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Brennan PG, Mota L, Aridi T, Patel N, Liang P, Ferran C. Advancements in Omics and Breakthrough Gene Therapies: A Glimpse into the Future of Peripheral Artery Disease. Ann Vasc Surg 2024:S0890-5096(24)00156-0. [PMID: 38582204 DOI: 10.1016/j.avsg.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 01/01/2024] [Indexed: 04/08/2024]
Abstract
Peripheral artery disease (PAD), a highly prevalent global disease, associates with significant morbidity and mortality in affected patients. Despite progress in endovascular and open revascularization techniques for advanced PAD, these interventions grapple with elevated rates of arterial restenosis and vein graft failure attributed to intimal hyperplasia (IH). Novel multiomics technologies, coupled with sophisticated analyses tools recently powered by advances in artificial intelligence, have enabled the study of atherosclerosis and IH with unprecedented single-cell and spatial precision. Numerous studies have pinpointed gene hubs regulating pivotal atherogenic and atheroprotective signaling pathways as potential therapeutic candidates. Leveraging advancements in viral and nonviral gene therapy (GT) platforms, gene editing technologies, and cutting-edge biomaterial reservoirs for delivery uniquely positions us to develop safe, efficient, and targeted GTs for PAD-related diseases. Gene therapies appear particularly fitting for ex vivo genetic engineering of IH-resistant vein grafts. This manuscript highlights currently available state-of-the-art multiomics approaches, explores promising GT-based candidates, and details GT delivery modalities employed by our laboratory and others to thwart mid-term vein graft failure caused by IH, as well as other PAD-related conditions. The potential clinical translation of these targeted GTs holds the promise to revolutionize PAD treatment, thereby enhancing patients' quality of life and life expectancy.
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Affiliation(s)
- Phillip G Brennan
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Lucas Mota
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Tarek Aridi
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Nyah Patel
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Patric Liang
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Christiane Ferran
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Division of Nephrology and the Transplant Institute, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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Islam P, Schaly S, Abosalha AK, Boyajian J, Thareja R, Ahmad W, Shum-Tim D, Prakash S. Nanotechnology in development of next generation of stent and related medical devices: Current and future aspects. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2024; 16:e1941. [PMID: 38528392 DOI: 10.1002/wnan.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/08/2023] [Accepted: 01/03/2024] [Indexed: 03/27/2024]
Abstract
Coronary stents have saved millions of lives in the last three decades by treating atherosclerosis especially, by preventing plaque protrusion and subsequent aneurysms. They attenuate the vascular SMC proliferation and promote reconstruction of the endothelial bed to ensure superior revascularization. With the evolution of modern stent types, nanotechnology has become an integral part of stent technology. Nanocoating and nanosurface fabrication on metallic and polymeric stents have improved their drug loading capacity as well as other mechanical, physico-chemical, and biological properties. Nanofeatures can mimic the natural nanofeatures of vascular tissue and control drug-delivery. This review will highlight the role of nanotechnology in addressing the challenges of coronary stents and the recent advancements in the field of related medical devices. Different generations of stents carrying nanoparticle-based formulations like liposomes, lipid-polymer hybrid NPs, polymeric micelles, and dendrimers are discussed highlighting their roles in local drug delivery and anti-restenotic properties. Drug nanoparticles like Paclitaxel embedded in metal stents are discussed as a feature of first-generation drug-eluting stents. Customized precision stents ensure safe delivery of nanoparticle-mediated genes or concerted transfer of gene, drug, and/or bioactive molecules like antibodies, gene mimics via nanofabricated stents. Nanotechnology can aid such therapies for drug delivery successfully due to its easy scale-up possibilities. However, limitations of this technology such as their potential cytotoxic effects associated with nanoparticle delivery that can trigger hypersensitivity reactions have also been discussed in this review. This article is categorized under: Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Therapeutic Approaches and Drug Discovery > Emerging Technologies.
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Affiliation(s)
- Paromita Islam
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Sabrina Schaly
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Ahmed Kh Abosalha
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Pharmaceutical Technology Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Jacqueline Boyajian
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Rahul Thareja
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Waqar Ahmad
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Dominique Shum-Tim
- Division of Cardiac Surgery, Royal Victoria Hospital, McGill University Health Centre, McGill University, Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada
| | - Satya Prakash
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
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Singh AK, Kilari S, Cai C, Misra S. Bindarit encapsulated nanoparticles prevent venous neointimal hyperplasia and restenosis in a murine angioplasty model. Transl Res 2022; 248:68-86. [PMID: 35914678 DOI: 10.1016/j.trsl.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/09/2022] [Accepted: 06/01/2022] [Indexed: 10/16/2022]
Abstract
Monocyte and macrophage recruitment occur to the injured vessel wall after percutaneous transluminal angioplasty (PTA) of stenotic arteriovenous fistulas (AVF) through increased expression of MCP-1 leading to venous neointimal hyperplasia (VNH) and venous stenosis (VS). We hypothesized that adventitial delivery of Bindarit, an oral selective inhibitor of MCP-1, -2, and -3 encapsulated in poly lactic-co-glycolic acid (PLGA) nanoparticles embedded in a thermosensitive Pluronic F127 hydrogel (BN NP) could prevent VNH/VS formation in a murine model of PTA with AVF. Scanning electron microscope and dynamic light scattering were used to characterize the BN NP and control nanoparticles (NP C). Liquid chromatography with tandem mass spectrometry (LC-MS/MS) was used to study drug release kinetics. Immediately after PTA, in a murine model of AVF stenosis, BN NP or NP C was administrated to the adventitia of outflow veins. Animals were sacrificed 3 and 21 days later for gene expression, histomorphometric, and immunohistochemical analyses. Doppler ultrasound was performed weekly. There was no difference in the size and storage modulus of BN NP compared to controls. The pharmacokinetic analysis demonstrated increased drug release from BN NP when compared to controls. BN NP-treated vessels had reduced MCP-1, MCP-2, and MCP-3 gene, and protein levels, reduced macrophage/monocyte abundance, proinflammatory cytokines, and venous fibrosis resulting in positive vascular remodeling and improved patency with reduced VNH/VS. There was increased peak velocity 21 days after PTA in the BN NP group. Adventitial administration of BN NP to the outflow vein after PTA results in decreased VNH/VS.
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Affiliation(s)
- Avishek K Singh
- Departments of Radiology Mayo Clinic, Vascular and Interventional Translational Laboratory, Rochester, Minnesota
| | - Sreenivasulu Kilari
- Departments of Radiology Mayo Clinic, Vascular and Interventional Translational Laboratory, Rochester, Minnesota
| | - Chuanqui Cai
- Departments of Radiology Mayo Clinic, Vascular and Interventional Translational Laboratory, Rochester, Minnesota; Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sanjay Misra
- Departments of Radiology Mayo Clinic, Vascular and Interventional Translational Laboratory, Rochester, Minnesota.
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Wang X, Gao B, Feng Y. Recent advances in inhibiting atherosclerosis and restenosis: from pathogenic factors, therapeutic agents to nano-delivery strategies. J Mater Chem B 2022; 10:1685-1708. [DOI: 10.1039/d2tb00003b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Due to dominant atherosclerosis etiology, cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide. In clinical trials, advanced atherosclerotic plaques can be removed by angioplasty and vascular...
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Yin T, Du R, Wang Y, Huang J, Ge S, Huang Y, Tan Y, Liu Q, Chen Z, Feng H, Du J, Wang Y, Wang G. Two-stage degradation and novel functional endothelium characteristics of a 3-D printed bioresorbable scaffold. Bioact Mater 2021; 10:378-396. [PMID: 34901554 PMCID: PMC8636822 DOI: 10.1016/j.bioactmat.2021.08.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 12/13/2022] Open
Abstract
Bioresorbable scaffolds have emerged as a new generation of vascular implants for the treatment of atherosclerosis, and designed to provide a temporary scaffold that is subsequently absorbed by blood vessels over time. Presently, there is insufficient data on the biological and mechanical responses of blood vessels accompanied by bioresorbable scaffolds (BRS) degradation. Therefore, it is necessary to investigate the inflexion point of degradation, the response of blood vessels, and the pathophysiological process of vascular, as results of such studies will be of great value for the design of next generation of BRS. In this study, abdominal aortas of SD rats were received 3-D printed poly-l-actide vascular scaffolds (PLS) for various durations up to 12 months. The response of PLS implanted aorta went through two distinct processes: (1) the neointima with desirable barrier function was obtained in 1 month, accompanied with slow degradation, inflammation, and intimal hyperplasia; (2) significant degradation occurred from 6 months, accompanied with decreasing inflammation and intimal hyperplasia, while the extracellular matrix recovered to normal vessels which indicate the positive remodeling. These in vivo results indicate that 6 months is a key turning point. This “two-stage degradation and vascular characteristics” is proposed to elucidate the long-term effects of PLS on vascular repair and demonstrated the potential of PLS in promoting endothelium function and positive remodeling, which highlights the benefits of PLS and shed some light in the future researches, such as drug combination coatings design. Proposed two-stage degradation of a PLLA BRS to reveal distinct neointimal recovery and vascular responsive processes. Revealed novel benefits of BRS, including fine endothelium function, anti-thrombosis, and anti-inflammatory. Drug combination coatings should be designed concerning special degradation of BRS and the key turning point, 6 months.
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Affiliation(s)
- 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, 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, 400030, China
| | - Yang 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, China
| | - Junyang Huang
- 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, China
| | - 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, 400030, China
| | - Yuhua Huang
- 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, China
| | - Youhua Tan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Qing Liu
- Beijing Advanced Medical Technologies Inc., Beijing, 102609, China
| | - Zhong Chen
- Beijing Anzhen Hospital of Capital Medical University, Beijing, 100029, China
| | - Hanqing Feng
- Beijing Advanced Medical Technologies Inc., Beijing, 102609, China
| | - Jie Du
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Ave, Beijing, 10029, 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, 400030, China.,School of Medicine, Chongqing University, Chongqing, 400044, 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, China
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6
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Ravindran D, Karimi Galougahi K, Tan JTM, Kavurma MM, Bursill CA. The multiple roles of chemokines in the mechanisms of stent biocompatibility. Cardiovasc Res 2021; 117:2299-2308. [PMID: 32196069 DOI: 10.1093/cvr/cvaa072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/11/2020] [Accepted: 03/18/2020] [Indexed: 01/01/2023] Open
Abstract
While the advent of drug-eluting stents has been clinically effective in substantially reducing the rates of major stent-related adverse events compared with bare metal stents, vascular biological problems such as neointimal hyperplasia, delayed re-endothelialization, late stent thrombosis are not eliminated and, increasingly, neoatherosclerosis is the underlying mechanism for very late stent failure. Further understanding regarding the mechanisms underlying the biological responses to stent deployment is therefore required so that new and improved therapies can be developed. This review will discuss the accumulating evidence that the chemokines, small inflammatory proteins, play a role in each key biological process of stent biocompatibility. It will address the chemokine system in its specialized roles in regulating the multiple facets of vascular biocompatibility including neointimal hyperplasia, endothelial progenitor cell (EPC) mobilization and re-endothelialization after vascular injury, platelet activation and thrombosis, as well as neoatherosclerosis. The evidence in this review suggests that chemokine-targeting strategies may be effective in controlling the pathobiological processes that lead to stent failure. Preclinical studies provide evidence that inhibition of specific chemokines and/or broad-spectrum inhibition of the CC-chemokine class prevents neointimal hyperplasia, reduces thrombosis and suppresses the development of neoatherosclerosis. In contrast, however, to these apparent deleterious effects of chemokines on stent biocompatibility, the CXC chemokine, CXCL12, is essential for the mobilization and recruitment of EPCs that make important contributions to re-endothelialization post-stent deployment. This suggests that future chemokine inhibition strategies would need to be correctly targeted so that all key stent biocompatibility areas could be addressed, without compromising important adaptive biological responses.
