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Park DS, Na MH, Jeong MH, Sim DS, Jin YJ, Kee HJ, Kim MK, Kim JH, Hong YJ, Cho KH, Hyun DY, Oh S, Lim KS, Byeon DH, Kim JH. Efficacy and Safety Evaluation of Tacrolimus-Eluting Stent in a Porcine Coronary Artery Model. Tissue Eng Regen Med 2024; 21:723-735. [PMID: 38834902 PMCID: PMC11187055 DOI: 10.1007/s13770-024-00646-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/16/2024] [Accepted: 04/21/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND A drug-eluting stent (DES) is a highly beneficial medical device used to widen or unblock narrowed blood vessels. However, the drugs released by the implantation of DES may hinder the re-endothelialization process, increasing the risk of late thrombosis. We have developed a tacrolimus-eluting stent (TES) that as acts as a potent antiproliferative and immunosuppressive agent, enhancing endothelial regeneration. In addition, we assessed the safety and efficacy of TES through both in vitro and in vivo tests. METHODS Tacrolimus and Poly(lactic-co-glycolic acid) (PLGA) were applied to the metal stent using electrospinning equipment. The surface morphology of the stent was examined before and after coating using a scanning electron microscope (SEM) and energy dispersive X-rays (EDX). The drug release test was conducted through high-performance liquid chromatography (HPLC). Cell proliferation and migration assays were performed using smooth muscle cells (SMC). The stent was then inserted into the porcine coronary artery and monitored for a duration of 4 weeks. RESULTS SEM analysis confirmed that the coating surface was uniform. Furthermore, EDX analysis showed that the surface was coated with both polymer and drug components. The HPCL analysis of TCL at a wavelength of 215 nm revealed that the drug was continuously released over a period of 4 weeks. Smooth muscle cell migration was significantly decreased in the tacrolimus group (54.1% ± 11.90%) compared to the non-treated group (90.1% ± 4.86%). In animal experiments, the stenosis rate was significantly reduced in the TES group (29.6% ± 7.93%) compared to the bare metal stent group (41.3% ± 10.18%). Additionally, the fibrin score was found to be lower in the TES group compared to the group treated with a sirolimus-eluting stent (SES). CONCLUSION Similar to SES, TES reduces neointimal proliferation in a porcine coronary artery model, specifically decreasing the fibrins score. Therefore, tacrolimus could be considered a promising drug for reducing restenosis and thrombosis.
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Affiliation(s)
- Dae Sung Park
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- The Research Institute of Medical Sciences, Chonnam National University, Gwangju, Korea
| | - Mi Hyang Na
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
| | - Myung Ho Jeong
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea.
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea.
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea.
- Department of Cardiovascular Center, Gwangju Veterans Hospital, Gwangju, Korea.
| | - Doo Sun Sim
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea.
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea.
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea.
| | - Yu Jeong Jin
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
| | - Hae Jin Kee
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Mun Ki Kim
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Jeong Ha Kim
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Young Joon Hong
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung Hoon Cho
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Dae Young Hyun
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Seok Oh
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Seob Lim
- Futuristic Animal Resource & Research Center, Korea Research Institute of Bioscience and Biotechnology, Ochang, Korea
| | | | - Jeong Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
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Reppas L, Spiliopoulos S, Kitrou P, Katsanos K, Papadimatos P, Vaiou M, Lampropoulos G, Moulas AN, Karnabatidis D, Brountzos E. Evaluation of a new paclitaxel-coated balloon catheter in an in vivo porcine peripheral venous model: Feasibility, safety, and drug deliverability. J Vasc Access 2024; 25:504-511. [PMID: 36113056 DOI: 10.1177/11297298221122115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Abstract
PURPOSE To evaluate in vivo the feasibility, safety, and paclitaxel (PTX) deliverability of a newly developed non-commercially available Paclitaxel-Coated Balloon (PCB) catheter in the swine healthy peripheral vein model. MATERIALS AND METHODS In total 12 PCBs were deployed in 12 venous segments. Primary feasibility endpoint was the successful application of the devices to the veins of the animals. Primary efficacy endpoint was the determination of the drug content in the venous tissue at 24 h and 7 days after balloon expansion, as assessed by analysis of the vein tissue with High Performance Liquid Chromatography (HPLC) coupled with tandem mass spectrometry. Primary safety endpoint was freedom from any major adverse event. Secondary endpoint was the investigation of any independent factor affecting the primary endpoints. RESULTS Paclitaxel was detected in five out of six tissue samples 24 h post-intervention and five out of six tissues at 7 days following the procedure (10 tissue samples out of 12). The mean weight of tissue that was examined was 0.20604 ± 0.29822 g (range: 1.02823-0.03377 g) and the mean PTX concentration detected was 8.4 ± 13.1 μg/g (range: 0-36.1 μg/g). The average drug content detected at 24 h (17.1 ± 17.1 μg/g) was numerically superior, but non-statistically significant, compared to 7 days (3.1 ± 3.6 μg/g). An average of 33.8% of the drug remained on the balloon after retrieval. According to the multiple linear regression analysis, there was no significant correlation between transition time, PTX remaining on the balloon, time of analysis (24 h/7 days) and PTX tissue concentration. No abnormalities were noted during autopsy. CONCLUSION The newly developed PCB successfully delivered within the healthy venous wall a dose of Paclitaxel that inhibits neointimal hyperplasia. No safety issues were raised at short-term follow-up.
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Affiliation(s)
- Lazaros Reppas
- Second Department of Radiology, Interventional Radiology Unit, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece
| | - Stavros Spiliopoulos
- Second Department of Radiology, Interventional Radiology Unit, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece
| | - Panagiotis Kitrou
- Department of Interventional Radiology, School of Medicine, Patras University Hospital, Rion, Greece
| | - Konstantinos Katsanos
- Department of Interventional Radiology, School of Medicine, Patras University Hospital, Rion, Greece
| | - Panagiotis Papadimatos
- Department of Interventional Radiology, School of Medicine, Patras University Hospital, Rion, Greece
| | - Maria Vaiou
- General Department, University of Thessaly, Larissa, Greece
| | | | | | - Dimitrios Karnabatidis
- Department of Interventional Radiology, School of Medicine, Patras University Hospital, Rion, Greece
| | - Elias Brountzos
- Second Department of Radiology, Interventional Radiology Unit, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece
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Park DS, Oh S, Jin YJ, Na MH, Kim M, Kim JH, Hyun DY, Cho KH, Hong YJ, Kim JH, Ahn Y, Hermida-Prieto M, Vázquez-Rodríguez JM, Gutiérrez-Chico JL, Mariñas-Pardo L, Lim KS, Park JK, Byeon DH, Cho YN, Kee SJ, Sim DS, Jeong MH. Preliminary Investigation on Efficacy and Safety of Substance P-Coated Stent for Promoting Re-Endothelialization: A Porcine Coronary Artery Restenosis Model. Tissue Eng Regen Med 2024; 21:53-64. [PMID: 37973692 PMCID: PMC10764706 DOI: 10.1007/s13770-023-00608-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/10/2023] [Accepted: 10/11/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Current polymer-based drug-eluting stents (DESs) have fundamental issues about inflammation and delayed re-endothelializaton of the vessel wall. Substance-P (SP), which plays an important role in inflammation and endothelial cells, has not yet been applied to coronary stents. Therefore, this study compares poly lactic-co-glycolic acid (PLGA)-based everolimus-eluting stents (PLGA-EESs) versus 2-methacryloyloxyethyl phosphorylcholine (MPC)-based SP-eluting stents (MPC-SPs) in in-vitro and in-vivo models. METHODS The morphology of the stent surface and peptide/drug release kinetics from stents were evaluated. The in-vitro proliferative effect of SP released from MPC-SP is evaluated using human umbilical vein endothelial cell. Finally, the safety and efficacy of the stent are evaluated after inserting it into a pig's coronary artery. RESULTS Similar to PLGA-EES, MPC-SP had a uniform surface morphology with very thin coating layer thickness (2.074 μm). MPC-SP showed sustained drug release of SP for over 2 weeks. Endothelial cell proliferation was significantly increased in groups treated with SP (n = 3) compared with the control (n = 3) and those with everolimus (n = 3) (SP: 118.9 ± 7.61% vs. everolimus: 64.3 ± 12.37% vs. the control: 100 ± 6.64%, p < 0.05). In the animal study, the percent stenosis was higher in MPC-SP group (n = 7) compared to PLGA-EES group (n = 7) (MPC-SP: 28.6 ± 10.7% vs. PLGA-EES: 16.7 ± 6.3%, p < 0.05). MPC-SP group showed, however, lower inflammation (MPC-SP: 0.3 ± 0.26 vs. PLGA-EES: 1.2 ± 0.48, p < 0.05) and fibrin deposition (MPC-SP: 1.0 ± 0.73 vs. PLGA-EES: 1.5 ± 0.59, p < 0.05) around the stent strut. MPC-SP showed more increased expression of cluster of differentiation 31, suggesting enhanced re-endothelialization. CONCLUSION Compared to PLGA-EES, MPC-SP demonstrated more decreased inflammation of the vascular wall and enhanced re-endothelialization and stent coverage. Hence, MPC-SP has the potential therapeutic benefits for the treatment of coronary artery disease by solving limitations of currently available DESs.
