCID: PMC10558044 DOI: 10.1093/ehjopen/oead083] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/24/2023] [Accepted: 08/15/2023] [Indexed: 10/10/2023]
Abstract
Percutaneous coronary intervention (PCI) has evolved significantly over the past four decades. Since its inception, in-stent restenosis (ISR)-the progressive reduction in vessel lumen diameter after PCI-has emerged as the main complication of the procedure. Although the incidence of ISR has reduced from 30% at 6 months with bare-metal stents to 7% at 4 years with drug-eluting stents (DESs), its occurrence is relevant in absolute terms because of the dimensions of the population treated with PCI. The aim of this review is to summarize the emerging understanding of the biological pathways that underlie ISR. In-stent restenosis is associated with several factors, including patient-related, genetic, anatomic, stent, lesion, and procedural characteristics. Regardless of associated factors, there are common pathophysiological pathways involving molecular phenomena triggered by the mechanical trauma caused by PCI. Such biological pathways are responses to the denudation of the intima during balloon angioplasty and involve inflammation, hypersensitivity reactions, and stem cell mobilization particularly of endothelial progenitor cells (EPCs). The results of these processes are either vessel wall healing or neointimal hyperplasia and/or neo-atherosclerosis. Unravelling the key molecular and signal pathways involved in ISR is crucial to identify appropriate therapeutic strategies aimed at abolishing the 'Achille's heel' of PCI. In this regard, we discuss novel approaches to prevent DES restenosis. Indeed, available evidence suggests that EPC-capturing stents promote rapid stent re-endothelization, which, in turn, has the potential to decrease the risk of stent thrombosis and allow the use of a shorter-duration dual antiplatelet therapy.
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Affiliation(s)
- Francesco Pelliccia
- Department of Cardiovascular Sciences, University Sapienza, Viale del Policlinico 155, 00161 Rome, Italy
| | - Marco Zimarino
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Viale Abruzzo, 332, 66100 Chieti, Italy
- Department of Cardiology, “SS. Annunziata Hospital”, ASL 2 Abruzzo, Via dei Vestini, 66100 Chieti, Italy
| | - Giampaolo Niccoli
- Department of Cardiology, University of Parma, Piazzale S. Francesco, 3, 43121 Parma, Italy
| | - Doralisa Morrone
- Department of Surgical, Medical and Molecular Pathology and of Critical Sciences, University of Pisa, Lungarno Antonio Pacinotti 43, 56126 Pisa, Italy
| | - Giuseppe De Luca
- Division of Cardiology, AOU “Policlinico G. Martino”, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy
- Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio, Via Cristina Belgioioso 173, 20157 Milan, Italy
| | - Fabio Miraldi
- Department of Cardiovascular Sciences, University Sapienza, Viale del Policlinico 155, 00161 Rome, Italy
| | - Raffaele De Caterina
- Department of Surgical, Medical and Molecular Pathology and of Critical Sciences, University of Pisa, Lungarno Antonio Pacinotti 43, 56126 Pisa, Italy
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Kapnisis K, Stylianou A, Kokkinidou D, Martin A, Wang D, Anderson PG, Prokopi M, Papastefanou C, Brott BC, Lemons JE, Anayiotos A. Multilevel Assessment of Stent-Induced Inflammation in the Adjacent Vascular Tissue. ACS Biomater Sci Eng 2023; 9:4747-4760. [PMID: 37480152 PMCID: PMC10428095 DOI: 10.1021/acsbiomaterials.3c00540] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
A recent U.S. Food and Drug Administration report presented the currently available scientific information related to biological response to metal implants. In this work, a multilevel approach was employed to assess the implant-induced and biocorrosion-related inflammation in the adjacent vascular tissue using a mouse stent implantation model. The implications of biocorrosion on peri-implant tissue were assessed at the macroscopic level via in vivo imaging and histomorphology. Elevated matrix metalloproteinase activity, colocalized with the site of implantation, and histological staining indicated that stent surface condition and implantation time affect the inflammatory response and subsequent formation and extent of neointima. Hematological measurements also demonstrated that accumulated metal particle contamination in blood samples from corroded-stetted mice causes a stronger immune response. At the cellular level, the stent-induced alterations in the nanostructure, cytoskeleton, and mechanical properties of circulating lymphocytes were investigated. It was found that cells from corroded-stented samples exhibited higher stiffness, in terms of Young's modulus values, compared to noncorroded and sham-stented samples. Nanomechanical modifications were also accompanied by cellular remodeling, through alterations in cell morphology and stress (F-actin) fiber characteristics. Our analysis indicates that surface wear and elevated metal particle contamination, prompted by corroded stents, may contribute to the inflammatory response and the multifactorial process of in-stent restenosis. The results also suggest that circulating lymphocytes could be a novel nanomechanical biomarker for peri-implant tissue inflammation and possibly the early stage of in-stent restenosis. Large-scale studies are warranted to further investigate these findings.