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Affiliation(s)
- Dhanya Ravindran
- Heart Research Institute, Sydney 2042, Australia.,The University of Sydney, Sydney Medical School, Sydney 2006, Australia
| | | | - Joanne T M Tan
- South Australian Health and Medical Research Institute, Vascular Research Centre, Adelaide 5000, Australia.,University of Adelaide, Faculty of Health and Medical Science, Adelaide 5000, Australia
| | - Mary M Kavurma
- Heart Research Institute, Sydney 2042, Australia.,The University of Sydney, Sydney Medical School, Sydney 2006, Australia
| | - Christina A Bursill
- South Australian Health and Medical Research Institute, Vascular Research Centre, Adelaide 5000, Australia.,University of Adelaide, Faculty of Health and Medical Science, Adelaide 5000, Australia
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7
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Recent advances in cardiovascular stent for treatment of in-stent restenosis: Mechanisms and strategies. Chin J Chem Eng 2021. [DOI: 10.1016/j.cjche.2020.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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8
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Kim GD, Ng HP, Chan ER, Mahabeleshwar GH. Macrophage-Hypoxia-Inducible Factor-1α Signaling in Carotid Artery Stenosis. THE AMERICAN JOURNAL OF PATHOLOGY 2021; 191:1118-1134. [PMID: 33753024 PMCID: PMC8176143 DOI: 10.1016/j.ajpath.2021.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 12/26/2022]
Abstract
Macrophages play crucial and diverse roles in the pathogenesis of inflammatory vascular diseases. Macrophages are the principal innate immune cells recruited to arterial walls to govern vascular homeostasis by modulating the proliferation of vascular smooth muscle cells, the reorganization of extracellular matrix components, the elimination of dead cells, and the restoration of normal blood flow. However, chronic sterile inflammation within the arterial walls draws inflammatory macrophages into intimal/neointimal regions that may contribute to disease pathogenesis. In this context, the accumulation and aberrant activation of macrophages in the neointimal regions govern the progression of inflammatory arterial wall diseases. Herein, we report that myeloid-hypoxia-inducible factor-1α (HIF1α) deficiency attenuates vascular smooth muscle cells and macrophage abundance in stenotic arteries and abrogates carotid neointima formation in vivo. The integrated transcriptomics, Gene Set Enrichment Analysis, metabolomics, and target gene evaluation showed that HIF1α represses oxidative phosphorylation, tricarboxylic acid cycle, fatty acid metabolism, and c-MYC signaling pathways while promoting inflammatory, glycolytic, hypoxia response gene expression in stenotic artery macrophages. At the molecular level, proinflammatory agents utilized STAT3 signaling pathways to elevate HIF1α expression in macrophages. Collectively, this study uncovers that macrophage-HIF1α deficiency restrains the pathogenesis of carotid artery stenosis by rewiring inflammatory and metabolic signaling pathways in macrophages.
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Affiliation(s)
- Gun-Dong Kim
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
| | - Hang Pong Ng
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
| | - E Ricky Chan
- Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio
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Umezu R, Koga JI, Matoba T, Katsuki S, Wang L, Hasuzawa N, Nomura M, Tsutsui H, Egashira K. Macrophage (Drp1) Dynamin-Related Protein 1 Accelerates Intimal Thickening After Vascular Injury. Arterioscler Thromb Vasc Biol 2020; 40:e214-e226. [PMID: 32493171 DOI: 10.1161/atvbaha.120.314383] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Mitochondria consistently change their morphology in a process regulated by proteins, including Drp1 (dynamin-related protein 1), a protein promoting mitochondrial fission. Drp1 is involved in the mechanisms underlying various cardiovascular diseases, such as myocardial ischemia/reperfusion injury, heart failure, and pulmonary arterial hypertension. However, its role in macrophages, which promote various vascular diseases, is poorly understood. We therefore tested our hypothesis that macrophage Drp1 promotes vascular remodeling after injury. METHOD AND RESULTS To explore the selective role of macrophage Drp1, we created macrophage-selective Drp1-deficient mice and performed femoral arterial wire injury. In these mice, intimal thickening and negative remodeling were attenuated at 4 weeks after injury when compared with control mice. Deletion of macrophage Drp1 also attenuated the macrophage accumulation and cell proliferation in the injured arteries. Gain- and loss-of-function experiments using cultured macrophages indicated that Drp1 induces the expression of molecules associated with inflammatory macrophages. Morphologically, mitochondrial fission was induced in inflammatory macrophages, whereas mitochondrial fusion was induced in less inflammatory/reparative macrophages. Pharmacological inhibition or knockdown of Drp1 decreased the mitochondrial reactive oxygen species and chemotactic activity in cultured macrophages. Co-culture experiments of macrophages with vascular smooth muscle cells indicated that deletion of macrophage Drp1 suppresses growth and migration of vascular smooth muscle cells induced by macrophage-derived soluble factors. CONCLUSIONS Macrophage Drp1 accelerates intimal thickening after vascular injury by promoting macrophage-mediated inflammation. Macrophage Drp1 may be a potential therapeutic target of vascular diseases.
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Affiliation(s)
- Ryuta Umezu
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (R.U., J.K., T.M., S.K., H.T.), Kyushu University, Fukuoka, Japan
| | - Jun-Ichiro Koga
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (R.U., J.K., T.M., S.K., H.T.), Kyushu University, Fukuoka, Japan.,the Department of Cardiovascular Research, Development, and Translational Medicine, Center for Cardiovascular Disruptive Innovation (J.K., K.E.), Kyushu University, Fukuoka, Japan
| | - Tetsuya Matoba
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (R.U., J.K., T.M., S.K., H.T.), Kyushu University, Fukuoka, Japan
| | - Shunsuke Katsuki
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (R.U., J.K., T.M., S.K., H.T.), Kyushu University, Fukuoka, Japan
| | - Lixiang Wang
- The Department of Medicine and Bioregulatory Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (L.W., N.H., M.N.).,Department of Medical Biochemistry (L.W.), Kurume University School of Medicine, Japan
| | - Nao Hasuzawa
- The Department of Medicine and Bioregulatory Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (L.W., N.H., M.N.).,Division of Endocrinology and Metabolism, Department of Internal Medicine (N.H., M.N.), Kurume University School of Medicine, Japan
| | - Masatoshi Nomura
- The Department of Medicine and Bioregulatory Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (L.W., N.H., M.N.).,Division of Endocrinology and Metabolism, Department of Internal Medicine (N.H., M.N.), Kurume University School of Medicine, Japan
| | - Hiroyuki Tsutsui
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (R.U., J.K., T.M., S.K., H.T.), Kyushu University, Fukuoka, Japan
| | - Kensuke Egashira
- the Department of Cardiovascular Research, Development, and Translational Medicine, Center for Cardiovascular Disruptive Innovation (J.K., K.E.), Kyushu University, Fukuoka, Japan.,Department of Translational Medicine, Kyushu University Graduate School of Pharmaceutical Sciences, Fukuoka, Japan (K.E.)
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Beshchasna N, Saqib M, Kraskiewicz H, Wasyluk Ł, Kuzmin O, Duta OC, Ficai D, Ghizdavet Z, Marin A, Ficai A, Sun Z, Pichugin VF, Opitz J, Andronescu E. Recent Advances in Manufacturing Innovative Stents. Pharmaceutics 2020; 12:E349. [PMID: 32294908 PMCID: PMC7238261 DOI: 10.3390/pharmaceutics12040349] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases are the most distributed cause of death worldwide. Stenting of arteries as a percutaneous transluminal angioplasty procedure became a promising minimally invasive therapy based on re-opening narrowed arteries by stent insertion. In order to improve and optimize this method, many research groups are focusing on designing new or improving existent stents. Since the beginning of the stent development in 1986, starting with bare-metal stents (BMS), these devices have been continuously enhanced by applying new materials, developing stent coatings based on inorganic and organic compounds including drugs, nanoparticles or biological components such as genes and cells, as well as adapting stent designs with different fabrication technologies. Drug eluting stents (DES) have been developed to overcome the main shortcomings of BMS or coated stents. Coatings are mainly applied to control biocompatibility, degradation rate, protein adsorption, and allow adequate endothelialization in order to ensure better clinical outcome of BMS, reducing restenosis and thrombosis. As coating materials (i) organic polymers: polyurethanes, poly(ε-caprolactone), styrene-b-isobutylene-b-styrene, polyhydroxybutyrates, poly(lactide-co-glycolide), and phosphoryl choline; (ii) biological components: vascular endothelial growth factor (VEGF) and anti-CD34 antibody and (iii) inorganic coatings: noble metals, wide class of oxides, nitrides, silicide and carbide, hydroxyapatite, diamond-like carbon, and others are used. DES were developed to reduce the tissue hyperplasia and in-stent restenosis utilizing antiproliferative substances like paclitaxel, limus (siro-, zotaro-, evero-, bio-, amphi-, tacro-limus), ABT-578, tyrphostin AGL-2043, genes, etc. The innovative solutions aim at overcoming the main limitations of the stent technology, such as in-stent restenosis and stent thrombosis, while maintaining the prime requirements on biocompatibility, biodegradability, and mechanical behavior. This paper provides an overview of the existing stent types, their functionality, materials, and manufacturing conditions demonstrating the still huge potential for the development of promising stent solutions.