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Affiliation(s)
- Dae Sung Park
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- The Research Institute of Medical Sciences, Chonnam National University, Gwangju, Korea
| | - Seok Oh
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Yu Jeong Jin
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
| | - Mi Hyang Na
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
| | - Munki Kim
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Jeong Ha Kim
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Dae Young Hyun
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Hoon Cho
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young Joon Hong
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju Han Kim
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Manuel Hermida-Prieto
- Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña (UDC), A Coruña, Spain
| | - José Manuel Vázquez-Rodríguez
- Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña (UDC), A Coruña, Spain
- Servicio de Cardiología, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Juan Luis Gutiérrez-Chico
- Bundeswehrzentralkrankenhaus (Federal Army Central Military Hospital), Koblenz, Germany
- Universidad Alfonso X el Sabio, Madrid, Spain
| | - Luis Mariñas-Pardo
- Facultad de Ciencias de La Salud, Universidad Internacional de Valencia (VIU), Valencia, Spain
| | - Kyung Seob Lim
- Futuristic Animal Resource & Research Center, Korea Research Institute of Bioscience and Biotechnology, Ochang, Korea
| | | | | | - Young-Nan Cho
- Department of Clinical Laboratory Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Seung-Jung Kee
- Department of Clinical Laboratory Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea.
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea.
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
| | - Myung Ho Jeong
- The Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea.
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea.
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
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van Mechelen RJS, Wolters JEJ, Fredrich S, Bertens CJF, Gijbels MJJ, Schenning APHJ, Pinchuk L, Gorgels TGMF, Beckers HJM. A Degradable Sustained-Release Drug Delivery System for Bleb-Forming Glaucoma Surgery. Macromol Biosci 2023; 23:e2300075. [PMID: 37249127 DOI: 10.1002/mabi.202300075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/12/2023] [Indexed: 05/31/2023]
Abstract
Fibrosis of the filtering bleb is one of the main causes of failure after bleb-forming glaucoma surgery. Intraoperative application of mitomycin C (MMC) is the current gold standard to reduce the fibrotic response. However, MMC is cytotoxic and one-time application is often insufficient. A sustained-release drug delivery system (DDS), loaded with MMC, may be less cytotoxic and equally or more effective. Two degradable (polycaprolactone (PCL) and polylactic-co-glycolic acid (PLGA)) MMC-loaded DDSs are developed. Release kinetics are first assessed in vitro followed by rabbit implants in conjunction with the PRESERFLO MicroShunt. As a control, the MicroShunt is implanted with adjunctive use of a MMC solution. Rabbits are euthanized at postoperative day (POD) 28 and 90. The PLGA and PCL DDSs release (on average) 99% and 75% of MMC, respectively. All groups show functioning blebs until POD 90. Rabbits implanted with a DDS show more inflammation with avascular thin-walled blebs when compared to the control. However, collagen is more loosely arranged. The PLGA DDS shows less inflammation, less foreign body response (FBR), and more complete degradation at POD 90 when compared to the PCL DDS. Further optimization with regard to dosage is required to reduce side effects to the conjunctiva.
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Affiliation(s)
- Ralph J S van Mechelen
- University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), Maastricht, 6202 AZ, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, 6229 ER, The Netherlands
| | - Jarno E J Wolters
- University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), Maastricht, 6202 AZ, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, 6229 ER, The Netherlands
| | - Sebastian Fredrich
- Department of Medical Biochemistry, Experimental Vascular Biology, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam UMC, A.M. Vree G1-146, Amsterdam, 1100 DD, Netherlands
| | - Christian J F Bertens
- University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), Maastricht, 6202 AZ, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, 6229 ER, The Netherlands
| | - Marion J J Gijbels
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, 6229 ER, The Netherlands
- Department of Medical Biochemistry, Experimental Vascular Biology, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam UMC, A.M. Vree G1-146, Amsterdam, 1100 DD, Netherlands
| | - Albert P H J Schenning
- Laboratory of Stimuli-responsive Functional Materials and Devices, Department of Chemical Engineering and Chemistry, Technical University of Eindhoven, Eindhoven, 5600 MB, The Netherlands
| | - Leonard Pinchuk
- InnFocus Inc. a Santen company, 12415 S.W. 136 Avenue, Miami, FL, 33186, USA
| | - Theo G M F Gorgels
- University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), Maastricht, 6202 AZ, The Netherlands
| | - Henny J M Beckers
- University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), Maastricht, 6202 AZ, The Netherlands
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Benfor B, Sinha K, Karmonik C, Lumsden AB, Roy TL. Human Cadaveric Model for Vessel Preparation Device Testing in Calcified Tibial Arteries. J Cardiovasc Transl Res 2023; 16:502-509. [PMID: 36103037 PMCID: PMC10151304 DOI: 10.1007/s12265-022-10319-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/05/2022] [Indexed: 11/26/2022]
Abstract
To describe an ex vivo model for vessel preparation device testing in tibial arteries. We performed orbital atherectomy (OA), intravascular lithotripsy (IVL), and plain balloon angioplasty (POBA) on human amputated limbs with evidence of concentric tibial artery calcification. The arterial segments were then harvested for ex vivo processing which included imaging with microCT, decalcification, and histology. The model was tested out in 15 limbs and was successful in 14 but had to be aborted in 1/15 case due to inability to achieve wire access. A total of 22 lesions were treated with OA on 3/22 lesions, IVL on 8/22, and POBA without vessel preparation on the remaining 11/22. Luminal gain was assessed with intravascular ultrasound and histology was able to demonstrate plaque disruption, dissections, and cracks within the calcified lesions. A human cadaveric model using amputated limbs is a feasible, high-fidelity option for evaluating the performance of vessel preparation devices in calcified tibial arteries.
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Affiliation(s)
- Bright Benfor
- Department of Vascular Surgery, Houston Methodist Debakey Heart & Vascular Center, 6565 Fannin St, Suite B5-022, Houston, TX, 77030, USA.
| | - Kavya Sinha
- Department of Vascular Surgery, Houston Methodist Debakey Heart & Vascular Center, 6565 Fannin St, Suite B5-022, Houston, TX, 77030, USA
| | - Christof Karmonik
- Translational Imaging Center, Houston Methodist Academic Institute, Houston, TX, USA
| | - Alan B Lumsden
- Department of Vascular Surgery, Houston Methodist Debakey Heart & Vascular Center, 6565 Fannin St, Suite B5-022, Houston, TX, 77030, USA
| | - Trisha L Roy
- Department of Vascular Surgery, Houston Methodist Debakey Heart & Vascular Center, 6565 Fannin St, Suite B5-022, Houston, TX, 77030, USA
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6
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Park DS, Jeong MH, Jin YJ, Na MH, Sim DS, Kim M, Cho KH, Hyun DY, Oh S, Kim JH, Lim KS, Park JK, Kim HK, Hong YJ, Kim JH, Ahn Y, Kim JH. Preclinical Evaluation of an Everolimus-Eluting Bioresorbable Vascular Scaffold Via a Long-Term Rabbit Iliac Artery Model. Tissue Eng Regen Med 2023; 20:239-249. [PMID: 36881249 PMCID: PMC10070568 DOI: 10.1007/s13770-023-00518-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Biodegradable poly (l-lactic acid) (PLLA), a bio safe polymer with a large elastic modulus, is widely used in biodegradable medical devices. However, because of its poor mechanical properties, a PLLA strut must be made twice as thick as a metal strut for adequate blood vessel support. Therefore, the mechanical properties of a drug-eluting metal-based stents (MBS) and a bioresorbable vascular scaffolds (BVS) were evaluated and their safety and efficacy were examined via a long-term rabbit iliac artery model. METHODS The surface morphologies of the MBSs and BVSs were investigated via optical and scanning electron microscopy. An everolimus-eluting (EE) BVS or an EE-MBS was implanted into rabbit iliac arteries at a 1.1:1 stent-to-artery ratio. Twelve months afterward, stented iliac arteries from each group were analyzed via X-ray angiography, optical coherence tomography (OCT), and histopathologic evaluation. RESULTS Surface morphology analysis of the EE coating on the MBS confirmed that it was uniform and very thin (4.7 μm). Comparison of the mechanical properties of the EE-MBS and EE-BVS showed that the latter outperformed the former in all aspects (radial force (2.75 vs. 0.162 N/mm), foreshortening (0.24% vs. 1.9%), flexibility (0.52 vs. 0.19 N), and recoil (3.2% vs. 6.3%). At all time points, the percent area restenosis was increased in the EE-BVS group compared to the EE-MBS group. The OCT and histopathological analyses indicate no significant changes in strut thickness. CONCLUSION BVSs with thinner struts and shorter resorption times should be developed. A comparable long-term safety/efficacy evaluation after complete absorption of BVSs should be conducted.