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Affiliation(s)
- Konstantinos Kapnisis
- Department
of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol 3036, Cyprus
| | - Andreas Stylianou
- School
of Sciences, European University Cyprus, Nicosia 2404, Cyprus
- Department
of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia 1678, Cyprus
| | - Despoina Kokkinidou
- Department
of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol 3036, Cyprus
| | - Adam Martin
- Department
of Pathology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0111, United States
| | - Dezhi Wang
- Department
of Pathology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0111, United States
| | - Peter G. Anderson
- Department
of Pathology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0111, United States
| | - Marianna Prokopi
- Department
of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol 3036, Cyprus
| | | | - Brigitta C. Brott
- Department
of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294-0111, United States
| | - Jack E. Lemons
- Department
of Biomedical Engineering, University of
Alabama at Birmingham, Birmingham, Alabama 35294-0111, United States
| | - Andreas Anayiotos
- Department
of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, Limassol 3036, Cyprus
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13
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Yoon WJ, Mani K, Han SM, Lee CJ, Cho JS, Wanhainen A. Near-wall hemodynamic changes in subclavian artery perfusion induced by retrograde inner branched thoracic endograft implantation. JVS Vasc Sci 2023; 4:100116. [PMID: 37496886 PMCID: PMC10366580 DOI: 10.1016/j.jvssci.2023.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/05/2023] [Indexed: 07/28/2023] Open
Abstract
Objective Left subclavian artery (LSA)-branched endografts with retrograde inner branch configuration (thoracic branch endoprosthesis [TBE]) offer a complete endovascular solution when LSA preservation is required during zone 2 thoracic endovascular aortic repair. However, the hemodynamic consequences of the TBE have not been well-investigated. We compared near-wall hemodynamic parameters before and after the TBE implantation using computational fluid dynamic simulations. Methods Eleven patients who had undergone TBE implantation were included. Three-dimensional aortic arch geometries were constructed from the pre- and post-TBE implantation computed tomography images. The resulting 22 three-dimensional aortic arch geometries were then discretized into finite element meshes for computational fluid dynamic simulations. Inflow boundary conditions were prescribed using normal physiological pulsatile circulation. Outlet boundary conditions consisted of Windkessel models with previously published values. Blood flow, modeled as Newtonian fluid, simulations were performed with rigid wall assumptions using SimVascular's incompressible Navier-Stokes solver. We compared well-established hemodynamic descriptors: pressure, flow rate, time-averaged wall shear stress (TAWSS), the oscillatory shear index (OSI), and percent area with an OSI of >0.2. Data were presented on the stented portion of the LSA. Results TBE implantation was associated with a small decrease in peak LSA pressure (153 mm Hg; interquartile range [IQR], 151-154 mm Hg vs 159 mm Hg; IQR, 158-160 mm Hg; P = .005). No difference was observed in peak LSA flow rates before and after implantation: 40.4 cm3/ (IQR, 39.5-41.6 cm3/s) vs 41.3 cm3/s (IQR, 37.2-44.8 cm3/s; P = .59). There was a significant postimplantation increase in TAWSS (15.2 dynes/cm2 [IQR, 12.2-17.7 dynes/cm2] vs 6.2 dynes/cm2 [IQR, 5.7-10.3 dynes/cm2]; P = .003), leading to decreases in both the OSI (0.088 [IQR, 0.063 to -0.099] vs 0.1 [IQR, 0.096-0.16]; P = .03) and percentage of area with an OSI of >0.2 (10.4 [IQR, 5.8-15.8] vs 15.7 [IQR, 10.7-31.9]; P = .13). Neither LSA side branch angulation (median, 81°, IQR, 77°-109°) nor moderate compression (16%-58%) seemed to have an impact on the pressure, flow rate, TAWSS, or percentage of area with an OSI of >0.2 in the stented LSA. Conclusions The implantation of TBE produces modest hemodynamic disturbances that are unlikely to result in clinically relevant changes.
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Affiliation(s)
- William J. Yoon
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Kevin Mani
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden
| | - Sukgu M. Han
- Comprehensive Aortic Center, Keck Medical Center of University of Southern California, Los Angeles, CA
| | - Cheong J. Lee
- Division of Vascular Surgery, Department of Surgery, NorthShore University Health System, Evanston, IL
| | - Jae S. Cho
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Anders Wanhainen
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden
- Department of Surgical and perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
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14
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Structural and temporal dynamics analysis on drug-eluting stents: History, research hotspots and emerging trends. Bioact Mater 2023; 23:170-186. [DOI: 10.1016/j.bioactmat.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/04/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
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15
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Huang J, Zhang K, Du R, Liu W, Zhang H, Tian T, Wang Y, Wang G, Yin T. The Janus-faced role of Piezo1 in cardiovascular health under mechanical stimulation. Genes Dis 2022. [PMID: 37492728 PMCID: PMC10363580 DOI: 10.1016/j.gendis.2022.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
In recent years, cardiovascular health problems are becoming more and more serious. At the same time, mechanical stimulation closely relates to cardiovascular health. In this context, Piezo1, which is very sensitive to mechanical stimulation, has attracted our attention. Here, we review the critical significance of Piezo1 in mechanical stimulation of endothelial cells, NO production, lipid metabolism, DNA damage protection, the development of new blood vessels and maturation, narrowing of blood vessels, blood pressure regulation, vascular permeability, insulin sensitivity, and maintenance of red blood cell function. Besides, Piezo1 may participate in the occurrence and development of atherosclerosis, diabetes, hypertension, and other cardiovascular diseases. It is worth noting that Piezo1 has dual effects on maintaining cardiovascular health. On the one hand, the function of Piezo1 is necessary to maintain cardiovascular health; on the other hand, under some extreme mechanical stimulation, the overexpression of Piezo1 may bring adverse factors such as inflammation. Therefore, this review discusses the Janus-faced role of Piezo1 in maintaining cardiovascular health and puts forward new ideas to provide references for gene therapy or nanoagents targeting Piezo1.
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16
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Chen X, Xu J, Bao W, Li H, Wu W, Liu J, Pi J, Tomlinson B, Chan P, Ruan C, Zhang Q, Zhang L, Fan H, Morrisey E, Liu Z, Zhang Y, Lin L, Liu J, Zhuang T. Endothelial Foxp1 Regulates Neointimal Hyperplasia Via Matrix Metalloproteinase-9/Cyclin Dependent Kinase Inhibitor 1B Signal Pathway. J Am Heart Assoc 2022; 11:e026378. [PMID: 35904197 PMCID: PMC9375493 DOI: 10.1161/jaha.122.026378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The endothelium is essential for maintaining vascular physiological homeostasis and the endothelial injury leads to the neointimal hyperplasia because of the excessive proliferation of vascular smooth muscle cells. Endothelial Foxp1 (forkhead box P1) has been shown to control endothelial cell (EC) proliferation and migration in vitro. However, whether EC-Foxp1 participates in neointimal formation in vivo is not clear. Our study aimed to investigate the roles and mechanisms of EC-Foxp1 in neointimal hyperplasia. Methods and Results The wire injury femoral artery neointimal hyperplasia model was performed in Foxp1 EC-specific loss-of-function and gain-of-function mice. EC-Foxp1 deletion mice displayed the increased neointimal formation through elevation of vascular smooth muscle cell proliferation and migration, and the reduction of EC proliferation hence reendothelialization after injury. In contrast, EC-Foxp1 overexpression inhibited the neointimal formation. EC-Foxp1 paracrine regulated vascular smooth muscle cell proliferation and migration via targeting matrix metalloproteinase-9. Also, EC-Foxp1 deletion impaired EC repair through reduction of EC proliferation via increasing cyclin dependent kinase inhibitor 1B expression. Delivery of cyclin dependent kinase inhibitor 1B-siRNA to ECs using RGD (Arg-Gly-Asp)-peptide magnetic nanoparticle normalized the EC-Foxp1 deletion-mediated impaired EC repair and attenuated the neointimal formation. EC-Foxp1 regulates matrix metalloproteinase-9/cyclin dependent kinase inhibitor 1B signaling pathway to control injury induced neointimal formation. Conclusions Our study reveals that targeting EC-Foxp1-matrix metalloproteinase-9/cyclin dependent kinase inhibitor 1B pathway might provide future novel therapeutic interventions for restenosis.