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Affiliation(s)
- Natalia Beshchasna
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, Maria-Reiche-Str. 2, 01109 Dresden, Germany; (M.S.); (J.O.)
| | - Muhammad Saqib
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, Maria-Reiche-Str. 2, 01109 Dresden, Germany; (M.S.); (J.O.)
| | | | - Łukasz Wasyluk
- Balton Sp. z o.o. Modlińska 294, 03-152 Warsaw, Poland; (H.K.); (Ł.W.)
| | - Oleg Kuzmin
- VIP Technologies, Prospect Academicheskiy 8/2, 634055 Tomsk, Russia;
| | - Oana Cristina Duta
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
| | - Denisa Ficai
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
| | - Zeno Ghizdavet
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
| | - Alexandru Marin
- Department of Hydraulics, Hydraulic Machinery and Environmental Engineering, Faculty of Power Engineering, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania;
| | - Anton Ficai
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
- Academy of Romanian Scientists, Spl. Independentei 54, 050094 Bucharest, Romania
| | - Zhilei Sun
- Research School of High-Energy Physics, Tomsk Polytechnic University, Lenin Avenue 30, 634050 Tomsk, Russia;
| | - Vladimir F. Pichugin
- Research School of High-Energy Physics, Tomsk Polytechnic University, Lenin Avenue 30, 634050 Tomsk, Russia;
| | - Joerg Opitz
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, Maria-Reiche-Str. 2, 01109 Dresden, Germany; (M.S.); (J.O.)
| | - Ecaterina Andronescu
- Department of Science and Engineering of Oxide Materials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania; (O.C.D.); (D.F.); (Z.G.); (E.A.)
- Academy of Romanian Scientists, Spl. Independentei 54, 050094 Bucharest, Romania
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Huang YH, Xu Q, Shen T, Li JK, Sheng JY, Shi HJ. Prevention of in-stent restenosis with endothelial progenitor cell (EPC) capture stent placement combined with regional EPC transplantation: An atherosclerotic rabbit model. Cardiol J 2018; 26:283-291. [PMID: 29611172 DOI: 10.5603/cj.a2018.0027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 12/14/2017] [Accepted: 01/15/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Even with drug-eluting stents, the risk of in-stent restenosis (ISR) remains high. The goal of this study was to investigate the use of an endothelial progenitor cell (EPC) capture stent plus regional EPC transplantation to reduce the ISR rate. METHODS Endothelial progenitor cell capture stents were fabricated using fibrin gel and anti-CD34 plus anti-VEGFR-2 dual antibodies. Twenty male New Zealand white rabbits established as an atherosclerotic model were randomly divided into two groups: group 1 (n = 10), in which EPC capture stents were deployed into the right iliac artery; and group 2 (n = 10), in which sirolimus-eluting stents were placed. In both groups, EPCs were transplanted into target vessels beyond the stents, with outflow blocked. Radiologic-pathologic correlation outcomes were reviewed after 2 months. RESULTS The technical success rate of EPC capture stent placement plus EPC transplantation was 100%. The ISR rate in group 1 was lower than in group 2 (1/10 vs. 4/10; p > 0.05). Minimal luminal diameters were larger in group 1 than in group 2 (computed tomographic angiography, 1.85 ± 0.15 mm vs. 1.50 ± 0.20 mm; duplex ultrasound, 1.90 ± 0.10 mm vs. 1.70 ± 0.30 mm; p > 0.05). Transplanted EPCs were tracked positively only in group 1. Pathologic analysis demonstrated neointimal hyperplasia thickness of 0.21 ± 0.09 mm in group 1 vs. 0.11 ± 0.07 mm in group 2 (p < 0.05). CONCLUSION Endothelial progenitor cell capture stent placement plus local EPC transplant decreases the ISR rate through thrombosis reduction rather than through neointimal hyperplasia inhibition.
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Affiliation(s)
- You-Hua Huang
- Department of Radiology, Wujin Hospital, Jiangsu University, Changzhou, China
| | - Qiang Xu
- Department of Radiology, Wujin Hospital, Jiangsu University, Changzhou, China
| | - Tao Shen
- Department of Radiology, Wujin Hospital, Jiangsu University, Changzhou, China
| | - Jian-Ke Li
- Department of Radiology, Wujin Hospital, Jiangsu University, Changzhou, China
| | - Jing-Yu Sheng
- Department of Cardiology, Wujin Hospital, Jiangsu University, Changzhou, China
| | - Hong-Jian Shi
- Department of Radiology, Wujin Hospital, Jiangsu University, Changzhou, China.
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12
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Krishnagopal A, Reddy A, Sen D. Stent-mediated gene and drug delivery for cardiovascular disease and cancer: A brief insight. J Gene Med 2018; 19. [PMID: 28370939 DOI: 10.1002/jgm.2954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 03/23/2017] [Accepted: 03/28/2017] [Indexed: 12/17/2022] Open
Abstract
This review concisely recapitulates the different existing modes of stent-mediated gene/drug delivery, their considerable advancement in clinical trials and a rationale for other merging new technologies such as nanotechnology and microRNA-based therapeutics, in addition to addressing the limitations in each of these perpetual stent platforms. Over the past decade, stent-mediated gene/drug delivery has materialized as a hopeful alternative for cardiovascular disease and cancer in contrast to routine conventional treatment modalities. Regardless of the phenomenal recent developments achieved by coronary interventions and cancer therapies that employ gene and drug-eluting stents, practical hurdles still remain a challenge. The present review highlights the limitations that each of the existing stent-based gene/drug delivery system encompasses and therefore provides a vision for the future with respect to discovering an ideal stent therapeutic platform that would circumvent all the practical hurdles witnessed with the existing technology. Further study of the improvisation of next-generation drug-eluting stents has helped to overcome the issue of restenosis to some extent. However, current stent formulations fall short of the anticipated clinically meaningful outcomes and there is an explicit need for more randomized trials aiming to further evaluate stent platforms in favour of enhanced safety and clinical value. Gene-eluting stents may hold promise in contributing new ideas for stent-based prevention of in-stent restenosis through genetic interventions by capitalizing on a wide variety of molecular targets. Therefore, the central consideration directs us toward finding an ideal stent therapeutic platform that would tackle all of the gaps in the existing technology.
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Affiliation(s)
| | - Aakash Reddy
- Cellular and Molecular Therapeutics Laboratory, Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), VIT University, Vellore, Tamil Nadu, India
| | - Dwaipayan Sen
- Cellular and Molecular Therapeutics Laboratory, Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), VIT University, Vellore, Tamil Nadu, India
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13
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Falconer D, Papageorgiou N, Antoniades C, Tousoulis D. Gene Therapy. Coron Artery Dis 2018. [DOI: 10.1016/b978-0-12-811908-2.00015-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Lekshmi KM, Che HL, Cho CS, Park IK. Drug- and Gene-eluting Stents for Preventing Coronary Restenosis. Chonnam Med J 2017; 53:14-27. [PMID: 28184335 PMCID: PMC5299126 DOI: 10.4068/cmj.2017.53.1.14] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/17/2016] [Accepted: 08/18/2016] [Indexed: 12/19/2022] Open
Abstract
Coronary artery disease (CAD) has been reported to be a major cause of death worldwide. Current treatment methods include atherectomy, coronary angioplasty (as a percutaneous coronary intervention), and coronary artery bypass. Among them, the insertion of stents into the coronary artery is one of the commonly used methods for CAD, although the formation of in-stent restenosis (ISR) is a major drawback, demanding improvement in stent technology. Stents can be improved using the delivery of DNA, siRNA, and miRNA rather than anti-inflammatory/anti-thrombotic drugs. In particular, genes that could interfere with the development of plaque around infected regions are conjugated on the stent surface to inhibit neointimal formation. Despite their potential benefits, it is necessary to explore the various properties of gene-eluting stents. Furthermore, multifunctional electronic stents that can be used as a biosensor and deliver drug- or gene-based on physiological condition will be a very promising way to the successful treatment of ISR. In this review, we have discussed the molecular mechanism of restenosis, the use of drug- and gene-eluting stents, and the possible roles that these stents have in the prevention and treatment of coronary restenosis. Further, we have explained how multifunctional electronic stents could be used as a biosensor and deliver drugs based on physiological conditions.
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Affiliation(s)
- Kamali Manickavasagam Lekshmi
- Department of Biomedical Sciences and BK21 PLUS Centre for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Korea
| | - Hui-Lian Che
- Department of Biomedical Sciences and BK21 PLUS Centre for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Korea.; Heart Research Centre, Chonnam National University Hospital, Gwangju, Korea
| | - Chong-Su Cho
- Department of Agricultural Biotechnology and Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea
| | - In-Kyu Park
- Department of Biomedical Sciences and BK21 PLUS Centre for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Korea
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15
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Wu CC, Chen TY, Hsieh MY, Lin L, Yang CW, Chuang SY, Tarng DC. Monocyte Chemoattractant Protein-1 Levels and Postangioplasty Restenosis of Arteriovenous Fistulas. Clin J Am Soc Nephrol 2017; 12:113-121. [PMID: 27797894 PMCID: PMC5220654 DOI: 10.2215/cjn.04030416] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/25/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Inflammation is relevant in restenosis of atherosclerotic vascular diseases, but its role in dialysis arteriovenous fistula remains unknown. In animal studies, upregulation of monocyte chemoattractant protein-1 has been shown in venous segments of arteriovenous fistula. We, therefore, aimed to investigate serial changes in circulating monocyte chemoattractant protein-1 after percutaneous transluminal angioplasty of dialysis arteriovenous fistulas and its relation to restenosis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Fifty-nine patients with dysfunctional arteriovenous fistulas that were referred for percutaneous transluminal angioplasty were enrolled prospectively between January of 2010 and July of 2012. Three of them were excluded due to percutaneous transluminal angioplasty failure or acute infection. Blood was sampled from arteriovenous fistulas at baseline, 2 days, 2 weeks, and 3 months after percutaneous transluminal angioplasty. Clinical follow-up was continued monthly for 3 months. Angiographic follow-up was arranged at the end of 3 months. Seventeen patients without significant stenosis were enrolled as the control group. RESULTS Fifty-six patients completed clinical follow-up. Significant increases in monocyte chemoattractant protein-1 were observed at 2 days and 2 weeks (both P<0.001) after percutaneous transluminal angioplasty. Twenty-three (41%) patients had symptomatic restenosis. The restenosis group had a higher percentage change in monocyte chemoattractant protein-1 levels at 2 days (median =47%; interquartile range, 27%-65% versus median =17%; interquartile range, 10%-25%; P<0.001) after percutaneous transluminal angioplasty compared with the patent group. Fifty-two patients completed angiographic follow-up. A positive correlation between relative luminal loss and monocyte chemoattractant protein-1 increase at 2 days after percutaneous transluminal angioplasty was found (r=0.53; P<0.001). In multivariate analysis, postangioplasty monocyte chemoattractant protein-1 increase at 2 days was an independent predictor of restenosis. Using receiver operator characteristic analysis, >25% postangioplasty increase of monocyte chemoattractant protein-1 was significantly associated with restenosis after percutaneous transluminal angioplasty (hazard ratio, 5.36; 95% confidence interval, 1.81 to 15.8). CONCLUSIONS Circulating monocyte chemoattractant protein-1 levels were elevated 2 days and 2 weeks after percutaneous transluminal angioplasty. Early postangioplasty increase of monocyte chemoattractant protein-1 level was associated with restenosis of arteriovenous fistulas.