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Affiliation(s)
- Dae Sung Park
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
- The Research Institute of Medical Sciences, Chonnam National University, Gwangju, 61469, Republic of Korea
| | - Myung Ho Jeong
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea.
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea.
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea.
| | - Yu Jeong Jin
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
| | - Mi Hyang Na
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
| | - Doo Sun Sim
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
| | - Munki Kim
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
| | - Kyung Hoon Cho
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
| | - Dae Young Hyun
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
| | - Seok Oh
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
| | - Jeong Ha Kim
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
| | - Kyung Seob Lim
- The Futuristic Animal Research Center, The Korean Research Institute of Bioscience and Biotechnology, Ochang, 28116, Republic of Korea
| | | | - Han Ki Kim
- CGBio Co. Ltd., Seoul, Republic of Korea
| | - Young Joon Hong
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
| | - Ju Han Kim
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
| | - Youngkeun Ahn
- The Korean Cardiovascular Stent Research Institute, Jangsung, 57248, Republic of Korea
- The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, 61469, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
| | - Jeong Hun Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
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7
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Peri-Interventional Triple Therapy with Dabigatran Modifies Vasomotion after Bare-Metal Stent Implantation in a Pig Coronary Artery Model. J Pers Med 2023; 13:jpm13020280. [PMID: 36836514 PMCID: PMC9962101 DOI: 10.3390/jpm13020280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Coronary artery stenting leads to local inflammation, disturbs vasomotion, and slows endothelialization, increasing vascular thrombus risk. We used a pig stenting coronary artery model to assess how peri-interventional triple therapy with dabigatran ameliorates these effects. (2) Methods: In a total of 28 pigs bare-metal stents were implanted. Four days before the percutaneous coronary intervention (PCI), we started 16 of the animals on dabigatran, maintained through 4 days after the procedure. As controls, the remaining 12 pigs received no therapy. In both groups, dual antiplatelet therapy (DAPT) (clopidogrel, 75 mg plus aspirin, 100 mg) was administered until animals were euthanized. Just after the PCI and on day 3 after the procedure, we performed optical coherence tomography (OCT) in eight animals in the dabigatran group and four controls and euthanized them. We followed the eight remaining animals in each group with OCT and angiography for one month before euthanizing them and performed in vitro myometry and histology on harvested coronary arteries from all animals. (3) Results: The dabigatran group showed a significantly increased vasoconstriction at 3 days after PCI (10.97 ± 3.85 mN vs. 7.32 ± 5.41 mN, p = 0.03), but we found no differences between endothelium-dependent and -independent vasodilatation. We also found no group differences in OCT, quantitative angiography, or histomorphometry findings. (4) Conclusions: Starting a short course of dabigatran just before PCI and continuing for a 3-day window along with usual post-PCI DAPT is associated with enhanced vasoconstriction after bare-metal stent implantation without reducing neointimal formation at one month.
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8
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van der Velden J, Asselbergs FW, Bakkers J, Batkai S, Bertrand L, Bezzina CR, Bot I, Brundel BJJM, Carrier L, Chamuleau S, Ciccarelli M, Dawson D, Davidson SM, Dendorfer A, Duncker DJ, Eschenhagen T, Fabritz L, Falcão-Pires I, Ferdinandy P, Giacca M, Girao H, Gollmann-Tepeköylü C, Gyongyosi M, Guzik TJ, Hamdani N, Heymans S, Hilfiker A, Hilfiker-Kleiner D, Hoekstra AG, Hulot JS, Kuster DWD, van Laake LW, Lecour S, Leiner T, Linke WA, Lumens J, Lutgens E, Madonna R, Maegdefessel L, Mayr M, van der Meer P, Passier R, Perbellini F, Perrino C, Pesce M, Priori S, Remme CA, Rosenhahn B, Schotten U, Schulz R, Sipido KR, Sluijter JPG, van Steenbeek F, Steffens S, Terracciano CM, Tocchetti CG, Vlasman P, Yeung KK, Zacchigna S, Zwaagman D, Thum T. Animal models and animal-free innovations for cardiovascular research: current status and routes to be explored. Consensus document of the ESC Working Group on Myocardial Function and the ESC Working Group on Cellular Biology of the Heart. Cardiovasc Res 2022; 118:3016-3051. [PMID: 34999816 PMCID: PMC9732557 DOI: 10.1093/cvr/cvab370] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 01/05/2022] [Indexed: 01/09/2023] Open
Abstract
Cardiovascular diseases represent a major cause of morbidity and mortality, necessitating research to improve diagnostics, and to discover and test novel preventive and curative therapies, all of which warrant experimental models that recapitulate human disease. The translation of basic science results to clinical practice is a challenging task, in particular for complex conditions such as cardiovascular diseases, which often result from multiple risk factors and comorbidities. This difficulty might lead some individuals to question the value of animal research, citing the translational 'valley of death', which largely reflects the fact that studies in rodents are difficult to translate to humans. This is also influenced by the fact that new, human-derived in vitro models can recapitulate aspects of disease processes. However, it would be a mistake to think that animal models do not represent a vital step in the translational pathway as they do provide important pathophysiological insights into disease mechanisms particularly on an organ and systemic level. While stem cell-derived human models have the potential to become key in testing toxicity and effectiveness of new drugs, we need to be realistic, and carefully validate all new human-like disease models. In this position paper, we highlight recent advances in trying to reduce the number of animals for cardiovascular research ranging from stem cell-derived models to in situ modelling of heart properties, bioinformatic models based on large datasets, and state-of-the-art animal models, which show clinically relevant characteristics observed in patients with a cardiovascular disease. We aim to provide a guide to help researchers in their experimental design to translate bench findings to clinical routine taking the replacement, reduction, and refinement (3R) as a guiding concept.