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Affiliation(s)
- Xiaoli Chen
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Jianfei Xu
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Wenzhen Bao
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Hongda Li
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Wenrun Wu
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Jiwen Liu
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Jingjiang Pi
- Department of CardiologyShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Brian Tomlinson
- Faculty of MedicineMacau University of Science and TechnologyMacauChina
| | - Paul Chan
- Division of CardiologyDepartment of Internal MedicineWan Fang HospitalTaipei Medical UniversityTaipeiTaiwan
| | - Chengchao Ruan
- Department of Physiology and Pathophysiology School of Basic Medical SciencesFudan UniversityShanghaiChina
| | - Qi Zhang
- Department of CardiologyShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Lin Zhang
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Huimin Fan
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Edward Morrisey
- Department of Cell and Developmental Biology (R.W., E.E.M.)Department of Medicine (E.E.M.)Penn Cardiovascular Institute (E.E.M.), and Penn Institute for Regenerative Medicine (E.E.M.)University of PennsylvaniaPhiladelphiaPennsylvania
| | - Zhongmin Liu
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Yuzhen Zhang
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Li Lin
- Department of CardiologyShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Jie Liu
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Tao Zhuang
- Key Laboratory of Arrhythmias of the Ministry of Education of ChinaResearch Center for Translational MedicineShanghai East HospitalTongji University School of MedicineShanghaiChina,Department of Physiology and Pathophysiology School of Basic Medical SciencesFudan UniversityShanghaiChina,Shanghai Jinshan Eye Disease Prevention and Treatment InstituteShanghai Jinshan Nuclear and Chemical Injury Emergency Treatment CenterJinshan HospitalFudan UniversityShanghaiChina
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Nandan S, Schiavi-Tritz J, Hellmuth R, Dunlop C, Vaughan TJ, Dolan EB. Design and Verification of a Novel Perfusion Bioreactor to Evaluate the Performance of a Self-Expanding Stent for Peripheral Artery Applications. FRONTIERS IN MEDICAL TECHNOLOGY 2022; 4:886458. [PMID: 35800467 PMCID: PMC9253816 DOI: 10.3389/fmedt.2022.886458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Endovascular stenting presents a promising approach to treat peripheral artery stenosis. However, a significant proportion of patients require secondary interventions due to complications such as in-stent restenosis and late stent thrombosis. Clinical failure of stents is not only attributed to patient factors but also on endothelial cell (EC) injury response, stent deployment techniques, and stent design. Three-dimensional in vitro bioreactor systems provide a valuable testbed for endovascular device assessment in a controlled environment replicating hemodynamic flow conditions found in vivo. To date, very few studies have verified the design of bioreactors based on applied flow conditions and their impact on wall shear stress, which plays a key role in the development of vascular pathologies. In this study, we develop a computationally informed bioreactor capable of capturing responses of human umbilical vein endothelial cells seeded on silicone tubes subjected to hemodynamic flow conditions and deployment of a self-expanding nitinol stents. Verification of bioreactor design through computational fluid dynamics analysis confirmed the application of pulsatile flow with minimum oscillations. EC responses based on morphology, nitric oxide (NO) release, metabolic activity, and cell count on day 1 and day 4 verified the presence of hemodynamic flow conditions. For the first time, it is also demonstrated that the designed bioreactor is capable of capturing EC responses to stent deployment beyond a 24-hour period with this testbed. A temporal investigation of EC responses to stent implantation from day 1 to day 4 showed significantly lower metabolic activity, EC proliferation, no significant changes to NO levels and EC's aligning locally to edges of stent struts, and random orientation in between the struts. These EC responses were indicative of stent-induced disturbances to local hemodynamics and sustained EC injury response contributing to neointimal growth and development of in-stent restenosis. This study presents a novel computationally informed 3D in vitro testbed to evaluate stent performance in presence of hemodynamic flow conditions found in native peripheral arteries and could help to bridge the gap between the current capabilities of 2D in vitro cell culture models and expensive pre-clinical in vivo models.
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Affiliation(s)
- Swati Nandan
- Biomedical Engineering and Biomechanics Research Centre (BioMEC), School of Engineering, College of Science and Engineering, National University of Ireland Galway, Galway, Ireland
- Vascular Flow Technology, Dundee, United Kingdom
| | - Jessica Schiavi-Tritz
- Biomedical Engineering and Biomechanics Research Centre (BioMEC), School of Engineering, College of Science and Engineering, National University of Ireland Galway, Galway, Ireland
| | | | - Craig Dunlop
- Vascular Flow Technology, Dundee, United Kingdom
| | - Ted J. Vaughan
- Biomedical Engineering and Biomechanics Research Centre (BioMEC), School of Engineering, College of Science and Engineering, National University of Ireland Galway, Galway, Ireland
- *Correspondence: Ted J. Vaughan
| | - Eimear B. Dolan
- Biomedical Engineering and Biomechanics Research Centre (BioMEC), School of Engineering, College of Science and Engineering, National University of Ireland Galway, Galway, Ireland
- Eimear B. Dolan
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18
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Wang H, Sun A, Li Y, Xi Y, Fan Y, Deng X, Chen Z. A systematic review of DVT and stent restenosis after stent implantation for iliac vein compression syndrome. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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19
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Semi-Automatic Reconstruction of Patient-Specific Stented Coronaries based on Data Assimilation and Computer Aided Design. Cardiovasc Eng Technol 2022; 13:517-534. [PMID: 34993928 DOI: 10.1007/s13239-021-00570-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/26/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE The interplay between geometry and hemodynamics is a significant factor in the development of cardiovascular diseases. This is particularly true for stented coronary arteries. To elucidate this factor, an accurate patient-specific analysis requires the reconstruction of the geometry following the stent deployment for a computational fluid dynamics (CFD) investigation. The image-based reconstruction is troublesome for the different possible positions of the stent struts in the lumen and the coronary wall. However, the accurate inclusion of the stent footprint in the hemodynamic analysis is critical for detecting abnormal stress conditions and flow disturbances, particularly for thick struts like in bioresorbable scaffolds. Here, we present a novel reconstruction methodology that relies on Data Assimilation and Computer Aided Design. METHODS The combination of the geometrical model of the undeployed stent and image-based data assimilated by a variational approach allows the highly automated reconstruction of the skeleton of the stent. A novel approach based on computational mechanics defines the map between the intravascular frame of reference (called L-view) and the 3D geometry retrieved from angiographies. Finally, the volumetric expansion of the stent skeleton needs to be self-intersection free for the successive CFD studies; this is obtained by using implicit representations based on the definition of Nef-polyhedra. RESULTS We assessed our approach on a vessel phantom, with less than 10% difference (properly measured) vs. a customized manual (and longer) procedure previously published, yet with a significant higher level of automation and a shorter turnaround time. Computational hemodynamics results were even closer. We tested the approach on two patient-specific cases as well. CONCLUSIONS The method presented here has a high level of automation and excellent accuracy performances, so it can be used for larger studies involving patient-specific geometries.