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Affiliation(s)
- Chih-Cheng Wu
- Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Institute of Biomedical Engineering, National Tsing-Hua University, Hsinchu, Taiwan
- College of Medicine, National Taiwan University and School of Medicine and
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Mu-Yang Hsieh
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Lin Lin
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-Wei Yang
- Hemodialysis Centers, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Shao-Yuan Chuang
- Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; and
| | - Der-Cheng Tarng
- Institutes of Physiology and Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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16
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Fishbein I, Alferiev IS, Chorny M, Levy RJ. Gene Delivery from Stents for Prevention of In-Stent Restenosis. EUROPEAN MEDICAL JOURNAL 2016. [DOI: 10.33590/emj/10314517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
The increasing sophistication of vascular stent design, especially devices that combine mechanical support with local drug delivery to the vascular wall, has resulted in major progress in the management of coronary and peripheral artery disease. This progress is reflected in expanded anatomical and clinical indications for stent angioplasty, with complementary reduction in bypass surgery rates and decreased need for target-lesion revascularisation. Nevertheless, even with second-generation drug-eluting stents (DES), the most common cause of stent failure, in-stent restenosis, while <10%, generates high numbers of cases due to the large scale of stent use (there are >1 million stent angioplasty procedures yearly in the USA alone). Gene-eluting stents (GES), the next generation of stent devices now in the preclinical phase of development, have evolved over the past two decades around the concept of localised vessel wall delivery of gene vectors attached to the stent struts. GES potentially provide several important advantages over DES, such as prolonged or even permanent anti-restenotic effect, capacity to deliver dissimilar impact on smooth muscle cells and endothelium, and fine-tuning of transgene expression and pharmacological effect with systemically administered therapeutics. Furthermore, GES can be used for treating non-occlusive lesions with the aim of slowing the underlying atherosclerotic process in the vessel wall. GES research at this time is concerned with achieving effective and safe transgene overexpression in the stented arteries, optimal vector choice, and proper techniques for vector immobilisation on the stent struts.
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Affiliation(s)
- Ilia Fishbein
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ivan S. Alferiev
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael Chorny
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert J. Levy
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania, Philadelphia, Pennsylvania, USA
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17
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Nabeshima A, Pajarinen J, Lin TH, Jiang X, Gibon E, Córdova LA, Loi F, Lu L, Jämsen E, Egashira K, Yang F, Yao Z, Goodman SB. Mutant CCL2 protein coating mitigates wear particle-induced bone loss in a murine continuous polyethylene infusion model. Biomaterials 2016; 117:1-9. [PMID: 27918885 DOI: 10.1016/j.biomaterials.2016.11.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/10/2016] [Accepted: 11/24/2016] [Indexed: 01/22/2023]
Abstract
Wear particle-induced osteolysis limits the long-term survivorship of total joint replacement (TJR). Monocyte/macrophages are the key cells of this adverse reaction. Monocyte Chemoattractant Protein-1 (MCP-1/CCL2) is the most important chemokine regulating trafficking of monocyte/macrophages in particle-induced inflammation. 7ND recombinant protein is a mutant of CCL2 that inhibits CCL2 signaling. We have recently developed a layer-by-layer (LBL) coating platform on implant surfaces that can release biologically active 7ND. In this study, we investigated the effect of 7ND on wear particle-induced bone loss using the murine continuous polyethylene (PE) particle infusion model with 7ND coating of a titanium rod as a local drug delivery device. PE particles were infused into hollow titanium rods with or without 7ND coating implanted in the distal femur for 4 weeks. Specific groups were also injected with RAW 264.7 as the reporter macrophages. Wear particle-induced bone loss and the effects of 7ND were evaluated by microCT, immunohistochemical staining, and bioluminescence imaging. Local delivery of 7ND using the LBL coating decreased systemic macrophage recruitment, the number of osteoclasts and wear particle-induced bone loss. The development of a novel orthopaedic implant coating with anti-CCL2 protein may be a promising strategy to mitigate peri-prosthetic osteolysis.
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Affiliation(s)
- Akira Nabeshima
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Jukka Pajarinen
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Tzu-Hua Lin
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Xinyi Jiang
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Emmanuel Gibon
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Luis A Córdova
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Florence Loi
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Laura Lu
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Eemeli Jämsen
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Kensuke Egashira
- Department of Cardiovascular Research, Development, and Translational Medicine, Kyushu University, Fukuoka, Japan
| | - Fan Yang
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA; Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Zhenyu Yao
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA; Department of Bioengineering, Stanford University, Stanford, CA, USA.
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18
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Sato T, Pajarinen J, Behn A, Jiang X, Lin TH, Loi F, Yao Z, Egashira K, Yang F, Goodman SB. The effect of local IL-4 delivery or CCL2 blockade on implant fixation and bone structural properties in a mouse model of wear particle induced osteolysis. J Biomed Mater Res A 2016; 104:2255-62. [PMID: 27114284 DOI: 10.1002/jbm.a.35759] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 03/25/2016] [Accepted: 04/21/2016] [Indexed: 12/21/2022]
Abstract
Modulation of macrophage polarization and prevention of CCL2-induced macrophage chemotaxis are emerging strategies to reduce wear particle induced osteolysis and aseptic total joint replacement loosening. In this study, the effect of continuous IL-4 delivery or bioactive implant coating that constitutively releases a protein inhibitor of CCL2 signaling (7ND) on particle induced osteolysis were studied in the murine continuous femoral intramedullary particle infusion model. Polyethylene particles with or without IL-4 were infused into mouse distal femurs implanted with hollow titanium rods using subcutaneous infusion pumps. In another experimental group, particles were infused into the femur through a 7ND coated rod. After 4 weeks, fixation of the implant was assessed using a pullout test. The volume of trabecular bone and the geometry of the local cortical bone were assessed by µCT and the corresponding structural properties of the cortical bone determined by torsional testing. Continuous IL-4 delivery led to increased trabecular bone volume as well as enhanced local bone geometry and structural properties, while 7ND implant coating did not have effect on these parameters. The results suggest that local IL-4 treatment is a promising strategy to mitigate wear particle induced osteolysis. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2255-2262, 2016.
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Affiliation(s)
- Taishi Sato
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Jukka Pajarinen
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Anthony Behn
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Xinyi Jiang
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Tzu-Hua Lin
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Florence Loi
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Zhenyu Yao
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Kensuke Egashira
- Department of Cardiovascular Research, Development, and Translational Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Fan Yang
- Department of Orthopaedic Surgery, Stanford University, Stanford, California.,Department of Bioengineering, Stanford University, Stanford, California
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University, Stanford, California.,Department of Bioengineering, Stanford University, Stanford, California
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19
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Bessler WK, Kim G, Hudson FZ, Mund JA, Mali R, Menon K, Kapur R, Clapp DW, Ingram DA, Stansfield BK. Nf1+/- monocytes/macrophages induce neointima formation via CCR2 activation. Hum Mol Genet 2016; 25:1129-39. [PMID: 26740548 DOI: 10.1093/hmg/ddv635] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/30/2015] [Indexed: 12/21/2022] Open
Abstract
Persons with neurofibromatosis type 1 (NF1) have a predisposition for premature and severe arterial stenosis. Mutations in the NF1 gene result in decreased expression of neurofibromin, a negative regulator of p21(Ras), and increases Ras signaling. Heterozygous Nf1 (Nf1(+/-)) mice develop a marked arterial stenosis characterized by proliferating smooth muscle cells (SMCs) and a predominance of infiltrating macrophages, which closely resembles arterial lesions from NF1 patients. Interestingly, lineage-restricted inactivation of a single Nf1 allele in monocytes/macrophages is sufficient to recapitulate the phenotype observed in Nf1(+/-) mice and to mobilize proinflammatory CCR2+ monocytes into the peripheral blood. Therefore, we hypothesized that CCR2 receptor activation by its primary ligand monocyte chemotactic protein-1 (MCP-1) is critical for monocyte infiltration into the arterial wall and neointima formation in Nf1(+/-) mice. MCP-1 induces a dose-responsive increase in Nf1(+/-) macrophage migration and proliferation that corresponds with activation of multiple Ras kinases. In addition, Nf1(+/-) SMCs, which express CCR2, demonstrate an enhanced proliferative response to MCP-1 when compared with WT SMCs. To interrogate the role of CCR2 activation on Nf1(+/-) neointima formation, we induced neointima formation by carotid artery ligation in Nf1(+/-) and WT mice with genetic deletion of either MCP1 or CCR2. Loss of MCP-1 or CCR2 expression effectively inhibited Nf1(+/-) neointima formation and reduced macrophage content in the arterial wall. Finally, administration of a CCR2 antagonist significantly reduced Nf1(+/-) neointima formation. These studies identify MCP-1 as a potent chemokine for Nf1(+/-) monocytes/macrophages and CCR2 as a viable therapeutic target for NF1 arterial stenosis.
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Affiliation(s)
- Waylan K Bessler
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics and Neonatal-Perinatal Medicine and Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Grace Kim
- Department of Pediatrics and Neonatal-Perinatal Medicine and Vascular Biology Center, Augusta University, Augusta, GA 30912, USA
| | - Farlyn Z Hudson
- Department of Pediatrics and Neonatal-Perinatal Medicine and Vascular Biology Center, Augusta University, Augusta, GA 30912, USA
| | - Julie A Mund
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics and Neonatal-Perinatal Medicine and
| | - Raghuveer Mali
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics and Neonatal-Perinatal Medicine and Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Keshav Menon
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics and Neonatal-Perinatal Medicine and
| | - Reuben Kapur
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics and Neonatal-Perinatal Medicine and Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - D Wade Clapp
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics and Neonatal-Perinatal Medicine and Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - David A Ingram
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics and Neonatal-Perinatal Medicine and Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Brian K Stansfield
- Department of Pediatrics and Neonatal-Perinatal Medicine and Vascular Biology Center, Augusta University, Augusta, GA 30912, USA
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20
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Roopmani P, Sethuraman S, Satheesh S, Maheswari Krishnan U. The metamorphosis of vascular stents: passive structures to smart devices. RSC Adv 2016. [DOI: 10.1039/c5ra19109b] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The role of nanotechnology enabled techniques in the evolution of vascular stents.