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Grants
- R01 HL150359 NHLBI NIH HHS
- RG/16/14/32397 British Heart Foundation
- FS/18/37/33642 British Heart Foundation
- PG/17/64/33205 British Heart Foundation
- PG/15/88/31780 British Heart Foundation
- FS/RTF/20/30009, NH/19/1/34595, PG/18/35/33786, CS/17/4/32960, PG/15/88/31780, and PG/17/64/33205 British Heart Foundation
- NC/T001488/1 National Centre for the Replacement, Refinement and Reduction of Animals in Research
- PG/18/44/33790 British Heart Foundation
- CH/16/3/32406 British Heart Foundation
- FS/RTF/20/30009 British Heart Foundation
- NWO-ZonMW
- ZonMW and Heart Foundation for the translational research program
- Dutch Cardiovascular Alliance (DCVA)
- Leducq Foundation
- Dutch Research Council
- Association of Collaborating Health Foundations (SGF)
- UCL Hospitals NIHR Biomedical Research Centre, and the DCVA
- Netherlands CardioVascular Research Initiative CVON
- Stichting Hartekind and the Dutch Research Counsel (NWO) (OCENW.GROOT.2019.029)
- National Fund for Scientific Research, Belgium and Action de Recherche Concertée de la Communauté Wallonie-Bruxelles, Belgium
- Netherlands CardioVascular Research Initiative CVON (PREDICT2 and CONCOR-genes projects), the Leducq Foundation
- ERA PerMed (PROCEED study)
- Netherlands Cardiovascular Research Initiative
- Dutch Heart Foundation
- German Centre of Cardiovascular Research (DZHH)
- Chest Heart and Stroke Scotland
- Tenovus Scotland
- Friends of Anchor and Grampian NHS-Endowments
- National Institute for Health Research University College London Hospitals Biomedical Research Centre
- German Centre for Cardiovascular Research
- European Research Council (ERC-AG IndivuHeart), the Deutsche Forschungsgemeinschaft
- European Union Horizon 2020 (REANIMA and TRAINHEART)
- German Ministry of Education and Research (BMBF)
- Centre for Cardiovascular Research (DZHK)
- European Union Horizon 2020
- DFG
- National Research, Development and Innovation Office of Hungary
- Research Excellence Program—TKP; National Heart Program
- Austrian Science Fund
- European Union Commission’s Seventh Framework programme
- CVON2016-Early HFPEF
- CVON She-PREDICTS
- CVON Arena-PRIME
- European Union’s Horizon 2020 research and innovation programme
- Deutsche Forschungsgemeinschaft
- Volkswagenstiftung
- French National Research Agency
- ERA-Net-CVD
- Fédération Française de Cardiologie, the Fondation pour la Recherche Médicale
- French PIA Project
- University Research Federation against heart failure
- Netherlands Heart Foundation
- Dekker Senior Clinical Scientist
- Health Holland TKI-LSH
- TUe/UMCU/UU Alliance Fund
- south African National Foundation
- Cancer Association of South Africa and Winetech
- Netherlands Heart Foundation/Applied & Engineering Sciences
- Dutch Technology Foundation
- Pie Medical Imaging
- Netherlands Organisation for Scientific Research
- Dr. Dekker Program
- Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation
- Dutch Federation of University Medical Centres
- Netherlands Organization for Health Research and Development and the Royal Netherlands Academy of Sciences for the GENIUS-II project
- Netherlands Organization for Scientific Research (NWO) (VICI grant); the European Research Council
- Incyte s.r.l. and from Ministero dell’Istruzione, Università e Ricerca Scientifica
- German Center for Cardiovascular Research (Junior Research Group & Translational Research Project), the European Research Council (ERC Starting Grant NORVAS),
- Swedish Heart-Lung-Foundation
- Swedish Research Council
- National Institutes of Health
- Bavarian State Ministry of Health and Care through the research project DigiMed Bayern
- ERC
- ERA-CVD
- Dutch Heart Foundation, ZonMw
- the NWO Gravitation project
- Ministero dell'Istruzione, Università e Ricerca Scientifica
- Regione Lombardia
- Netherlands Organisation for Health Research and Development
- ITN Network Personalize AF: Personalized Therapies for Atrial Fibrillation: a translational network
- MAESTRIA: Machine Learning Artificial Intelligence Early Detection Stroke Atrial Fibrillation
- REPAIR: Restoring cardiac mechanical function by polymeric artificial muscular tissue
- Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)
- European Union H2020 program to the project TECHNOBEAT
- EVICARE
- BRAV3
- ZonMw
- German Centre for Cardiovascular Research (DZHK)
- British Heart Foundation Centre for Cardiac Regeneration
- British Heart Foundation studentship
- NC3Rs
- Interreg ITA-AUS project InCARDIO
- Italian Association for Cancer Research
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Affiliation(s)
- Jolanda van der Velden
- Amsterdam UMC, Vrije Universiteit, Physiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - Folkert W Asselbergs
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Faculty of Population Health Sciences, Institute of Cardiovascular Science and Institute of Health Informatics, University College London, London, UK
| | - Jeroen Bakkers
- Hubrecht Institute-KNAW and University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sandor Batkai
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
| | - Luc Bertrand
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
| | - Connie R Bezzina
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Pole of Cardiovascular Research, Brussels, Belgium
| | - Ilze Bot
- Heart Center, Department of Experimental Cardiology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands
- Division of BioTherapeutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Bianca J J M Brundel
- Amsterdam UMC, Vrije Universiteit, Physiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Lucie Carrier
- Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Steven Chamuleau
- Amsterdam UMC, Heart Center, Cardiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Odontology, University of Salerno, Fisciano (SA), Italy
| | - Dana Dawson
- Department of Cardiology, Aberdeen Cardiovascular and Diabetes Centre, Aberdeen Royal Infirmary and University of Aberdeen, Aberdeen, UK
| | - Sean M Davidson
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK
| | - Andreas Dendorfer
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Thomas Eschenhagen
- Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Larissa Fabritz
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
- University Center of Cardiovascular Sciences and Department of Cardiology, University Heart Center Hamburg, Germany and Institute of Cardiovascular Sciences, University of Birmingham, UK
| | - Ines Falcão-Pires
- UnIC - Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal
| | - Péter Ferdinandy
- Cardiometabolic Research Group and MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Mauro Giacca
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Integrata Trieste, Trieste, Italy
- International Center for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
- King’s British Heart Foundation Centre, King’s College London, London, UK
| | - Henrique Girao
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology, Faculty of Medicine, Coimbra, Portugal
- Clinical Academic Centre of Coimbra, Coimbra, Portugal
| | | | - Mariann Gyongyosi
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Tomasz J Guzik
- Instutute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Jagiellonian University, Collegium Medicum, Kraków, Poland
| | - Nazha Hamdani
- Division Cardiology, Molecular and Experimental Cardiology, Ruhr University Bochum, Bochum, Germany
- Institute of Physiology, Ruhr University Bochum, Bochum, Germany
| | - Stephane Heymans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Andres Hilfiker
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Denise Hilfiker-Kleiner
- Department for Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Department of Cardiovascular Complications in Pregnancy and in Oncologic Therapies, Comprehensive Cancer Centre, Philipps-Universität Marburg, Germany
| | - Alfons G Hoekstra
- Computational Science Lab, Informatics Institute, Faculty of Science, University of Amsterdam, Amsterdam, the Netherlands
| | - Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, F-75015 Paris, France
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, France
| | - Diederik W D Kuster
- Amsterdam UMC, Vrije Universiteit, Physiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Linda W van Laake
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Sandrine Lecour
- Department of Medicine, Hatter Institute for Cardiovascular Research in Africa and Cape Heart Institute, University of Cape Town, Cape Town, South Africa
| | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, the Netherlands
| | - Wolfgang A Linke
- Institute of Physiology II, University of Muenster, Robert-Koch-Str. 27B, 48149 Muenster, Germany
| | - Joost Lumens
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Esther Lutgens
- Experimental Vascular Biology Division, Department of Medical Biochemistry, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Institute for Cardiovascular Prevention, Ludwig-Maximilians-Universität München (LMU), Munich, Germany
- DZHK, Partner Site Munich Heart Alliance, Munich, Germany
| | - Rosalinda Madonna
- Department of Pathology, Cardiology Division, University of Pisa, 56124 Pisa, Italy
- Department of Internal Medicine, Cardiology Division, University of Texas Medical School in Houston, Houston, TX, USA
| | - Lars Maegdefessel
- DZHK, Partner Site Munich Heart Alliance, Munich, Germany
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Mayr
- King’s British Heart Foundation Centre, King’s College London, London, UK
| | - Peter van der Meer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Robert Passier
- Department of Applied Stem Cell Technologies, TechMed Centre, University of Twente, 7500AE Enschede, The Netherlands
- Department of Anatomy and Embryology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
| | - Filippo Perbellini
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
| | - Cinzia Perrino
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Maurizio Pesce
- Unità di Ingegneria Tissutale Cardiovascolare, Centro cardiologico Monzino, IRCCS, Milan, Italy
| | - Silvia Priori
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, Pavia, Italy
- University of Pavia, Pavia, Italy
| | - Carol Ann Remme
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Pole of Cardiovascular Research, Brussels, Belgium
| | - Bodo Rosenhahn
- Institute for information Processing, Leibniz University of Hanover, 30167 Hannover, Germany
| | - Ulrich Schotten
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Rainer Schulz
- Institute of Physiology, Justus Liebig University Giessen, Giessen, Germany
| | - Karin R Sipido
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Joost P G Sluijter
- Experimental Cardiology Laboratory, Department of Cardiology, Regenerative Medicine Center Utrecht, Circulatory Health Laboratory, Utrecht University, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank van Steenbeek
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Sabine Steffens
- Institute for Cardiovascular Prevention, Ludwig-Maximilians-Universität München (LMU), Munich, Germany
- DZHK, Partner Site Munich Heart Alliance, Munich, Germany
| | | | - Carlo Gabriele Tocchetti
- Cardio-Oncology Unit, Department of Translational Medical Sciences, Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center for Clinical and Translational Research (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy
| | - Patricia Vlasman
- Amsterdam UMC, Vrije Universiteit, Physiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Kak Khee Yeung
- Amsterdam UMC, Vrije Universiteit, Surgery, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Serena Zacchigna
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Integrata Trieste, Trieste, Italy
- International Center for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Dayenne Zwaagman
- Amsterdam UMC, Heart Center, Cardiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Thomas Thum
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
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9
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Cherian AM, Joseph J, Nair MB, Nair SV, Vijayakumar M, Menon D. Coupled benefits of nanotopography and titania surface chemistry in fostering endothelialization and reducing in-stent restenosis in coronary stents. BIOMATERIALS ADVANCES 2022; 142:213149. [PMID: 36270158 DOI: 10.1016/j.bioadv.2022.213149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/03/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Recent advances in coronary stents have all been distinctively focused towards directing re-endothelialization with minimal in-stent restenosis, potentially via alterations in surface topographical cues, for augmenting the efficacy of vascular implants. This perspective was proven by our group utilizing a simple and easily scalable nanosurface modification strategy on metallic stents devoid of any drugs or polymers. In the present work, we explore the impact of surface characteristics in modulating this cell response in-vitro and in-vivo, using titania coated cobalt-chromium (CC) stents, with and without nanotopography, in comparison to commercial controls. Interestingly, titania nanotopography facilitated a preferential cell response in-vitro as against the titania coated and bare CC surfaces, which can be attributed to surface topography, hydrophilicity, and roughness. This in turn altered the cellular adhesion, proliferation and focal contact formations of endothelial and smooth muscle cells. We also demonstrate that titania nanotexturing plays a pivotal role in fostering rapid re-endothelialization with minimal neointimal hyperplasia, leading to excellent in-vivo patency of CC stents post 8 weeks implantation in rabbit iliac arteries, in comparison to bare CC, nano-less titania coated CC, and commercial drug-eluting stents (CC DES), without administering antiplatelet agents. This exciting result for the drug and polymer-free titania nanotextured stents, in the absence of platelet therapy, reveals the possibility of proposing an alternative to clinical DES for coronary stenting.