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20
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Sunderland K, Jiang J, Zhao F. Disturbed flow's impact on cellular changes indicative of vascular aneurysm initiation, expansion, and rupture: A pathological and methodological review. J Cell Physiol 2022; 237:278-300. [PMID: 34486114 PMCID: PMC8810685 DOI: 10.1002/jcp.30569] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/06/2021] [Accepted: 08/16/2021] [Indexed: 01/03/2023]
Abstract
Aneurysms are malformations within the arterial vasculature brought on by the structural breakdown of the microarchitecture of the vessel wall, with aneurysms posing serious health risks in the event of their rupture. Blood flow within vessels is generally laminar with high, unidirectional wall shear stressors that modulate vascular endothelial cell functionality and regulate vascular smooth muscle cells. However, altered vascular geometry induced by bifurcations, significant curvature, stenosis, or clinical interventions can alter the flow, generating low stressor disturbed flow patterns. Disturbed flow is associated with altered cellular morphology, upregulated expression of proteins modulating inflammation, decreased regulation of vascular permeability, degraded extracellular matrix, and heightened cellular apoptosis. The understanding of the effects disturbed flow has on the cellular cascades which initiate aneurysms and promote their subsequent growth can further elucidate the nature of this complex pathology. This review summarizes the current knowledge about the disturbed flow and its relation to aneurysm pathology, the methods used to investigate these relations, as well as how such knowledge has impacted clinical treatment methodologies. This information can contribute to the understanding of the development, growth, and rupture of aneurysms and help develop novel research and aneurysmal treatment techniques.
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Affiliation(s)
- Kevin Sunderland
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931
| | - Jingfeng Jiang
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931,Corresponding Authors: Feng Zhao, 101 Bizzell Street, College Station, TX 77843-312, Tel : 979-458-1239, , Jingfeng Jiang, 1400 Townsend Dr., Houghton, MI 49931, Tel: 906-487-1943
| | - Feng Zhao
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843,Corresponding Authors: Feng Zhao, 101 Bizzell Street, College Station, TX 77843-312, Tel : 979-458-1239, , Jingfeng Jiang, 1400 Townsend Dr., Houghton, MI 49931, Tel: 906-487-1943
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21
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Current status and outlook of biodegradable metals in neuroscience and their potential applications as cerebral vascular stent materials. Bioact Mater 2021; 11:140-153. [PMID: 34938919 PMCID: PMC8665265 DOI: 10.1016/j.bioactmat.2021.09.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/01/2021] [Accepted: 09/18/2021] [Indexed: 12/12/2022] Open
Abstract
Over the past two decades, biodegradable metals (BMs) have emerged as promising materials to fabricate temporary biomedical devices, with the purpose of avoiding potential side effects of permanent implants. In this review, we first surveyed the current status of BMs in neuroscience, and briefly summarized the representative stents for treating vascular stenosis. Then, inspired by the convincing clinical evidence on the in vivo safety of Mg alloys as cardiovascular stents, we analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for treating ischemic stroke. For these novel applications, some key factors should also be considered in designing BM brain stents, including the anatomic features of the cerebral vasculature, hemodynamic influences, neuro-cytocompatibility and selection of alloying elements. This work may provide insights into the future design and fabrication of BM neurological devices, especially for brain stents. The current status of the application of biodegradable metals (BM) in neuroscience was presented. We analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for ischemic stroke treatment. Key factors in designing BM brain stents were discussed. This work may provide insights into the future design and fabrication of BM neurological devices, especially for brain stents.
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22
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Shen Y, Zhang W, Xie Y, Li A, Wang X, Chen X, Liu Q, Wang Q, Zhang G, Liu Q, Liu J, Zhang D, Zhang Z, Ding J. Surface modification to enhance cell migration on biomaterials and its combination with 3D structural design of occluders to improve interventional treatment of heart diseases. Biomaterials 2021; 279:121208. [PMID: 34749074 DOI: 10.1016/j.biomaterials.2021.121208] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/29/2021] [Accepted: 10/20/2021] [Indexed: 12/17/2022]
Abstract
The dominant source of thromboembolism in heart comes from the left atrial appendage (LAA). An occluder can close LAA and significantly reduce the risk of strokes, particularly for those patients with atrial fibrillation. However, it is technically challenging to fabricate an LAA occluder that is appropriate for percutaneous implantation and can be rapidly endothelialized to accomplish complete closure and avoid severe complication. Hypothesizing that a fast migration rate of endothelial cells on the implant surface would lead to rapid endothelialization, we fabricated an LAA occlusion device for interventional treatment with a well-designed 3D architecture and a nanoscale 2D coating. Through screening of biomaterials surfaces with cellular studies in vitro including cell observations, qPCR, RNA sequencing, and implantation studies in vivo, we revealed that a titanium-nitrogen nanocoating on a NiTi alloy promoted high migration rate of endothelial cells on the surface. The effectiveness of this first nanocoating LAA occluder was validated in animal experiments and a patient case, both of which exhibited successful implantation, fast sealing and long-term safety of the device. The mechanistic insights gained in this study will be useful for the design of medical devices with appropriate surface modification, not necessarily for improved cell adhesion but sometimes for enhanced cell migration.
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Affiliation(s)
- Yang Shen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, China
| | - Wanqian Zhang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, China; R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen, 518057, China
| | - Yumei Xie
- Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Anning Li
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen, 518057, China
| | - Xiuli Wang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, China
| | - Xianmiao Chen
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen, 518057, China
| | - Qingsong Liu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, China
| | - Qunsong Wang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, China
| | - Gui Zhang
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen, 518057, China
| | - Qiong Liu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, China
| | - Jianxiong Liu
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen, 518057, China
| | - Deyuan Zhang
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen, 518057, China.
| | - Zhiwei Zhang
- Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, China.