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Affiliation(s)
- Purandhi Roopmani
- Centre for Nanotechnology and Advanced Biomaterials (CeNTAB)
- School of Chemical and Biotechnology
- SASTRA University
- Thanjavur-613 401
- India
| | - Swaminathan Sethuraman
- Centre for Nanotechnology and Advanced Biomaterials (CeNTAB)
- School of Chemical and Biotechnology
- SASTRA University
- Thanjavur-613 401
- India
| | - Santhosh Satheesh
- Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER)
- Department of Cardiology
- Pondicherry-605 006
- India
| | - Uma Maheswari Krishnan
- Centre for Nanotechnology and Advanced Biomaterials (CeNTAB)
- School of Chemical and Biotechnology
- SASTRA University
- Thanjavur-613 401
- India
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21
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Yu Y, Wise SG, Celermajer DS, Bilek MMM, Ng MKC. Bioengineering stents with proactive biocompatibility. Interv Cardiol 2015. [DOI: 10.2217/ica.15.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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22
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Yao EH, Wang HJ, Xu CS. Effects of tongxinluo on the neointima formation and expression of inflammatory cytokines in rats after carotid artery balloon injury. Indian J Pharmacol 2014; 46:510-4. [PMID: 25298580 PMCID: PMC4175887 DOI: 10.4103/0253-7613.140582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 03/15/2014] [Accepted: 07/26/2014] [Indexed: 12/05/2022] Open
Abstract
Objective: Tongxinluo (TXL) is a traditional Chinese medicine (TCM). It is used to treat coronary heart disease and atherosclerosis. We investigated the effects of TXL on the neointima formation and expression of inflammatory cytokines in rats after carotid artery balloon injury. Materials and Methods: Male Sprague-Dawley rats were randomly divided into four groups: sham operation group (Sham, n = 15), balloon injury group treated with vehicle (Control, n = 15), TXL low-dose group treated with TXL of 0.5 g/kg/d (TXL-L, n = 15), and TXL high-dose group treated with TXL of 1.0 g/kg/d (TXL-H, n = 15). TXL was given by gavage daily. 14 days after injury’, the levels of serum nitric oxide (NO), endothelin-1 (ET-1), monocyte chemoattractant protein-1 (MCP-1), and soluble intercellular adhesion molecule-1 (sICAM-1) were evaluated. The morphology of carotid artery tissue was observed with hematoxylin-eosin staining. Expressions of MCP-1 and ICAM-1 in the artery were detected by real-time polymerase chain reaction (RT-PCR) and western blotting. Results: 14 days after injury, a significant increase in concentrations of serum ET-1, MCP-1, and sICAM-1 (P < 0.05), as well as a significant decrease in NO serum level were observed in rats subjected to artery injury compared to the sham rats (P < 0.05). TXL significantly decreased ET-1, MCP-1 and sICAM-1 serum levels (P < 0.05), whereas significantly increased NO serum level compared with the control (P < 0.05). TXL significantly reduced the neointimal thickening at day14 after injury (P < 0.05). In addition, TXL significantly reduced mRNA and protein expressions of ICAM-1 and MCP-1 in injured artery (P < 0.05). Conclusions: This study demonstrates that TXL is effective in improving endothelial function, attenuating neointimal formation of artery after balloon injury, and reducing expression of inflammatory cytokine MCP-1 and ICAM-1. It may be a useful agent for protecting the artery against injury.
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Affiliation(s)
- En-Hui Yao
- Department of Cardiology, Union Hospital of Fujian Medical University, Fujian Institute of Coronary Artery Disease, Fuzhou, China
| | - Hua-Jun Wang
- Fujian Hypertension Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Chang-Sheng Xu
- Fujian Hypertension Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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23
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Fishbein I, Forbes SP, Adamo RF, Chorny M, Levy RJ, Alferiev IS. Vascular gene transfer from metallic stent surfaces using adenoviral vectors tethered through hydrolysable cross-linkers. J Vis Exp 2014:e51653. [PMID: 25145470 PMCID: PMC4356350 DOI: 10.3791/51653] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In-stent restenosis presents a major complication of stent-based revascularization procedures widely used to re-establish blood flow through critically narrowed segments of coronary and peripheral arteries. Endovascular stents capable of tunable release of genes with anti-restenotic activity may present an alternative strategy to presently used drug-eluting stents. In order to attain clinical translation, gene-eluting stents must exhibit predictable kinetics of stent-immobilized gene vector release and site-specific transduction of vasculature, while avoiding an excessive inflammatory response typically associated with the polymer coatings used for physical entrapment of the vector. This paper describes a detailed methodology for coatless tethering of adenoviral gene vectors to stents based on a reversible binding of the adenoviral particles to polyallylamine bisphosphonate (PABT)-modified stainless steel surface via hydrolysable cross-linkers (HC). A family of bifunctional (amine- and thiol-reactive) HC with an average t1/2 of the in-chain ester hydrolysis ranging between 5 and 50 days were used to link the vector with the stent. The vector immobilization procedure is typically carried out within 9 hr and consists of several steps: 1) incubation of the metal samples in an aqueous solution of PABT (4 hr); 2) deprotection of thiol groups installed in PABT with tris(2-carboxyethyl) phosphine (20 min); 3) expansion of thiol reactive capacity of the metal surface by reacting the samples with polyethyleneimine derivatized with pyridyldithio (PDT) groups (2 hr); 4) conversion of PDT groups to thiols with dithiothreitol (10 min); 5) modification of adenoviruses with HC (1 hr); 6) purification of modified adenoviral particles by size-exclusion column chromatography (15 min) and 7) immobilization of thiol-reactive adenoviral particles on the thiolated steel surface (1 hr). This technique has wide potential applicability beyond stents, by facilitating surface engineering of bioprosthetic devices to enhance their biocompatibility through the substrate-mediated gene delivery to the cells interfacing the implanted foreign material.
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Affiliation(s)
- Ilia Fishbein
- Department of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania;
| | - Scott P Forbes
- Department of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania
| | - Richard F Adamo
- Department of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania
| | - Michael Chorny
- Department of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania
| | - Robert J Levy
- Department of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania
| | - Ivan S Alferiev
- Department of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania
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Wang Y, Liang A, Luo J, Liang M, Han G, Mitch WE, Cheng J. Blocking Notch in endothelial cells prevents arteriovenous fistula failure despite CKD. J Am Soc Nephrol 2014; 25:773-83. [PMID: 24480830 DOI: 10.1681/asn.2013050490] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Neointima formation causes the failure of 60% of arteriovenous fistulas (AVFs) within 2 years. Neointima-forming mechanisms are controversial but possibly linked to excess proinflammatory responses and dysregulated Notch signaling. To identify how AVFs fail, we anastomosed the carotid artery to the internal jugular vein in normal and uremic mice and compared these findings with those in failed AVFs from patients with ESRD. Endothelial cells (ECs) of AVFs in uremic mice or patients expressed mesenchymal markers (FSP-1 and/or α-SMA) and exhibited increased expression and nuclear localization of Notch intracellular domain compared with ECs of AVFs in pair-fed control mice. Furthermore, expression of VE-Cadherin decreased, whereas expression of Notch1 and -4, Notch ligands, the downstream transcription factor of Notch, RBP-Jκ, and Notch target genes increased in ECs of AVFs in uremic mice. In cultured ECs, ectopic expression of Notch ligand or treatment with TGF-β1 triggered the expression of mesenchymal markers and induced endothelial cell barrier dysfunction, both of which were blocked by Notch inhibition or RBP-Jκ knockout. Furthermore, Notch-induced defects in barrier function, invasion of inflammatory cells, and neointima formation were suppressed in mice with heterozygous knockdown of endothelial-specific RBP-Jκ. These results suggest that increased TGF-β1, a complication of uremia, activates Notch in endothelial cells of AVFs, leading to accelerated neointima formation and AVF failure. Suppression of Notch activation could be a strategy for improving AFV function in uremia.
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Affiliation(s)
- Yun Wang
- Division of Nephrology, Baylor College of Medicine, Houston, Texas
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Yin RX, Yang DZ, Wu JZ. Nanoparticle drug- and gene-eluting stents for the prevention and treatment of coronary restenosis. Theranostics 2014; 4:175-200. [PMID: 24465275 PMCID: PMC3900802 DOI: 10.7150/thno.7210] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 10/23/2013] [Indexed: 01/16/2023] Open
Abstract
Percutaneous coronary intervention (PCI) has become the most common revascularization procedure for coronary artery disease. The use of stents has reduced the rate of restenosis by preventing elastic recoil and negative remodeling. However, in-stent restenosis remains one of the major drawbacks of this procedure. Drug-eluting stents (DESs) have proven to be effective in reducing the risk of late restenosis, but the use of currently marketed DESs presents safety concerns, including the non-specificity of therapeutics, incomplete endothelialization leading to late thrombosis, the need for long-term anti-platelet agents, and local hypersensitivity to polymer delivery matrices. In addition, the current DESs lack the capacity for adjustment of the drug dose and release kinetics appropriate to the disease status of the treated vessel. The development of efficacious therapeutic strategies to prevent and inhibit restenosis after PCI is critical for the treatment of coronary artery disease. The administration of drugs using biodegradable polymer nanoparticles as carriers has generated immense interest due to their excellent biocompatibility and ability to facilitate prolonged drug release. Despite the potential benefits of nanoparticles as smart drug delivery and diagnostic systems, much research is still required to evaluate potential toxicity issues related to the chemical properties of nanoparticle materials, as well as to their size and shape. This review describes the molecular mechanism of coronary restenosis, the use of DESs, and progress in nanoparticle drug- or gene-eluting stents for the prevention and treatment of coronary restenosis.
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Liu T, Liu S, Zhang K, Chen J, Huang N. Endothelialization of implanted cardiovascular biomaterial surfaces: The development fromin vitrotoin vivo. J Biomed Mater Res A 2013; 102:3754-72. [DOI: 10.1002/jbm.a.35025] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/10/2013] [Accepted: 10/18/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Tao Liu
- Key Lab. of Advanced Technology for Materials of Chinese Education Ministry; School of Materials Science and Engineering, Southwest Jiaotong University; Chengdu China
| | - Shihui Liu
- Key Lab. of Advanced Technology for Materials of Chinese Education Ministry; School of Materials Science and Engineering, Southwest Jiaotong University; Chengdu China
- Naton Institute of Medical Technology, Naton Medical Group; Peking China
| | - Kun Zhang
- Key Lab. of Advanced Technology for Materials of Chinese Education Ministry; School of Materials Science and Engineering, Southwest Jiaotong University; Chengdu China
| | - Junying Chen
- Key Lab. of Advanced Technology for Materials of Chinese Education Ministry; School of Materials Science and Engineering, Southwest Jiaotong University; Chengdu China
| | - Nan Huang
- Key Lab. of Advanced Technology for Materials of Chinese Education Ministry; School of Materials Science and Engineering, Southwest Jiaotong University; Chengdu China
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Keeney M, Waters H, Barcay K, Jiang X, Yao Z, Pajarinen J, Egashira K, Goodman SB, Yang F. Mutant MCP-1 protein delivery from layer-by-layer coatings on orthopedic implants to modulate inflammatory response. Biomaterials 2013; 34:10287-95. [PMID: 24075408 DOI: 10.1016/j.biomaterials.2013.09.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 09/09/2013] [Indexed: 12/27/2022]
Abstract
Total joint replacement (TJR) is a common and effective surgical procedure for hip or knee joint reconstruction. However, the production of wear particles is inevitable for all TJRs, which activates macrophages and initiates an inflammatory cascade often resulting in bone loss, prosthetic loosening and eventual TJR failure. Macrophage Chemoattractant Protein-1 (MCP-1) is one of the most potent cytokines responsible for macrophage cell recruitment, and previous studies suggest that mutant MCP-1 proteins such as 7ND may be used as a decoy drug to block the receptor and reduce inflammatory cell recruitment. Here we report the development of a biodegradable, layer-by-layer (LBL) coating platform that allows efficient loading and controlled release of 7ND proteins from the surface of orthopedic implants using as few as 14 layers. Scanning electron microscopy and fluorescence imaging confirmed effective coating using the LBL procedure on titanium rods. 7ND protein loading concentration and release kinetics can be modulated by varying the polyelectrolytes of choice, the polymer chemistry, the pH of the polyelectrolyte solution, and the degradation rate of the LBL assembly. The released 7ND from LBL coating retained its bioactivity and effectively reduced macrophage migration towards MCP-1. Finally, the LBL coating remained intact following a femoral rod implantation procedure as determined by immunostaining of the 7ND coating. The LBL platform reported herein may be applied for in situ controlled release of 7ND protein from orthopedic implants, to reduce wear particle-induced inflammatory responses in an effort to prolong the lifetime of implants.