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Affiliation(s)
- Aleena Mary Cherian
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin 682041, Kerala, India
| | - John Joseph
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin 682041, Kerala, India
| | - Manitha B Nair
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin 682041, Kerala, India
| | - Shantikumar V Nair
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin 682041, Kerala, India
| | - M Vijayakumar
- Department of cardiology, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin 682041, Kerala, India.
| | - Deepthy Menon
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin 682041, Kerala, India.
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10
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Liao R, Li Z, Wang Q, Lin H, Sun H. Revascularization of chronic total occlusion coronary artery and cardiac regeneration. Front Cardiovasc Med 2022; 9:940808. [PMID: 36093131 PMCID: PMC9455703 DOI: 10.3389/fcvm.2022.940808] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
Coronary chronic total occlusion (CTO) contributes to the progression of heart failure in patients with ischemic cardiomyopathy. Randomized controlled trials demonstrated that percutaneous coronary intervention (PCI) for CTO significantly improves angina symptoms and quality of life but fails to reduce clinical events compared with optimal medical therapy. Even so, intervening physicians strongly support CTO-PCI. Cardiac regeneration therapy after CTO-PCI should be a promising approach to improving the prognosis of ischemic cardiomyopathy. However, the relationship between CTO revascularization and cardiac regeneration has rarely been studied, and experimental studies on cardiac regeneration usually employ rodent models with permanent ligation of the coronary artery rather than reopening of the occlusive artery. Limited early-stage clinical trials demonstrated that cell therapy for cardiac regeneration in ischemic cardiomyopathy reduces scar size, reverses cardiac remodeling, and promotes angiogenesis. This review focuses on the status quo of CTO-PCI in ischemic cardiomyopathy and the clinical prospect of cardiac regeneration in this setting.
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Affiliation(s)
- Ruoxi Liao
- Department of Clinical Medicine, Dalian Medical University, Dalian, China
| | - Zhihong Li
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiancheng Wang
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hairuo Lin
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Hairuo Lin, ,
| | - Huijun Sun
- Department of Clinical Pharmacology, College of Pharmacy, Dalian Medical University, Dalian, China
- Huijun Sun,
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11
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Histopathological evaluation of a retinoic acid eluting stent in a rabbit iliac artery model. Sci Rep 2022; 12:13305. [PMID: 35922518 PMCID: PMC9349184 DOI: 10.1038/s41598-022-16025-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/04/2022] [Indexed: 11/08/2022] Open
Abstract
This study aimed to evaluate the safety and efficacy of innovative retinoic acid (RA) eluting stents with bioabsorbable polymer. Sixty stents divided in ten groups were implanted in the iliac arteries of 30 rabbits. Two polymers ("A", poly (lactic-co-glycolic acid) and "B", polylactic acid), and three doses ("Low", "Medium" and "High") of RA (groups: AL, AM, AH, BL, BM, BH) were used on cobalt chromium stents (Rontis Corporation), one group of bare stent (C), one group (D) of Everolimus eluting stent (Xience-Pro, Abbot Vascular), and two groups of Rontis Everolimus eluting stents coated with polymer A (EA) and B (EB). Treated arteries were explanted after 4 weeks, processed by methyl methacrylate resin and evaluated by histopathology. None of the implanted stents was related with thrombus formation or extensive inflammation. Image analysis showed limited differences between groups regarding area stenosis (BH, D and EB groups had the lower values). Group BH had lower intimal mean thickness than AH (105.1 vs 75.3 μm, p = 0.024). Stents eluting RA, a non-cytotoxic drug, were not related with thrombus formation and had an acceptable degree of stenosis 4 weeks post implantation. RA dose and type of polymer may play role in the biocompatibility of the stents.
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12
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Kaluza GL, Creech JL, Furer A, Afari ME, Milewski K, Yi GH, Cheng Y, Conditt GB, McGregor JC, Blum D, Rousselle SD, Granada JF, Burkhoff D. Chronic myocardial and coronary arterial effects of intracoronary supersaturated oxygen therapy in swine with normal and ischemic-reperfused myocardium. Sci Rep 2022; 12:5785. [PMID: 35388096 PMCID: PMC8987078 DOI: 10.1038/s41598-022-09776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 03/16/2022] [Indexed: 11/08/2022] Open
Abstract
The study assessed chronic myocardial, coronary and systemic effects of intracoronary supersaturated oxygen (SSO2) therapy. Left anterior descending coronary arteries of 40 swine were stented and randomized to 90-min selective intracoronary infusion of SSO2 (pO2 760-1000 mmHg) or normoxemic saline. In 20 out of 40 animals, SSO2 delivery followed a 60-min balloon occlusion to induce myocardial infarction (MI). In both normal and MI models, intracoronary treatment with hyperoxemic SSO2 therapy showed no evidence of coronary thrombosis. There were no biologically relevant differences between treatments at either time point in regard to coronary intervention site healing and neointimal growth. No signs of any myocardial or systemic toxicity were observed after 7 or 30 days. A trend was observed toward reduced incidence of microscopic MI scars and reduced infarct size in histopathology, as well as toward better recovery of echocardiographically evaluated global and regional contractility at 30 days. No treatment related infarcts or thromboemboli were observed in the downstream organs.
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Affiliation(s)
- Grzegorz L Kaluza
- Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, NY, USA.
| | | | - Ariel Furer
- Sheba Tel HaShomer City of Health, Ramat Gan, Israel
| | | | | | - Geng-Hua Yi
- Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, NY, USA
| | - Yanping Cheng
- Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, NY, USA
| | - Gerard B Conditt
- Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, NY, USA
| | - Jenn C McGregor
- Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, NY, USA
| | | | | | - Juan F Granada
- Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, NY, USA
| | - Daniel Burkhoff
- Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, NY, USA
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13
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Liu F, Ge Y, Rong D, Zhu Y, Yin J, Sun G, Jia X, Guo W. Injury and Healing Response of Healthy Peripheral Arterial Tissue to Intravascular Lithotripsy: A Prospective Animal Study. Front Cardiovasc Med 2022; 9:787973. [PMID: 35419438 PMCID: PMC8995801 DOI: 10.3389/fcvm.2022.787973] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/03/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives Intravascular lithotripsy (IVL) is a novel clinical technique for the management of severely calcified lesions. However, the biological effects of shock wave on the healthy arterial tissue have not been demonstrated. The preclinical safety study aimed to investigate the vascular response to IVL shock wave compared to plain old balloon angioplasty (POBA) in porcine peripheral arteries. Methods The left and right iliofemoral arterial segments of 16 mini-pigs were subjected to IVL and POBA, respectively. The vascular response was evaluated using quantitative vascular angiography (QVA), light microscopy, and scanning electron microscopy (SEM) at 0, 5, and 28 days. Results With the emission of shock wave, adjacent muscle contraction was observed. QVA showed there was no statistically significant difference in percent diameter stenosis and late lumen loss between the two groups. SEM examination showed the endothelial cell layer was intact in both groups at all timepoints. Under light microscopy, no area stenosis was observed. However, IVL shock wave resulted in significantly higher percent area stenosis and intimal area at 28 days. Neointima score showed a trend toward a higher rate in the IVL group, although there was no statistically significant difference at 28 days. There were no statistically significant differences in the scored parameters between groups at all timepoints. However, the parameters of inflammation and neointima showed a trend toward higher scores in the IVL group. After disruption of the internal elastic lamina, the arteries demonstrated significantly neointimal thickening. Conclusions The safety and operability of IVL are comparable to POBA. The histological response of healthy arteries to IVL shock wave is mild and sustained. IVL shock wave do not cause serious vascular tissue damage, especially endothelial denudation.