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Kim K, Park S, Park JH, Cho WS, Kim HE, Lee SM, Kim JE, Kang HS, Jang TS. Improved Biocompatibility of Intra-Arterial Poly-L-Lactic Acid Stent by Tantalum Ion Implantation : 3-Month Results in a Swine Model. J Korean Neurosurg Soc 2021; 64:853-863. [PMID: 34706407 PMCID: PMC8590919 DOI: 10.3340/jkns.2021.0009] [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: 01/12/2021] [Accepted: 03/19/2021] [Indexed: 11/27/2022] Open
Abstract
Objective Biodegradable poly-L-lactic acid (PLLA) with a highly biocompatible surface via tantalum (Ta) ion implantation can be an innovative solution for the problems associated with current biodegradable stents. The purpose of this study is to develop a Ta-implanted PLLA stent for clinical use and to investigate its biological performance capabilities.
Methods A series of in vitro and in vivo tests were used to assess the biological performance of bare and Ta-implanted PLLA stents. The re-endothelialization ability and thrombogenicity were examined through in vitro endothelial cell and platelet adhesion tests. An in vivo swine model was used to evaluate the effects of Ta ion implantation on subacute restenosis and thrombosis. Angiographic and histologic evaluations were conducted at one, two and three months post-treatment.
Results The Ta-implanted PLLA stent was successfully fabricated, exhibiting a smooth surface morphology and modified layer integration. After Ta ion implantation, the surface properties were more favorable for rapid endothelialization and for less platelet attachment compared to the bare PLLA stent. In an in vivo animal test, follow-up angiography showed no evidence of in-stent stenosis in either group. In a microscopic histologic examination, luminal thrombus formation was significantly suppressed in the Ta-implanted PLLA stent group according to the 2-month follow-up assessment (21.2% vs. 63.9%, p=0.005). Cells positive for CD 68, a marker for the monocyte lineage, were less frequently identified around the Ta-implanted PLLA stent in the 1-month follow-up assessments.
Conclusion The use of a Ta-implanted PLLA stent appears to promote re-endothelialization and anti-thrombogenicity.
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Affiliation(s)
- Kangmin Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Suhyung Park
- Department of Materials Science and Engineering, Seoul National University, Seoul, Korea
| | - Jeong Hwan Park
- Department of Pathology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea
| | - Won-Sang Cho
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyoun-Ee Kim
- Department of Materials Science and Engineering, Seoul National University, Seoul, Korea
| | - Sung-Mi Lee
- Department of Materials Science and Engineering, Seoul National University, Seoul, Korea
| | - Jeong Eun Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun-Seung Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Sik Jang
- Department of Materials Science and Engineering, Chosun University, Gwangju, Korea
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Colombo M, He Y, Corti A, Gallo D, Ninno F, Casarin S, Rozowsky JM, Migliavacca F, Berceli S, Chiastra C. In-Stent Restenosis Progression in Human Superficial Femoral Arteries: Dynamics of Lumen Remodeling and Impact of Local Hemodynamics. Ann Biomed Eng 2021; 49:2349-2364. [PMID: 33928465 PMCID: PMC8455500 DOI: 10.1007/s10439-021-02776-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/31/2021] [Indexed: 12/17/2022]
Abstract
In-stent restenosis (ISR) represents a major drawback of stented superficial femoral arteries (SFAs). Motivated by the high incidence and limited knowledge of ISR onset and development in human SFAs, this study aims to (i) analyze the lumen remodeling trajectory over 1-year follow-up period in human stented SFAs and (ii) investigate the impact of altered hemodynamics on ISR initiation and progression. Ten SFA lesions were reconstructed at four follow-ups from computed tomography to quantify the lumen area change occurring within 1-year post-intervention. Patient-specific computational fluid dynamics simulations were performed at each follow-up to relate wall shear stress (WSS) based descriptors with lumen remodeling. The largest lumen remodeling was found in the first post-operative month, with slight regional-specific differences (larger inward remodeling in the fringe segments, p < 0.05). Focal re-narrowing frequently occurred after 6 months. Slight differences in the lumen area change emerged between long and short stents, and between segments upstream and downstream from stent overlapping portions, at specific time intervals. Abnormal patterns of multidirectional WSS were associated with lumen remodeling within 1-year post-intervention. This longitudinal study gave important insights into the dynamics of ISR and the impact of hemodynamics on ISR progression in human SFAs.
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Affiliation(s)
- Monika Colombo
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Yong He
- Department of Surgery, University of Florida, Gainesville, FL, USA
| | - Anna Corti
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Diego Gallo
- PoliToBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Federica Ninno
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
- Department of Medical Physics and Biomedical Engineering, University College of London, London, UK
| | - Stefano Casarin
- Department of Surgery, Houston Methodist Hospital, Houston, TX, USA
- Center for Computational Surgery, Houston Methodist Research Institute, Houston, TX, USA
- Houston Methodist Academic Institute, Houston, TX, USA
| | - Jared M Rozowsky
- Department of Surgery, University of Florida, Gainesville, FL, USA
| | - Francesco Migliavacca
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Scott Berceli
- Department of Surgery, University of Florida, Gainesville, FL, USA
- Malcom Randall VAMC, Gainesville, FL, USA
| | - Claudio Chiastra
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy.
- PoliToBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
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25
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Yang X, Yang Y, Guo J, Meng Y, Li M, Yang P, Liu X, Aung LHH, Yu T, Li Y. Targeting the epigenome in in-stent restenosis: from mechanisms to therapy. MOLECULAR THERAPY. NUCLEIC ACIDS 2021; 23:1136-1160. [PMID: 33664994 PMCID: PMC7896131 DOI: 10.1016/j.omtn.2021.01.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Coronary artery disease (CAD) is one of the most common causes of death worldwide. The introduction of percutaneous revascularization has revolutionized the therapy of patients with CAD. Despite the advent of drug-eluting stents, restenosis remains the main challenge in treating patients with CAD. In-stent restenosis (ISR) indicates the reduction in lumen diameter after percutaneous coronary intervention, in which the vessel's lumen re-narrowing is attributed to the aberrant proliferation and migration of vascular smooth muscle cells (VSMCs) and dysregulation of endothelial cells (ECs). Increasing evidence has demonstrated that epigenetics is involved in the occurrence and progression of ISR. In this review, we provide the latest and comprehensive analysis of three separate but related epigenetic mechanisms regulating ISR, namely, DNA methylation, histone modification, and non-coding RNAs. Initially, we discuss the mechanism of restenosis. Furthermore, we discuss the biological mechanism underlying the diverse epigenetic modifications modulating gene expression and functions of VSMCs, as well as ECs in ISR. Finally, we discuss potential therapeutic targets of the small molecule inhibitors of cardiovascular epigenetic factors. A more detailed understanding of epigenetic regulation is essential for elucidating this complex biological process, which will assist in developing and improving ISR therapy.