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Affiliation(s)
- Michael Keeney
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA 94305, USA.
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Forbes SP, Alferiev IS, Chorny M, Adamo RF, Levy RJ, Fishbein I. Modulation of NO and ROS production by AdiNOS transduced vascular cells through supplementation with L-Arg and BH4: implications for gene therapy of restenosis. Atherosclerosis 2013; 230:23-32. [PMID: 23958248 PMCID: PMC3763911 DOI: 10.1016/j.atherosclerosis.2013.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 05/15/2013] [Accepted: 06/04/2013] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Gene therapy with viral vectors encoding for NOS enzymes has been recognized as a potential therapeutic approach for the prevention of restenosis. Optimal activity of iNOS is dependent on the intracellular availability of L-Arg and BH4 via prevention of NOS decoupling and subsequent ROS formation. Herein, we investigated the effects of separate and combined L-Arg and BH4 supplementation on the production of NO and ROS in cultured rat arterial smooth muscle and endothelial cells transduced with AdiNOS, and their impact on the antirestenotic effectiveness of AdiNOS delivery to balloon-injured rat carotid arteries. METHODS AND RESULTS Supplementation of AdiNOS transduced endothelial and vascular smooth muscle cells with L-Arg (3.0 mM), BH4 (10 μM) and especially their combination resulted in a significant increase in NO production as measured by nitrite formation in media. Formation of ROS was dose-dependently increased following transduction with increasing MOIs of AdiNOS. Exposure of RASMC to AdiNOS tethered to meshes via a hydrolyzable cross-linker, modeling viral delivery from stents, resulted in increased ROS production, which was decreased by supplementation with BH4 but not L-Arg or L-Arg/BH4. Enhanced cell death, caused by AdiNOS transduction, was also preventable with BH4 supplementation. In the rat carotid model of balloon injury, intraluminal delivery of AdiNOS in BH4-, L-Arg-, and especially in BH4 and L-Arg supplemented animals was found to significantly enhance the antirestenotic effects of AdiNOS-mediated gene therapy. CONCLUSIONS Fine-tuning of iNOS function by L-Arg and BH4 supplementation in the transduced vasculature augments the therapeutic potential of gene therapy with iNOS for the prevention of restenosis.
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Affiliation(s)
- Scott P. Forbes
- Division of Cardiology, The Children’s Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA
| | - Ivan S. Alferiev
- Division of Cardiology, The Children’s Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Michael Chorny
- Division of Cardiology, The Children’s Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Richard F. Adamo
- Division of Cardiology, The Children’s Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA
| | - Robert J. Levy
- Division of Cardiology, The Children’s Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Ilia Fishbein
- Division of Cardiology, The Children’s Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
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Fishbein I, Forbes SP, Chorny M, Connolly JM, Adamo RF, Corrales RA, Alferiev IS, Levy RJ. Adenoviral vector tethering to metal surfaces via hydrolyzable cross-linkers for the modulation of vector release and transduction. Biomaterials 2013; 34:6938-48. [PMID: 23777912 DOI: 10.1016/j.biomaterials.2013.05.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 05/23/2013] [Indexed: 01/16/2023]
Abstract
The use of arterial stents and other medical implants as a delivery platform for surface immobilized gene vectors allows for safe and efficient localized expression of therapeutic transgenes. In this study we investigate the use of hydrolyzable cross-linkers with distinct kinetics of hydrolysis for delivery of gene vectors from polyallylamine bisphosphonate-modified metal surfaces. Three cross-linkers with the estimated t1/2 of ester bonds hydrolysis of 5, 12 and 50 days demonstrated a cumulative 20%, 39% and 45% vector release, respectively, after 30 days exposure to physiological buffer at 37 °C. Transgene expression in endothelial and smooth muscles cells transduced with substrate immobilized adenovirus resulted in significantly different expression profiles for each individual cross-linker. Furthermore, immobilization of adenoviral vectors effectively extended their transduction effectiveness beyond the initial phase of release. Transgene expression driven by adenovirus-tethered stents in rat carotid arteries demonstrated that a faster rate of cross-linker hydrolysis resulted in higher expression levels at day 1, which declined by day 8 after stent implantation, while inversely, slower hydrolysis was associated with increased arterial expression at day 8 in comparison with day 1. In conclusion, adjustable release of transduction-competent adenoviral vectors from metallic surfaces can be achieved, both in vitro and in vivo, through surface immobilization of adenoviral vectors using hydrolyzable cross-linkers with structure-specific release kinetics.
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Affiliation(s)
- Ilia Fishbein
- Division of Cardiology, The Children's Hospital of Philadelphia, Abramson Research Center, and Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, USA.
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30
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Ma G, Wang Y, Fishbein I, Yu M, Zhang L, Alferiev IS, Yang J, Song C, Levy RJ. Anchoring of self-assembled plasmid DNA/anti-DNA antibody/cationic lipid micelles on bisphosphonate-modified stent for cardiovascular gene delivery. Int J Nanomedicine 2013; 8:1029-35. [PMID: 23687446 PMCID: PMC3655620 DOI: 10.2147/ijn.s40077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Indexed: 01/24/2023] Open
Abstract
Purpose: To investigate the anchoring of plasmid DNA/anti-DNA antibody/cationic lipid tri-complex (DAC
micelles) onto bisphosphonate-modified 316 L coronary stents for cardiovascular site-specific gene
delivery. Methods: Stents were first modified with polyallylamine bisphosphonate (PAA-BP), thereby enabling the
retention of a PAA-BP molecular monolayer that permits the anchoring (via vector-binding molecules)
of DAC micelles. DAC micelles were then chemically linked onto the PAA-BP-modified stents by using
N-succinimidyl-3-(2-pyridyldithiol)-propionate (SPDP) as a crosslinker. Rhodamine-labeled DNA was
used to assess the anchoring of DAC micelles, and radioactive-labeled antibody was used to evaluate
binding capacity and stability. DAC micelles (encoding green fluorescent protein) were tethered onto
the PAA-BP-modified stents, which were assessed in cell culture. The presence of a PAA-BP molecular
monolayer on the steel surface was confirmed by X-ray photoelectron spectroscopy and atomic force
microscope analysis. Results: The anchoring of DAC micelles was generally uniform and devoid of large-scale patches of defects.
Isotopic quantification confirmed that the amount of antibody chemically linked on the stents was
17-fold higher than that of the physical adsorbed control stents and its retention time was also
significantly longer. In cell culture, numerous green fluorescent protein-positive cells were found
on the PAA-BP modified stents, which demonstrated high localization and efficiency of gene
delivery. Conclusion: The DAC micelle-immobilized PAA-BP-modified stents were successful as a gene delivery system.
Gene delivery using DAC micelle-tethered stent-based PAA-BP functionalization should be suitable for
a wide array of single or multiple therapeutic gene strategies, and could be used on cardiovascular
metallic implants for achieving efficient gene therapy.
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Affiliation(s)
- Guilei Ma
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People's Republic of China
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Goh D, Tan A, Farhatnia Y, Rajadas J, Alavijeh MS, Seifalian AM. Nanotechnology-Based Gene-Eluting Stents. Mol Pharm 2013; 10:1279-98. [DOI: 10.1021/mp3006616] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Debbie Goh
- Centre for Nanotechnology & Regenerative Medicine, UCL Division of Surgery & Interventional Science, University College London, London NW3 2QG, United Kingdom
- UCL Medical School, University
College London, London WC1E 6BT, United Kingdom
| | - Aaron Tan
- Centre for Nanotechnology & Regenerative Medicine, UCL Division of Surgery & Interventional Science, University College London, London NW3 2QG, United Kingdom
- UCL Medical School, University
College London, London WC1E 6BT, United Kingdom
| | - Yasmin Farhatnia
- Centre for Nanotechnology & Regenerative Medicine, UCL Division of Surgery & Interventional Science, University College London, London NW3 2QG, United Kingdom
| | - Jayakumar Rajadas
- Biomaterials & Advanced Drug Delivery Laboratory, School of Medicine, Stanford University, California 94305, United States
| | | | - Alexander M. Seifalian
- Centre for Nanotechnology & Regenerative Medicine, UCL Division of Surgery & Interventional Science, University College London, London NW3 2QG, United Kingdom
- Royal Free London NHS Foundation
Trust, London NW3 2QG, United Kingdom
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Fishbein I, Chorny M, Adamo RF, Forbes SP, Corrales RA, Alferiev IS, Levy RJ. Endovascular Gene Delivery from a Stent Platform: Gene- Eluting Stents. ACTA ACUST UNITED AC 2013. [PMID: 26225356 PMCID: PMC4516395 DOI: 10.4172/2329-9495.1000109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A synergistic impact of research in the fields of post-angioplasty restenosis, drug-eluting stents and vascular gene therapy over the past 15 years has shaped the concept of gene-eluting stents. Gene-eluting stents hold promise of overcoming some biological and technical problems inherent to drug-eluting stent technology. As the field of gene-eluting stents matures it becomes evident that all three main design modules of a gene-eluting stent: a therapeutic transgene, a vector and a delivery system are equally important for accomplishing sustained inhibition of neointimal formation in arteries treated with gene delivery stents. This review summarizes prior work on stent-based gene delivery and discusses the main optimization strategies required to move the field of gene-eluting stents to clinical translation.