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Affiliation(s)
- Feng Liu
- Department of Vascular and Endovascular Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Vascular and Endovascular Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yangyang Ge
- Department of Vascular and Endovascular Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Dan Rong
- Department of Vascular and Endovascular Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yating Zhu
- Department of Vascular and Endovascular Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jianhan Yin
- Department of Vascular and Endovascular Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Guoyi Sun
- Department of Vascular and Endovascular Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xin Jia
- Department of Vascular and Endovascular Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Guo
- Department of Vascular and Endovascular Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Wei Guo
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14
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King D, McCormick C, McGinty S. How Does Fluid Flow Influence Drug Release from Drug Filled Implants? Pharm Res 2022; 39:25-40. [PMID: 34997423 PMCID: PMC8837542 DOI: 10.1007/s11095-021-03127-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022]
Abstract
Drug-filled implants (DFIs) have emerged as an innovative approach to control the delivery of drugs. These devices contain the drug within the structure of the implant itself and avoid the need to include additional drug carrier materials such as a polymers, which are often associated with inflammation and delayed healing/tissue regeneration at the implant site. One common feature of in vitro experiments to generate drug release profiles is stirring or agitation of the release medium. However, the influence of the resulting fluid flow on the rate of drug release from DFIs has yet to be quantified. In this paper we consider two DFIs, which although similar in shape and size, employ different strategies to control the release of drug: a porous pin with pores on the order of μm and a pin drilled with orifices of the order of mm. We develop a multiphysics mathematical model of drug release from these DFIs, subject to fluid flow induced through stirring and show that fluid flow greatly influences the drug release profile for the orifice pin, but that the porous pin drug release profile is relatively insensitive to flow. We demonstrate that drug release from the porous pin may adequately be described through a simplified radial 1D dissolution-diffusion model, while a 3D dissolution-advection-diffusion model is required to describe drug release from the orifice pin. A sensitivity analysis reveals that that the balance of reaction-advection-diffusion in terms of key nondimensional numbers governs the overall drug release. Our findings potentially have important implications in terms of devising the most relevant experimental protocol for quantifying drug release from DFIs.
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Affiliation(s)
- David King
- Division of Biomedical Engineering, University of Glasgow, Glasgow, UK
| | | | - Sean McGinty
- Division of Biomedical Engineering, University of Glasgow, Glasgow, UK. .,Glasgow Computational Engineering Centre, University of Glasgow, Glasgow, UK.
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15
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Shim JW, Kim SS, Kim HK, Bae IH, Park DS, Park JK, Kim JU, Kim HB, Lee MY, Kim JS, Kim JH, Koo BS, Jeong KJ, Kim SU, Kim MC, Sim DS, Hong YJ, Ahn Y, Lim KS, Jeong MH. Effect of Novel Polymer-Free Nitrogen-Doped Titanium Dioxide Film-Coated Coronary Stent Loaded With Mycophenolic Acid. Front Bioeng Biotechnol 2021; 9:650408. [PMID: 34778222 PMCID: PMC8585759 DOI: 10.3389/fbioe.2021.650408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 10/15/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Titanium is commonly used in blood-exposed medical devices because it has superior blood compatibility. Mycophenolic acid inhibits the proliferation of vascular smooth muscle cells. This study examined the effect of a non-polymer TiO2 thin film–coated stent with mycophenolic acid in a porcine coronary overstretch restenosis model. Methods: Thirty coronary arteries in 15 pigs were randomized into three groups in which the coronary arteries were treated with a TiO2 film–coated stent with mycophenolic acid (NTM, n = 10), everolimus-eluting stent with biodegradable polymer (EES, n = 10), or TiO2 film–coated stent (NT, n = 10). A histopathologic analysis was performed 28 days after the stenting. Results: There were no significant intergroup differences in injury score, internal elastic lamina area, or inflammation score. Percent area stenosis was significantly smaller in the NTM and EES groups than in the NT group (36.1 ± 13.63% vs. 31.6 ± 7.74% vs. 45.5 ± 18.96%, respectively, p = 0.0003). Fibrin score was greater in the EES group than in the NTM and NT groups [2.0 (range, 2.0–2.0) vs. 1.0 (range, 1.0–1.75) vs. 1.0 (range, 1.0–1.0), respectively, p < 0.0001]. The in-stent occlusion rate measured by micro-computed tomography demonstrated similar percent area stenosis rates on histology analysis (36.1 ± 15.10% in NTM vs. 31.6 ± 8.89% in EES vs. 45.5 ± 17.26% in NT, p < 0.05). Conclusion: The NTM more effectively reduced neointima proliferation than the NT. Moreover, the inhibitory effect of NTM on smooth muscle cell proliferation was not inferior to that of the polymer-based EES with lower fibrin deposition in this porcine coronary restenosis model.
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Affiliation(s)
- Jae Won Shim
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Sung Soo Kim
- Division of Cardiology, Chosun University Hospital, Gwangju, South Korea
| | - Hyun Kuk Kim
- Division of Cardiology, Chosun University Hospital, Gwangju, South Korea
| | - In Ho Bae
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Dae Sung Park
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea.,Research Institute of Medical Sciences, Chonnam National University, Gwangju, South Korea
| | | | - Jae Un Kim
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Han Byul Kim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Min Young Lee
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Joong Sun Kim
- College of Veterinary Medicine, Chonnam National University, Gwangju, South Korea
| | - Jung Ha Kim
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Bon-Sang Koo
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Kang-Jin Jeong
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Sun-Uk Kim
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Min Chul Kim
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Doo Sun Sim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Young Joon Hong
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Youngkeun Ahn
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
| | - Kyung Seob Lim
- Futuristic Animal Resource and Research Center, National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, South Korea
| | - Myung Ho Jeong
- Korea Cardiovascular Stent Research Institute, Jangsung, South Korea.,Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, South Korea
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16
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Milewski K, Bryła-Wojciechowska A, Buszman PP, Jelonek K, Kachel M, Gąsior P, Krauze A, Błachut A, Musiał-Kulik M, Tellez A, Rousselle SD, Kiesz RS, Kasperczyk J, Buszman PE. Nanospheres encapsulated everolimus delivery into arterial wall-the tissue pharmacokinetics and vascular response experimental study. Catheter Cardiovasc Interv 2021; 98:914-922. [PMID: 32946190 DOI: 10.1002/ccd.29258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 06/09/2020] [Accepted: 08/02/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to evaluate the pharmacokinetic profile and tissue effects of everolimus delivered into arterial wall using biodegradable nanospheres. BACKGROUND Delivery of everolimus into the arterial wall is challenging due to its low-lipophilic profile. METHODS A pharmacokinetic study included 28 porcine coronary arterial segments initially injured with balloon angioplasty followed by the local delivery of everolimus encapsulated in nanospheres (EEN) via injection through a microporous delivery catheter. The animals were sacrificed at 1 hour, 1,7,28, and 90-day follow-up. In the tissue effects study 16 coronary bare metal stent (BMS) were implanted following EEN delivery, 15 BMS following nanospheres delivery without the drug (reference group) and 16 implanted BMS served as a control. Angiographic and histology follow-up was scheduled at 28 and 90-day. RESULTS The study showed high-everolimus concentrations in arterial tissue early after nanoparticles delivery followed by its gradual decrease to 1.15 ± 0.40 ng/mg at 90 days. Histology analysis showed favorable biocompatibility and healing profile with comparable area stenosis between groups at both time-points. CONCLUSIONS The present study demonstrates for the first time the safety, biocompatibility, and long-term retention of everolimus in arterial tissue after single local delivery of biodegradable nanospheres.