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Affiliation(s)
- Xi Yang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Road No. 59 Haier, Qingdao 266100, Shandong, People’s Republic of China
| | - Yanyan Yang
- Department of Immunology, School of Basic Medicine, Qingdao University, No. 308 Ningxia Road, Qingdao 266071, People’s Republic of China
| | - Junjie Guo
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Road No. 59 Haier, Qingdao 266100, Shandong, People’s Republic of China
| | - Yuanyuan Meng
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, People’s Republic of China
| | - Min Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, No. 38 Dengzhou Road, Qingdao 266021, People’s Republic of China
| | - Panyu Yang
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, People’s Republic of China
| | - Xin Liu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Road No. 59 Haier, Qingdao 266100, Shandong, People’s Republic of China
| | - Lynn Htet Htet Aung
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, No. 38 Dengzhou Road, Qingdao 266021, People’s Republic of China
| | - Tao Yu
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, People’s Republic of China
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, No. 38 Dengzhou Road, Qingdao 266021, People’s Republic of China
| | - Yonghong Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Road No. 59 Haier, Qingdao 266100, Shandong, People’s Republic of China
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26
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Wang X, Fang F, Ni Y, Yu H, Ma J, Deng L, Li C, Shen Y, Liu X. The Combined Contribution of Vascular Endothelial Cell Migration and Adhesion to Stent Re-endothelialization. Front Cell Dev Biol 2021; 9:641382. [PMID: 33748131 PMCID: PMC7969796 DOI: 10.3389/fcell.2021.641382] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Coronary stent placement inevitably causes mechanical damage to the endothelium, leading to endothelial denudation and in-stent restenosis (ISR). Re-endothelialization depends mainly on the migration of vascular endothelial cells (VECs) adjacent to the damaged intima, as well as the mobilization and adhesion of circulating VECs. To evaluate the combined contribution of VEC migration and adhesion to re-endothelialization under flow and the influence of stent, in vitro models were constructed to simulate various endothelial denudation scales (2 mm/5 mm/10 mm) and stent deployment depths (flat/groove/bulge). Our results showed that (1) in 2 mm flat/groove/bulge models, both VEC migration and adhesion combined completed the percentage of endothelial recovery about 27, 16, and 12%, and migration accounted for about 21, 15, and 7%, respectively. It was suggested that the flat and groove models were in favor of VEC migration. (2) With the augmentation of the injury scales (5 and 10 mm), the contribution of circulating VEC adhesion on endothelial repair increased. Taken together, endothelial restoration mainly depended on the migration of adjacent VECs when the injury scale was 2 mm. The adhered cells contributed to re-endothelialization in an injury scale-dependent way. This study is helpful to provide new enlightenment for surface modification of cardiovascular implants.
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Affiliation(s)
- Xiaoli Wang
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Fei Fang
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Yinghao Ni
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Hongchi Yu
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Jia Ma
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Li Deng
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Chunli Li
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Yang Shen
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Xiaoheng Liu
- West China School of Basic Medical Sciences and Forensic Medicine, Institute of Biomedical Engineering, Sichuan University, Chengdu, China
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27
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Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries. Sci Rep 2021; 11:1613. [PMID: 33452294 PMCID: PMC7810829 DOI: 10.1038/s41598-020-80681-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 12/24/2020] [Indexed: 11/08/2022] Open
Abstract
In-stent restenosis (ISR) is the major drawback of superficial femoral artery (SFA) stenting. Abnormal hemodynamics after stent implantation seems to promote the development of ISR. Accordingly, this study aims to investigate the impact of local hemodynamics on lumen remodeling in human stented SFA lesions. Ten SFA models were reconstructed at 1-week and 1-year follow-up from computed tomography images. Patient-specific computational fluid dynamics simulations were performed to relate the local hemodynamics at 1-week, expressed in terms of time-averaged wall shear stress (TAWSS), oscillatory shear index and relative residence time, with the lumen remodeling at 1-year, quantified as the change of lumen area between 1-week and 1-year. The TAWSS was negatively associated with the lumen area change (ρ = - 0.75, p = 0.013). The surface area exposed to low TAWSS was positively correlated with the lumen area change (ρ = 0.69, p = 0.026). No significant correlations were present between the other hemodynamic descriptors and lumen area change. The low TAWSS was the best predictive marker of lumen remodeling (positive predictive value of 44.8%). Moreover, stent length and overlapping were predictor of ISR at follow-up. Despite the limited number of analyzed lesions, the overall findings suggest an association between abnormal patterns of WSS after stenting and lumen remodeling.
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28
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Chen J, Dai S, Liu L, Maitz MF, Liao Y, Cui J, Zhao A, Yang P, Huang N, Wang Y. Photo-functionalized TiO 2 nanotubes decorated with multifunctional Ag nanoparticles for enhanced vascular biocompatibility. Bioact Mater 2021; 6:45-54. [PMID: 32817912 PMCID: PMC7417617 DOI: 10.1016/j.bioactmat.2020.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 11/30/2022] Open
Abstract
Titanium dioxide (TiO2) has a long history of application in blood contact materials, but it often suffers from insufficient anticoagulant properties. Recently, we have revealed the photocatalytic effect of TiO2 also induces anticoagulant properties. However, for long-term vascular implant devices such as vascular stents, besides anticoagulation, also anti-inflammatory, anti-hyperplastic properties, and the ability to support endothelial repair, are desired. To meet these requirements, here, we immobilized silver nanoparticles (AgNPs) on the surface of TiO2 nanotubes (TiO2-NTs) to obtain a composite material with enhanced photo-induced anticoagulant property and improvement of the other requested properties. The photo-functionalized TiO2-NTs showed protein-fouling resistance, causing the anticoagulant property and the ability to suppress cell adhesion. The immobilized AgNPs increased the photocatalytic activity of TiO2-NTs to enhances its photo-induced anticoagulant property. The AgNP density was optimized to endow the TiO2-NTs with anti-inflammatory property, a strong inhibitory effect on smooth muscle cells (SMCs), and low toxicity to endothelial cells (ECs). The in vivo test indicated that the photofunctionalized composite material achieved outstanding biocompatibility in vasculature via the synergy of photo-functionalized TiO2-NTs and the multifunctional AgNPs, and therefore has enormous potential in the field of cardiovascular implant devices. Our research could be a useful reference for further designing of multifunctional TiO2 materials with high vascular biocompatibility.