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Affiliation(s)
- Ilia Fishbein
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA ; The University of Pennsylvania, USA
| | - Michael Chorny
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA ; The University of Pennsylvania, USA
| | - Richard F Adamo
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA
| | - Scott P Forbes
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA
| | - Ricardo A Corrales
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA
| | - Ivan S Alferiev
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA ; The University of Pennsylvania, USA
| | - Robert J Levy
- Dept of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, USA ; The University of Pennsylvania, USA
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Tsukie N, Nakano K, Matoba T, Masuda S, Iwata E, Miyagawa M, Zhao G, Meng W, Kishimoto J, Sunagawa K, Egashira K. Pitavastatin-incorporated nanoparticle-eluting stents attenuate in-stent stenosis without delayed endothelial healing effects in a porcine coronary artery model. J Atheroscler Thromb 2012; 20:32-45. [PMID: 22986515 DOI: 10.5551/jat.13862] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The use of currently marketed drug-eluting stents presents safety concerns including increased late thrombosis, which is thought to result mainly from delayed endothelial healing effects (impaired re-endothelialization resulting in abnormal inflammation and fibrin deposition). We recently developed a bioabsorbable polymeric nanoparticle (NP)-eluting stent using a novel cationic electrodeposition technology. Statins are known to inhibit the proliferation of vascular smooth muscle cells (VSMC) and to promote vascular healing. We therefore hypothesized that statin-incorporated NP-eluting stents would attenuate in-stent stenosis without delayed endothelial healing effects. METHODS Among six marketed statins, pitavastatin (Pitava) was found to have the most potent effects on VSMC proliferation and endothelial regeneration in vitro. We thus formulated a Pitava-NP-eluting stent (20µg Pitava per stent). RESULTS In a pig coronary artery model, Pitava-NP-eluting stents attenuated in-stent stenosis as effectively as polymer-coated sirolimus-eluting stents (SES). At SES sites, delayed endothelial healing effects were noted, whereas no such effects were observed in Pitava-NP-eluting stent sites. CONCLUSION Pitava-NP-eluting stents attenuated in-stent stenosis as effectively as SES without the delayed endothelial healing effects of SES in a porcine coronary artery model. This nanotechnology platform could be developed into a safer and more effective device in the future.
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Affiliation(s)
- Noriaki Tsukie
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Koga JI, Aikawa M. Crosstalk between macrophages and smooth muscle cells in atherosclerotic vascular diseases. Vascul Pharmacol 2012; 57:24-8. [DOI: 10.1016/j.vph.2012.02.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 02/19/2012] [Accepted: 02/20/2012] [Indexed: 01/04/2023]
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Robertson KE, McDonald RA, Oldroyd KG, Nicklin SA, Baker AH. Prevention of coronary in-stent restenosis and vein graft failure: does vascular gene therapy have a role? Pharmacol Ther 2012; 136:23-34. [PMID: 22796519 DOI: 10.1016/j.pharmthera.2012.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 06/28/2012] [Indexed: 12/19/2022]
Abstract
Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), including stent insertion, are established therapies in both acute coronary syndromes (ACS) and symptomatic chronic coronary artery disease refractory to pharmacological therapy. These continually advancing treatments remain limited by failure of conduit grafts in CABG and by restenosis or thrombosis of stented vessel segments in PCI caused by neointimal hyperplasia, impaired endothelialisation and accelerated atherosclerosis. While pharmacological and technological advancements have improved patient outcomes following both procedures, when grafts or stents fail these result in significant health burdens. In this review we discuss the pathophysiology of vein graft disease and in-stent restenosis, gene therapy vector development and design, and translation from pre-clinical animal models through human clinical trials. We identify the key issues that are currently preventing vascular gene therapy from interfacing with clinical use and introduce the areas of research attempting to overcome these.
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Affiliation(s)
- Keith E Robertson
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Si Y, Ren J, Wang P, Rateri DL, Daugherty A, Shi XD, Kent KC, Liu B. Protein kinase C-delta mediates adventitial cell migration through regulation of monocyte chemoattractant protein-1 expression in a rat angioplasty model. Arterioscler Thromb Vasc Biol 2012; 32:943-54. [PMID: 22328773 DOI: 10.1161/atvbaha.111.244921] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The adventitia is increasingly recognized as an important player during the development of intimal hyperplasia. However, the mechanism of adventitial cell recruitment to the subintimal space remains largely undefined. We have shown previously that gene transfer of protein kinase C-delta (PKCδ) increases apoptosis of smooth muscle cells following balloon injury. In the current study, we investigated a potential role of PKCδ in regulating the recruitment of adventitial cells. METHODS AND RESULTS Conditioned media from PKCδ-overexpressing smooth muscle cells stimulated migration and CCR2 expression of adventitial fibroblasts through a MCP-1 dependent mechanism. Following balloon injury of rat carotid arteries, overexpression of PKCδ in smooth muscle cells significantly increased MCP-1 and CCR2 expression and the number of adventitia-originated cells detected in the neointima. Administration of an anti-MCP-1 antibody markedly diminished the recruitment of adventitial cells. Combined PKCδ overexpression and anti-MCP-1 inhibited intimal hyperplasia more effectively than either approach alone. CONCLUSIONS Our data suggest that PKCδ regulates recruitment of adventitial cells to the neointima via a mechanism involving upregulation of the MCP-1/CCR2 signaling axis in injured arteries. Blockage of MCP-1 while enhancing apoptosis may serve as a potential therapeutic strategy to attenuate intimal hyperplasia.
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Affiliation(s)
- Yi Si
- Division of Vascular Surgery, University of Wisconsin Madison, 53705, USA
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Ialenti A, Grassia G, Gordon P, Maddaluno M, Di Lauro MV, Baker AH, Guglielmotti A, Colombo A, Biondi G, Kennedy S, Maffia P. Inhibition of in-stent stenosis by oral administration of bindarit in porcine coronary arteries. Arterioscler Thromb Vasc Biol 2012; 31:2448-54. [PMID: 21852559 DOI: 10.1161/atvbaha.111.230078] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We have previously demonstrated that bindarit, a selective inhibitor of monocyte chemotactic proteins (MCPs), is effective in reducing neointimal formation in rodent models of vascular injury by reducing smooth muscle cell proliferation and migration and neointimal macrophage content, effects associated with the inhibition of MCP-1/CCL2 production. The aim of the current study was to evaluate the efficacy of bindarit on in-stent stenosis in the preclinical porcine coronary stent model. METHODS AND RESULTS One or 2 bare metal stents (Multi-Link Vision, 3.5 mm) were deployed (1:1.2 oversize ratio) in the coronary arteries of 42 pigs (20 bindarit versus 22 controls). Bindarit (50 mg/kg per day) was administered orally from 2 days before stenting until the time of euthanasia at 7 and 28 days. Bindarit caused a significant reduction in neointimal area (39.4%, P<0.001, n=9 group), neointimal thickness (51%, P<0.001), stenosis area (37%, P<0.001), and inflammatory score (40%, P<0.001) compared with control animals, whereas there was no significant difference in the injury score between the 2 groups. Moreover, treatment with bindarit significantly reduced the number of proliferating cells (by 45%, P<0.05; n=6 group) and monocyte/macrophage content (by 55%, P<0.01; n=5-6 group) in stented arteries at day 7 and 28, respectively. These effects were associated with a significant (P<0.05) reduction of MCP-1 plasma levels at day 28. In vitro data showed that bindarit (10-300 μmol/L) reduced tumor necrosis factor-α (50 ng/mL)-induced pig coronary artery smooth muscle cell proliferation and inhibited MCP-1 production. CONCLUSION Our results show the efficacy of bindarit in the prevention of porcine in-stent stenosis and support further investigation for clinical application of this compound.
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Affiliation(s)
- Armando Ialenti
- Department of Experimental Pharmacology, University of Naples Federico II, Naples, Italy.
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Nonviral delivery of genetic medicine for therapeutic angiogenesis. Adv Drug Deliv Rev 2012; 64:40-52. [PMID: 21971337 DOI: 10.1016/j.addr.2011.09.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 06/29/2011] [Accepted: 09/18/2011] [Indexed: 01/08/2023]
Abstract
Genetic medicines that induce angiogenesis represent a promising strategy for the treatment of ischemic diseases. Many types of nonviral delivery systems have been tested as therapeutic angiogenesis agents. However, their delivery efficiency, and consequently therapeutic efficacy, remains to be further improved, as few of these technologies are being used in clinical applications. This article reviews the diverse nonviral gene delivery approaches that have been applied to the field of therapeutic angiogenesis, including plasmids, cationic polymers/lipids, scaffolds, and stem cells. This article also reviews clinical trials employing nonviral gene therapy and discusses the limitations of current technologies. Finally, this article proposes a future strategy to efficiently develop delivery vehicles that might be feasible for clinically relevant nonviral gene therapy, such as high-throughput screening of combinatorial libraries of biomaterials.
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Kalderén C, Forsgren M, Karlström U, Stefansson K, Svensson R, Berglund MM, Palm G, Selander M, Sundbom M, Nilsson J, Sjögren A, Zachrisson K, Gelius SS. A truncated analogue of CCL2 mediates anti-fibrotic effects on murine fibroblasts independently of CCR2. Biochem Pharmacol 2011; 83:644-52. [PMID: 22177985 DOI: 10.1016/j.bcp.2011.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 11/30/2011] [Accepted: 12/01/2011] [Indexed: 10/14/2022]
Abstract
The truncated [1+9-76] CCL2 analogue, also known as 7ND, has been described in numerous reports as an anti-inflammatory and anti-fibrotic agent in a wide spectrum of animal models, e.g. models of cardiovascular disease, graft versus host disease and bleomycin-induced pulmonary fibrosis. 7ND has been reported to function as a competitive inhibitor of CCL2 signaling via CCR2 in human in vitro systems. In contrast, the mechanistic basis of 7ND action in animal models has not been previously reported. Here we have studied how 7ND interacts with CCL2 and CCR2 of murine origin. Surprisingly, 7ND was shown to be a weak inhibitor of murine CCL2/CCR2 signaling and displaced murine CCL2 (JE) from the receptor with a K(i)>1 μM. Using surface plasmon resonance, we found that 7ND binds murine CCL2 with a K(d) of 670 nM, which may indicate that 7ND inhibits murine CCL2/CCR2 signaling by a dominant negative mechanism rather than by competitive binding to the CCR2 receptor. In addition we observed that sub-nanomolar levels of 7ND mediate anti-fibrotic effects in CCR2 negative fibroblasts cultured from fibrotic lung of bleomycin-induced mice. Basal levels of extracellular matrix proteins were reduced (collagen type 1 and fibronectin) as well as expression levels of α-smooth muscle actin and CCL2. Our conclusion from these data is that the previously reported effects of 7ND in murine disease models most probably are mediated via mechanisms independent of CCR2.
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Chevigné A, Fievez V, Schmit JC, Deroo S. Engineering and screening the N-terminus of chemokines for drug discovery. Biochem Pharmacol 2011; 82:1438-56. [DOI: 10.1016/j.bcp.2011.07.091] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 07/21/2011] [Accepted: 07/22/2011] [Indexed: 01/21/2023]
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Abstract
The techniques and materials used during percutaneous coronary intervention have advanced considerably over the past 3 decades, yet restenosis remains one of the major drawbacks of this procedure. Many innovative technologies, including drug-eluting stents, with or without specific polymers, and fully biodegradable stents have been and continue to be developed in the search for a safe and effective antirestenosis therapy. Remarkable advances in stent design and nanoparticle delivery systems ('nanovehicles') have already fueled revolutionary changes in the prevention and treatment of in-stent restenosis. In this Review we provide an overview of the latest innovations for optimizing outcomes of coronary stenting, and up-to-date information about prevention and treatment of in-stent restenosis.