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Affiliation(s)
- Krzysztof Milewski
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland.,Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | | | - Piotr P Buszman
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland.,Cardiology Department, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland, Krakow, Poland
| | - Katarzyna Jelonek
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | - Mateusz Kachel
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland
| | - Paweł Gąsior
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland.,Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland, Medical University of Silesia, Katowice, Poland
| | - Agata Krauze
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland
| | - Aleksandra Błachut
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland.,Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Monika Musiał-Kulik
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | | | | | - R Stefan Kiesz
- San Antonio Endovascular and Heart Institute, Texas, USA.,University of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Janusz Kasperczyk
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | - Paweł E Buszman
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland.,Medical University of Silesia, Katowice, Poland
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17
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Schachtschneider KM, Schook LB, Meudt JJ, Shanmuganayagam D, Zoller JA, Haghani A, Li CZ, Zhang J, Yang A, Raj K, Horvath S. Epigenetic clock and DNA methylation analysis of porcine models of aging and obesity. GeroScience 2021; 43:2467-2483. [PMID: 34523051 PMCID: PMC8599541 DOI: 10.1007/s11357-021-00439-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/09/2021] [Indexed: 12/29/2022] Open
Abstract
DNA-methylation profiles have been used successfully to develop highly accurate biomarkers of age, epigenetic clocks, for many species. Using a custom methylation array, we generated DNA methylation data from n = 238 porcine tissues including blood, bladder, frontal cortex, kidney, liver, and lung, from domestic pigs (Sus scrofa domesticus) and minipigs (Wisconsin Miniature Swine™). Samples used in this study originated from Large White X Landrace crossbred pigs, Large White X Minnesota minipig crossbred pigs, and Wisconsin Miniature Swine™. We present 4 epigenetic clocks for pigs that are distinguished by their compatibility with tissue type (pan-tissue and blood clock) and species (pig and human). Two dual-species human-pig pan-tissue clocks accurately measure chronological age and relative age, respectively. We also characterized CpGs that differ between minipigs and domestic pigs. Strikingly, several genes implicated by our epigenetic studies of minipig status overlap with genes (ADCY3, TFAP2B, SKOR1, and GPR61) implicated by genetic studies of body mass index in humans. In addition, CpGs with different levels of methylation between the two pig breeds were identified proximal to genes involved in blood LDL levels and cholesterol synthesis, of particular interest given the minipig's increased susceptibility to cardiovascular disease compared to domestic pigs. Thus, breed-specific differences of domestic and minipigs may potentially help to identify biological mechanisms underlying weight gain and aging-associated diseases. Our porcine clocks are expected to be useful for elucidating the role of epigenetics in aging and obesity, and the testing of anti-aging interventions.
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Affiliation(s)
- Kyle M. Schachtschneider
- Department of Radiology, University of Illinois At Chicago, Chicago, IL USA
- Department of Biochemistry and Molecular Genetics, University of Illinois At Chicago, Chicago, IL USA
- National Center for Supercomputing Applications, University of Illinois At Urbana-Champaign, Urban, IL USA
| | - Lawrence B. Schook
- Department of Radiology, University of Illinois At Chicago, Chicago, IL USA
- Department of Animal Sciences, University of Illinois At Urbana-Champaign, Urbana, IL USA
| | - Jennifer J. Meudt
- Biomedical & Genomic Research Group, Department of Animal and Dairy Sciences, University of Wisconsin – Madison, Madison, WI USA
| | - Dhanansayan Shanmuganayagam
- Biomedical & Genomic Research Group, Department of Animal and Dairy Sciences, University of Wisconsin – Madison, Madison, WI USA
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - Joseph A. Zoller
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA USA
| | - Amin Haghani
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA USA
| | - Caesar Z. Li
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA USA
| | - Joshua Zhang
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Gonda Building, 695 Charles Young Drive South, Los Angeles, CA 90095 USA
| | - Andrew Yang
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA USA
| | - Ken Raj
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
| | - Steve Horvath
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA USA
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Gonda Building, 695 Charles Young Drive South, Los Angeles, CA 90095 USA
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18
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Yang L, Wu H, Lu L, He Q, Xi B, Yu H, Luo R, Wang Y, Zhang X. A tailored extracellular matrix (ECM) - Mimetic coating for cardiovascular stents by stepwise assembly of hyaluronic acid and recombinant human type III collagen. Biomaterials 2021; 276:121055. [PMID: 34371447 DOI: 10.1016/j.biomaterials.2021.121055] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/18/2021] [Accepted: 07/28/2021] [Indexed: 12/14/2022]
Abstract
Collagen, a central component of the extracellular matrix (ECM), has been widely applied in tissue engineering, among others, for wound healing or bone and nerve regeneration. However, the inherent thrombogenic properties of collagen hinder the application in blood-contacting devices. Herein, a brand-new recombinant human type III collagen (hCOLIII) was explored that does not present binding sites for platelets while retaining the affinity for endothelial cells. The hCOLIII together with hyaluronic acid (HA) were deposited on the substrates via layer-by-layer assembly to form an ECM-mimetic multilayer coating. In vitro platelet adhesion and ex vivo blood circulation tests demonstrated prominent thromboprotective properties for the hCOLIII-based ECM-mimetic coating. In addition, the coating effectively guided the vascular cell fate by supporting the proliferation of endothelial cells and inhibiting the proliferation of smooth muscle cells by differentiating them to a more contractile phenotype. A polylactic acid (PLA) stent coated with hCOLIII-based ECM-mimetic coating was implanted in the abdominal aorta of rabbits to investigate the healing of the neointima. The enhanced endothelialization, suppressed inflammatory response, inhibition of excessive neointimal hyperplasia, and the superior thromboprotection strongly indicated the prospect of the hCOLIII-based ECM-mimetic coating as a tailored blood-contacting material for cardiovascular stents.
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Affiliation(s)
- Li Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Haoshuang Wu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Lu Lu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences and Shanghai Public Health Clinical Center, Fudan-Jinbo Joint Research Center, Fudan University, Shanghai, 200302, China
| | - Qing He
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Boting Xi
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Hongchi Yu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Rifang Luo
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China.
| | - Yunbing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China.
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
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19
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Hemetsberger R, Farhan S, Lukovic D, Zlabinger K, Hajagos-Toth J, Bota J, Garcia-Garcia HM, Ay C, Samaha E, Gaspar R, Garamvölgyi R, Huber K, Gyöngyösi M, Spannbauer A. Peri-interventional Triple Therapy With Dabigatran Improves Vasomotion and Promotes Endothelialization in Porcine Coronary Stenting Model. Front Cardiovasc Med 2021; 8:690476. [PMID: 34307502 PMCID: PMC8300015 DOI: 10.3389/fcvm.2021.690476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: We evaluated the short and long-term effect of peri-interventional dabigatran therapy on vasomotion, endothelialization, and neointimal formation in a porcine coronary artery stenting model. Background: Stenting of coronary arteries induces local inflammation, impairs vasomotion and delays endothelialization. Methods: Twenty-eight animals underwent percutaneous coronary intervention (PCI) with drug eluting stents. Sixteen pigs started dabigatran therapy 4 days prior to PCI and continued for 4 days post-stenting, while 12 animals served as controls. Post-stenting dual antiplatelet therapy (75 mg clopidogrel and 100 mg aspirin) was continued in both groups until termination. Immediately post-stenting and at day 3 optical coherence tomography (OCT) was performed in all animals, followed by euthanasia of 8 dabigatran and 4 control animals. The remaining pigs (8 of each group) were followed up for 1 month, with control angiography and OCT. Tissue burden (degree of peri-strut structure—thrombus and/or fibrin) was evaluated. After euthanasia coronary arteries were harvested for in-vitro myometry and histology. Results: Thrombin generation was lower (p < 0.001) and tissue burden (0.83 ± 0.98 vs. 3.0 ± 2.45; p = 0.031) was significantly decreased in dabigatran treated animals. After 3 days post-PCI endothelium-dependent vasodilation was significantly improved (77 ± 40% vs. 41 ± 31%, p = 0.02) in dabigatran animals. Neither quantitative angiography nor histomorphometry showed differences between the groups. Endothelialization was faster in the dabigatran group as compared with controls (p = 0.045). Conclusion: Short-term peri-interventional triple therapy with dabigatran, aspirin, and clopidogrel led to an enhanced endothelium dependent vasodilation and faster endothelialization. However, neointimal formation 1-month after stent implantation was comparable between groups.