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Affiliation(s)
- Jiang Chen
- National Engineering Research Center for Biomaterials, Sichuan University, No.29 of Wangjiang Road, Wuhou District, Chengdu, Sichuan, 610064, China
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
| | - Sheng Dai
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
| | - Luying Liu
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
| | - Manfred F. Maitz
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
- Max Bergmann Center of Biomaterials, Leibniz Institute of Polymer Research Dresden, Hohe Strasse 6, Dresden, 01069, Germany
| | - Yuzhen Liao
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
| | - Jiawei Cui
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
| | - Ansha Zhao
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
| | - Ping Yang
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
| | - Nan Huang
- Institute of Biomaterials and Surface Engineering, Key Lab. for Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, NO.111 of the North 1st Section of Second Ring Road, Chengdu, 610031, China
| | - Yunbing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, No.29 of Wangjiang Road, Wuhou District, Chengdu, Sichuan, 610064, China
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29
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He S, Liu W, Qu K, Yin T, Qiu J, Li Y, Yuan K, Zhang H, Wang G. Effects of different positions of intravascular stent implantation in stenosed vessels on in-stent restenosis: An experimental and numerical simulation study. J Biomech 2020; 113:110089. [PMID: 33181394 DOI: 10.1016/j.jbiomech.2020.110089] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 09/08/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022]
Abstract
Percutaneous coronary intervention (PCI) has been widely used in the treatment of atherosclerosis, while in-stent restenosis (ISR) has not been completely resolved. Studies have shown that changes in intravascular mechanical environment are related to ISR. Hence, an in-depth understanding of the effects of stent intervention on vascular mechanics is important for clinically optimizing stent implantation and relieving ISR. Nine rabbits with stenotic carotid artery were collected by balloon injury. Intravascular stents were implanted into different longitudinal positions (proximal, middle and distal relative to the stenotic area) of the stenotic vessels for numerical simulations. Optical coherence tomography (OCT) scanning was performed to reconstruct the three-dimensional configuration of the stented carotid artery and blood flow velocity waveforms were collected by Doppler ultrasound. The numerical simulations were performed through direct solution of Naiver-Stokes equation in ANSYS. Results showed that the distributions of time-averaged wall shear stress (TAWSS), oscillating shear index (OSI) and relative residual time (RRT) in near-end segment were distinctively different from other regions of the stent which considered to promote restenosis for all three models. Spearman rank-correlation analysis showed a significant correlation between hemodynamic descriptors and the stent longitudinal positions (rTAWSS = -0.718, rOSI = 0.898, rRRT = 0.818, p < 0.01). Histology results of the near-end segment showed neointima thickening deepened with the longitudinal positions of stent which was consistent with the numerical simulations. The results suggest that stent implantation can promote restenosis at the near-end segment. As the stenting position moves to distal end, the impact on ISR is more significant.
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Affiliation(s)
- Shicheng He
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, PR China; State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, PR China
| | - Wanling Liu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, PR China
| | - Kai Qu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, PR China
| | - Tieying Yin
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, PR China
| | - Juhui Qiu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, PR China.
| | - Yan Li
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, PR China
| | - Kunshan Yuan
- National United Engineering Laboratory for Biomedical Material Modification, Dezhou, Shandong 251100, PR China
| | - Haijun Zhang
- National United Engineering Laboratory for Biomedical Material Modification, Dezhou, Shandong 251100, PR China
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, PR China.
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30
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Zou W, Li X, Li N, Guo T, Cai Y, Yang X, Liang J, Sun Y, Fan Y. A comparative study of autogenous, allograft and artificial bone substitutes on bone regeneration and immunotoxicity in rat femur defect model. Regen Biomater 2020; 8:rbaa040. [PMID: 33732488 PMCID: PMC7947581 DOI: 10.1093/rb/rbaa040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 12/15/2022] Open
Abstract
Repair and reconstruction of large bone defect were often difficult, and bone substitute materials, including autogenous bone, allogenic bone and artificial bone, were common treatment strategies. The key to elucidate the clinical effect of these bone repair materials was to study their osteogenic capacity and immunotoxicological compatibility. In this paper, the mechanical properties, micro-CT imaging analysis, digital image analysis and histological slice analysis of the three bone grafts were investigated and compared after different time points of implantation in rat femur defect model. Autogenous bone and biphasic calcium phosphate particular artificial bone containing 61.4% HA and 38.6% β-tricalcium phosphate with 61.64% porosity and 0.8617 ± 0.0068 g/cm3 density (d ≤ 2 mm) had similar and strong bone repair ability, but autogenous bone implant materials caused greater secondary damage to experimental animals; allogenic bone exhibited poor bone defect repair ability. At the early stage of implantation, the immunological indexes such as Immunoglobulin G, Immunoglobulin M concentration and CD4 cells' population of allogenic bone significantly increased in compared with those of autologous bone and artificial bone. Although the repair process of artificial bone was relatively inefficient than autologous bone graft, the low immunotoxicological indexes and acceptable therapeutic effects endowed it as an excellent alternative material to solve the problems with insufficient source and secondary trauma of autogenous bone.
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Affiliation(s)
- Wen Zou
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China.,Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Xing Li
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Na Li
- Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Tianwei Guo
- Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Yongfu Cai
- Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Xiaoqin Yang
- Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Jie Liang
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China.,Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Yong Sun
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
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31
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Deng Y, Zhang X, Shen H, He Q, Wu Z, Liao W, Yuan M. Application of the Nano-Drug Delivery System in Treatment of Cardiovascular Diseases. Front Bioeng Biotechnol 2020; 7:489. [PMID: 32083068 PMCID: PMC7005934 DOI: 10.3389/fbioe.2019.00489] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 12/31/2019] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular diseases (CVDs) have become a serious threat to human life and health. Though many drugs acting via different mechanism of action are available in the market as conventional formulations for the treatment of CVDs, they are still far from satisfactory due to poor water solubility, low biological efficacy, non-targeting, and drug resistance. Nano-drug delivery systems (NDDSs) provide a new drug delivery method for the treatment of CVDs with the development of nanotechnology, demonstrating great advantages in solving the above problems. Nevertheless, there are some problems about NDDSs need to be addressed, such as cytotoxicity. In this review, the types and targeting strategies of NDDSs were summarized, and the new research progress in the diagnosis and therapy of CVDs in recent years was reviewed. Future prospective for nano-carriers in drug delivery for CVDs includes gene therapy, in order to provide more ideas for the improvement of cardiovascular drugs. In addition, its safety was also discussed in the review.