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Abstract
Gene transfer within the cardiovascular system was first demonstrated in 1989 yet, despite extensive basic-science and clinical research, unequivocal benefit in the clinical setting remains to be demonstrated. Potential reasons for this include the fact that recombinant viral vectors, used in the majority of clinical studies, have inherent problems with immunogenicity that are difficult to circumvent. Attention has turned therefore to plasmid vectors, which possess many advantages over viruses in terms of safety and ease of use, and many clinical studies have now been performed using non-viral technology. This review will provide an overview of clinical trials for cardiovascular disease using plasmid vectors, recent developments in plasmid delivery and design, and potential directions for this modality of gene therapy.
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Affiliation(s)
- Paul D Williams
- Manchester Academic Health Science Centre, School of Biomedicine, Vascular Gene Therapy Unit, Core Technology Facility, The University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK.
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Masuda S, Nakano K, Funakoshi K, Zhao G, Meng W, Kimura S, Matoba T, Miyagawa M, Iwata E, Sunagawa K, Egashira K. Imatinib Mesylate-Incorporated Nanoparticle-Eluting Stent Attenuates In-Stent Neointimal Formation in Porcine Coronary Arteries. J Atheroscler Thromb 2011; 18:1043-53. [DOI: 10.5551/jat.8730] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Yue Y, Gui J, Xu W, Xiong S. Gene therapy with CCL2 (MCP-1) mutant protects CVB3-induced myocarditis by compromising Th1 polarization. Mol Immunol 2011; 48:706-13. [DOI: 10.1016/j.molimm.2010.11.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 09/27/2010] [Accepted: 11/23/2010] [Indexed: 11/27/2022]
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Shi HJ, Cao AH, Teng GJ. Seeding endothelial progenitor cells on a self-expanding metal stent: an in vitro study. J Vasc Interv Radiol 2010; 21:1061-5. [PMID: 20610181 DOI: 10.1016/j.jvir.2010.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 02/22/2010] [Accepted: 03/08/2010] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To demonstrate the feasibility of seeding a self-expanding metal stent with endothelial progenitor cells to enhance rapid reendothelialization, which is postulated to prevent local thrombus formation and restenosis after vascular intervention. MATERIALS AND METHODS Endothelial progenitor cells and fibrinogen were isolated from the peripheral blood of a domestic swine and then cultured and identified. Ten self-expanding nitinol stents were incubated in the culture medium with a cell concentration of 1 x 10(6)/mL with (n = 5, study group) or without (n = 5, control group) fibrin gel (5 mg/mL fibrinogen and 0.10 NIHU/mL thrombin) for 24 hours. The cell coverage of the stents was documented with en face photography and scanning electron microscopy. After simulated use in vitro, the cells were removed from each stent, counted with a cytometer, sequentially cultured for three passages, and identified again to compare their properties with those of the original seeding line. RESULTS After seeding the stent with the combination of endothelial progenitor cells and the fibrin gel coating, the stents took on a tube-like appearance with a confluent monolayer membrane. After digestion with trypsin, a mean of 2.5 x 10(5) +/- 1.3 cells were obtained from the fibrin gel stent (study group); fewer cells (4 x 10(4) +/- 1.5) were recovered from the bare stents (control group) (P < .01). The recovered cells, after amplification with culture, demonstrated the properties of the original endothelial progenitor cells. CONCLUSIONS An endothelial progenitor cell-coated stent can be successfully fabricated by using fibrin gel as the bonding agent in vitro. Further in vivo research is warranted.
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Affiliation(s)
- Hong-Jian Shi
- Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Rd, Nanjing, China
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Zhao Q. Dual targeting of CCR2 and CCR5: therapeutic potential for immunologic and cardiovascular diseases. J Leukoc Biol 2010; 88:41-55. [PMID: 20360402 DOI: 10.1189/jlb.1009671] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A cardinal feature of inflammation is the tissue recruitment of leukocytes, a process that is mediated predominantly by chemokines via their receptors on migrating cells. CCR2 and CCR5, two CC chemokine receptors, are important players in the trafficking of monocytes/macrophages and in the functions of other cell types relevant to disease pathogenesis. This review provides a brief overview of the biological actions of CCR2 and CCR5 and a comprehensive summary of published data that demonstrate the involvement of both receptors in the pathogenesis of immunologic diseases (RA, CD, and transplant rejection) and cardiovascular diseases (atherosclerosis and AIH). In light of the potential for functional redundancy of chemokine receptors in mediating leukocyte trafficking and the consequent concern over insufficient efficacy offered by pharmacologically inhibiting one receptor, this review presents evidence supporting dual targeting of CCR2 and CCR5 as a more efficacious strategy than targeting either receptor alone. It also examines potential safety issues associated with such dual targeting.
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Affiliation(s)
- Qihong Zhao
- Research and Development, Bristol-Myers Squibb, Princeton, New Jersey 08543, USA.
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Transjugular intrahepatic portosystemic shunt with an autologous endothelial progenitor cell seeded stent: a porcine model. Acad Radiol 2010; 17:358-67. [PMID: 19962914 DOI: 10.1016/j.acra.2009.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 10/09/2009] [Accepted: 10/12/2009] [Indexed: 01/07/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate the efficacy of a self-expanding metal stent seeded with autologous endothelial progenitor cells (EPCs) for preventing in-stent stenoses in transjugular intrahepatic portosystemic shunt (TIPS) in a swine model. MATERIALS AND METHODS TIPS was performed in 18 young adult pigs, using a self-expanding nitinol stent (control, n = 8) and an autologous EPC-seeded stent (treatment, n = 10). All pigs were sacrificed at 2 weeks post-TIPS procedure. Portography was performed immediately before the euthanasia. Gross, microscopic, and immunohistochemistry of the TIPS tract specimens were examined. The proliferative response of the shunt was quantified histologically. RESULTS TIPS was performed successfully in 16 swine, 2 animals died during the procedure. Another pig died of unknown causes 2 days post-procedure. At day 14 follow-up, portography and necropsy of the 15 remaining swine demonstrated that five shunts occluded and one shunt was stenotic (80%) in the control group (n = 6). Five shunts remained patent, two shunts were stenosed (50%, 70%), and the remaining two shunts were occluded in the treatment group (n = 9). The patency rate was significantly lower in the control group than in the treatment group, 0% versus 55.6% (P = .03). Histological analyses showed a significantly greater pseudointimal hyperplasia in the TIPS track of the control group than that of the treatment group (P < .05). Intact endothelium was documented in the lumina of all the EPC-implanted stent group. CONCLUSIONS The EPC-seeded metal stent is feasibly fabricated in vitro and improves the patency in TIPS in a porcine model.
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de Waard V, Bot I, de Jager SCA, Talib S, Egashira K, de Vries MR, Quax PHA, Biessen EAL, van Berkel TJC. Systemic MCP1/CCR2 blockade and leukocyte specific MCP1/CCR2 inhibition affect aortic aneurysm formation differently. Atherosclerosis 2010; 211:84-9. [PMID: 20197192 DOI: 10.1016/j.atherosclerosis.2010.01.042] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 11/20/2009] [Accepted: 01/28/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE CCR2, the receptor for monocyte chemoattractant protein 1 (MCP1), is involved in atherosclerosis and abdominal aortic aneurysms (AAAs). Here, we explored the potential beneficial blockade of the MCP1/CCR2 pathway. METHODS We applied an AAA model in aging apolipoprotein E deficient mice with pre-existing atherosclerotic lesions. These mice were subjected to two therapeutic strategies. First, a dominant negative form of MCP1 was overexpressed in femoral muscles, resulting in circulating levels of MCP1-7ND (7ND), competing with native MCP1. In the second approach, bone marrow transplantation was performed using bone marrow cells that were infected with a lentiviral construct containing siRNA for CCR2, to specifically inhibit only leukocyte CCR2 expression. RESULTS Both strategies did not influence lesion size of the advanced atherosclerotic plaques. However, 7ND induced a more fibrous plaque phenotype. Yet, surprisingly a trend in increased number and severity of AAA was observed in the 7ND group. Smooth muscle cells in the aneurysm showed decreased phosphorylated signal transducer and activator of transcription five (STAT5, P<0.01) in the 7ND group, which is indicative for a decreased proliferative and migratory (wound healing) response. This presumably resulted in the increased AAA development. In contrast, siRNA-induced inhibition of CCR2 in leukocytes led to a significant inhibition in aneurysm formation. In conclusion, systemic inhibition of the MCP1/CCR2 pathway leads to a fibrous plaque phenotype in the advanced atherosclerotic lesions, but to potential adverse effects on AAA formation, implying that for a beneficial overall therapeutic approach, specific inhibitory targeting of leukocyte CCR2 will be essential.
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Affiliation(s)
- Vivian de Waard
- Division of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research, Leiden University, The Netherlands.
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Furgeson SB, Simpson PA, Park I, Vanputten V, Horita H, Kontos CD, Nemenoff RA, Weiser-Evans MCM. Inactivation of the tumour suppressor, PTEN, in smooth muscle promotes a pro-inflammatory phenotype and enhances neointima formation. Cardiovasc Res 2010; 86:274-82. [PMID: 20051384 DOI: 10.1093/cvr/cvp425] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Phosphatase and tensin homolog (PTEN) is implicated as a negative regulator of vascular smooth muscle cell (SMC) proliferation and injury-induced vascular remodelling. We tested if selective depletion of PTEN only in SMC is sufficient to promote SMC phenotypic modulation, cytokine production, and enhanced neointima formation. METHODS AND RESULTS Smooth muscle marker expression and induction of pro-inflammatory cytokines were compared in cultured SMC expressing control or PTEN-specific shRNA. Compared with controls, PTEN-deficient SMC exhibited increased phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signalling and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kappaB) activity, reduced expression of SM markers (SM-alpha-actin and calponin), and increased production of stromal cell-derived factor-1alpha (SDF-1alpha), monocyte chemotactic protein-1 (MCP-1), interleukin-6 (IL-6), and chemokine (C-X-C motif) ligand 1 (KC/CXCL1) under basal conditions. PI3K/Akt or mTOR inhibition reversed repression of SM marker expression, whereas PI3K/Akt or NF-kappaB inhibition blocked cytokine induction mediated by PTEN depletion. Carotid ligation in mice with genetic reduction of PTEN specifically in SMC (SMC-specific PTEN heterozygotes) resulted in enhanced neointima formation, increased SMC hyperplasia, reduced SM-alpha-actin and calponin expression, and increased NF-kappaB and cytokine expression compared with wild-types. Lesion formation in SMC-specific heterozygotes was similar to lesion formation in global PTEN heterozygotes, indicating that inactivation of PTEN exclusively in SMC is sufficient to induce considerable increases in neointima formation. CONCLUSION PTEN activation specifically in SMC is a common upstream regulator of multiple downstream events involved in pathological vascular remodelling, including proliferation, de-differentiation, and production of multiple cytokines.
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Affiliation(s)
- Seth B Furgeson
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA
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