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Affiliation(s)
- Yudi Deng
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xudong Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Haibin Shen
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qiangnan He
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zijian Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wenzhen Liao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Miaomiao Yuan
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
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32
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Shen X, Jiang J, Deng Y, Zhu H, Lu K. Haemodynamics Study of Tapered Stents Intervention to Tapered Arteries. Cardiovasc Eng Technol 2019; 10:583-589. [DOI: 10.1007/s13239-019-00437-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
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33
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Li T, Feng ZQ, Qu M, Yan K, Yuan T, Gao B, Wang T, Dong W, Zheng J. Core/Shell Piezoelectric Nanofibers with Spatial Self-Orientated β-Phase Nanocrystals for Real-Time Micropressure Monitoring of Cardiovascular Walls. ACS NANO 2019; 13:10062-10073. [PMID: 31469542 DOI: 10.1021/acsnano.9b02483] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Implantable pressure biosensors show great potential for assessment and diagnostics of pressure-related diseases. Here, we present a structural design strategy to fabricate core/shell polyvinylidene difluoride (PVDF)/hydroxylamine hydrochloride (HHE) organic piezoelectric nanofibers (OPNs) with well-controlled and self-orientated nanocrystals in the spatial uniaxial orientation (SUO) of β-phase-rich fibers, which significantly enhance piezoelectric performance, fatigue resistance, stability, and biocompatibility. Then PVDF/HHE OPNs soft sensors are developed and used to monitor subtle pressure changes in vivo. Upon implanting into pig, PVDF/HHE OPNs sensors demonstrate their ultrahigh detecting sensitivity and accuracy to capture micropressure changes at the outside of cardiovascular walls, and output piezoelectric signals can real-time and synchronously reflect and distinguish changes of cardiovascular elasticity and occurrence of atrioventricular heart-block and formation of thrombus. Such biological information can provide a diagnostic basis for early assessment and diagnosis of thrombosis and atherosclerosis, especially for postoperative recrudescence of thrombus deep within the human body.
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Affiliation(s)
- Tong Li
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Zhang-Qi Feng
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Minghe Qu
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Ke Yan
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Tao Yuan
- Department of Orthopedic , Nanjing Jinling Hospital , Nanjing 210002 , China
| | - Bingbing Gao
- State Key Laboratory of Bioelectronics , Southeast University , Nanjing 210096 , China
| | - Ting Wang
- State Key Laboratory of Bioelectronics , Southeast University , Nanjing 210096 , China
| | - Wei Dong
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Jie Zheng
- Department of Chemical and Biomolecular Engineering , The University of Akron , Akron , Ohio 44325 , United States
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34
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Ge S, Xi Y, Du R, Ren Y, Xu Z, Tan Y, Wang Y, Yin T, Wang G. Inhibition of in-stent restenosis after graphene oxide double-layer drug coating with good biocompatibility. Regen Biomater 2019; 6:299-309. [PMID: 31616567 PMCID: PMC6783699 DOI: 10.1093/rb/rbz010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/15/2019] [Accepted: 02/21/2019] [Indexed: 12/20/2022] Open
Abstract
In this study, we designed a double layer-coated vascular stent of 316L stainless steel using an ultrasonic spray system to achieve both antiproliferation and antithrombosis. The coating included an inner layer of graphene oxide (GO) loaded with docetaxel (DTX) and an outer layer of carboxymethyl chitosan (CMC) loaded with heparin (Hep). The coated surface was uniform without aggregation and shedding phenomena before and after stent expanded. The coating treatment was able to inhibit the adhesion and activation of platelets and the proliferation and migration of smooth muscle cells, indicating the excellent biocompatibility and antiproliferation ability. The toxicity tests showed that the GO/DTX and CMC/Hep coating did not cause deformity and organ abnormalities in zebrafish under stereomicroscope. The stents with GO double-layer coating were safe and could effectively prevent thrombosis and in-stent restenosis after the implantation into rabbit carotid arteries for 4–12 weeks.
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Affiliation(s)
- Shuang Ge
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Yadong Xi
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Ruolin Du
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Yuzhen Ren
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Zichen Xu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Youhua Tan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yazhou Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Tieying Yin
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
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35
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Lu J, Zhuang W, Li L, Zhang B, Yang L, Liu D, Yu H, Luo R, Wang Y. Micelle-Embedded Layer-by-Layer Coating with Catechol and Phenylboronic Acid for Tunable Drug Loading, Sustained Release, Mild Tissue Response, and Selective Cell Fate for Re-endothelialization. ACS APPLIED MATERIALS & INTERFACES 2019; 11:10337-10350. [PMID: 30753784 DOI: 10.1021/acsami.9b01253] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Tunable/sustained drug loading/releasing are of significance in addressing low cytotoxicity, long-term performance, and localized mild healing response in biomedical applications. With an ingenious design, a self-healing sandwiched layer-by-layer (LBL) coating was constructed by using chitosan/heparin as adopted polyelectrolytes with embedding of micelles, in which the chitosan backbone was grafted with catechol and the micelle was modified with exposed phenylboronic acid, endowing the coating with enhanced stability by abundant interactions among coating components (e.g., boric acid ester bond formation, weak intermolecular cross-linking, π-π interactions, and H-bonding). Moreover, rapamycin and atorvastatin calcium were selected as drug candidates and loaded into micelles, followed by drug-releasing behavior study. It was found that the LBL coating maintained a linear growth mode up to 30 cycles, giving a favorable tunability of coating construction and drug loading. The coating could also support sustained release of payloads and provide wild tissue response. With the systematic in vitro and in vivo study, such catechol-phenylboronic acid-enhanced LBL coating with drug loading would also address enhanced antiplatelet adhesion/activation and direct cell fate of endothelial cells and smooth muscle cells via tuning of coating cycles and loaded drugs. With modular assembly, such coating indicated potential for achieving enhanced re-endothelialization for vascular implants.
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