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Affiliation(s)
- Rayyan Hemetsberger
- Department of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Serdar Farhan
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Dominika Lukovic
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Katrin Zlabinger
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Judit Hajagos-Toth
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Judit Bota
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | | | - Cihan Ay
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Eslam Samaha
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Robert Gaspar
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Rita Garamvölgyi
- Institute of Diagnostics and Radiation Oncology, University of Kaposvár, Kaposvár, Hungary
| | - Kurt Huber
- 3rd Medical Department of Cardiology, Wilhelminen Hospital, Vienna, Austria
| | - Mariann Gyöngyösi
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
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20
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Ijichi T, Nakazawa G, Torii S, Nagamatsu H, Yoshikawa A, Nakamura S, Souba J, Isobe A, Hagiwara H, Ikari Y. Late neointimal volume reduction is observed following biodegradable polymer-based drug eluting stent in porcine model. IJC HEART & VASCULATURE 2021; 34:100792. [PMID: 34036146 PMCID: PMC8134975 DOI: 10.1016/j.ijcha.2021.100792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND The BP-SES has an abluminally applied biodegradable polymer that is fully resorbed after 3-4 months but may have longer-lasting effects. The aim of this study was to determine the long-term vascular response to the novel Ultimaster™ sirolimus-eluting stent (BP-SES). METHODS BP-SESs, everolimus-eluting stents (DP-EESs), and bare metal stents were implanted in 22 coronary arteries of 15 mini-swine. All animals underwent optical frequent domain imaging (OFDI) to assess neointimal volume and quality at either 1 (n = 7) or 3 (n = 8) months and at 9 (n = 15) months and were euthanized at 9 months. Stents were subsequently histologically investigated to analyze the vascular response and maturity of neointimal tissue according to cell density. RESULTS OFDI revealed greater regression in neointimal volume from 3 to 9 months with BP-SESs than with DP-EESs (-0.6 ± 0.5 mm2 vs. 0.00 ± 0.4 mm2, p = 0.07). Although there was no significant difference between BP-SESs and DP-EESs in the inflammation score (BMS, BP-SES, and DP-EES: 0.1 ± 0.1, 0.3 ± 0.4, and 0.4 ± 0.4, respectively; p < 0.0001) in histological analysis, BP-SESs showed slightly greater maturity than DP-EESs (1.8 ± 0.3, 1.7 ± 0.3, and 1.6 ± 0.3, p = 0.09). CONCLUSIONS While both BP-SESs and DP-EESs showed minimal inflammatory responses at 9 months, BP-SESs showed a trend for greater neointimal maturity and regression, which may be related to earlier completion of the vascular response.
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Affiliation(s)
- Takeshi Ijichi
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Sho Torii
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Ayako Yoshikawa
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | | | - Junko Souba
- TERUMO Corporation Evaluation Center, Kanagawa, Japan
| | - Atsushi Isobe
- TERUMO Corporation Evaluation Center, Kanagawa, Japan
| | | | - Yuji Ikari
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
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21
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Shen D, Qi H, Lin W, Zhang W, Bian D, Shi X, Qin L, Zhang G, Fu W, Dou K, Xu B, Yin Z, Rao J, Alwi M, Wang S, Zheng Y, Zhang D, Gao R. PDLLA-Zn-nitrided Fe bioresorbable scaffold with 53-μm-thick metallic struts and tunable multistage biodegradation function. SCIENCE ADVANCES 2021; 7:7/23/eabf0614. [PMID: 34088662 PMCID: PMC8177708 DOI: 10.1126/sciadv.abf0614] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/19/2021] [Indexed: 05/02/2023]
Abstract
Balancing the biodegradability and mechanical integrity of a bioresorbable scaffold (BRS) with time after implantation to match the remodeling of the scaffolded blood vessel is important, but a key challenge in doing so remains. This study presents a novel intercalated structure of a metallic BRS by introducing a nanoscale Zn sacrificial layer between the nitrided Fe platform and the sirolimus-carrying poly(d,l-lactide) drug coating. The PDLLA-Zn-FeN BRS shows a multistage biodegradation behavior, maintaining mechanical integrity at the initial stage and exhibiting accelerated biodegradation at the subsequent stage in both rabbit abdominal aortas and human coronary arteries, where complete biodegradation was observed about 2 years after implantation. The presence of the nanoscale Zn sacrificial layer with an adjustable thickness also contributes to the tunable biodegradation of BRS and allows the reduction of the metallic strut thickness to 53 μm, with radial strength as strong as that of the current permanent drug-eluting stents.
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Affiliation(s)
- Danni Shen
- Beijing Advanced Innovation Center for Materials Genome Engineering and School of Materials Science and Engineering, Peking University, Beijing 100871, China
| | - Haiping Qi
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China
| | - Wenjiao Lin
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China
| | - Wanqian Zhang
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200433, China
| | - Dong Bian
- Beijing Advanced Innovation Center for Materials Genome Engineering and School of Materials Science and Engineering, Peking University, Beijing 100871, China
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China
| | - Xiaoli Shi
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China
| | - Li Qin
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China
| | - Gui Zhang
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China
| | - Wenchao Fu
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China
| | - Kefei Dou
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Bo Xu
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Zhenyuan Yin
- BioMed-X Center, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Jiancun Rao
- AIM Lab, Maryland NanoCenter, University of Maryland, College Park, MD 20742, USA
| | - Mazeni Alwi
- Paediatric Cardiology, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, Kuala Lumpur 50400, Malaysia
| | - Shuhan Wang
- Shen Zhen Testing Center of Medical Devices, Shenzhen 518057, China
| | - Yufeng Zheng
- Beijing Advanced Innovation Center for Materials Genome Engineering and School of Materials Science and Engineering, Peking University, Beijing 100871, China.
- BioMed-X Center, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Deyuan Zhang
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen 518110, China.
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
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22
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Jalaie H, Schleimer K, Toonder IM, Gombert A, Afify M, Doganci S, Modabber A, Razavi MK, Barbati ME. Effect of Stent Strut Interval on Neointima Formation After Venous Stenting in an Ovine Model. Eur J Vasc Endovasc Surg 2021; 62:276-283. [PMID: 34053840 DOI: 10.1016/j.ejvs.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 03/22/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The impact of stent design on venous patency is not well studied. The purpose of this study was to investigate the effect of stent material burden on endothelial coverage of stented venous segments, which may contribute to vessel healing and patency. METHODS Segmented self expanding bare nitinol stents (18 × 50 mm) comprising 5 mm long attached metallic rings separated by 2, 5, or 8 mm gaps were implanted in the inferior vena cava (IVC) of 10 sheep. These stents were designed and manufactured for the purposes of this study. At six, 12, and 24 weeks after implantation the animals were euthanised and the stented vessels harvested for histomorphometric analysis. Three sections from the metallic part as well as the gaps between the struts were reviewed for quantification of endothelialisation after six, 12, and 24 weeks. The intimal thickness over and between the stent struts was measured. The endothelialisation score (graded from 1 for complete luminal endothelialisation to 5 for absence of endothelial cells) was determined. RESULTS All stents were successfully deployed and all 10 sheep survived until the time of harvesting. Macroscopic inspection after 24 weeks showed only partial endothelialisation over stents with 2 mm and 5 mm skipped segments, whereas the stents with 8 mm skipped segments were totally incorporated into the vein wall. After 24 weeks, the mean (SD) neointimal thicknesses over stent struts with 2 mm, 5 mm, and 8 mm skipped segments were 254.0 (51.6), 182.2 (98.1), and 194.6 (101.1) μm, respectively. Comparison of endothelialisation scores of stents over time showed statistically significantly better endothelialisation over stents with 8 mm gaps after 12 and 24 weeks. CONCLUSION Stent designs providing structural support to veins with larger gaps between the scaffold material appear to lead to faster and more complete endothelialisation as well as a thinner intimal layer.
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Affiliation(s)
- Houman Jalaie
- Clinic of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Karina Schleimer
- Clinic of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Irwin M Toonder
- Clinic of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Alexander Gombert
- Clinic of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Mamdouh Afify
- Clinic of Cardiology, RWTH Aachen University Hospital, Aachen, Germany
| | - Suat Doganci
- Department of Cardiovascular Surgery, University of Health Sciences, Ankara, Turkey
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | | | - Mohammad E Barbati
- Clinic of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany.
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Abstract
Pigs represent a potentially attractive model for medical research. Similar body size and physiological patterns of kidney injury that more closely mimic those described in humans make larger animals attractive for experimentation. Using larger animals, including pigs, to investigate the pathogenesis of acute kidney injury (AKI) also serves as an experimental bridge, narrowing the gap between clinical disease and preclinical discoveries. This article compares the advantages and disadvantages of large versus small AKI animal models and provides a comprehensive overview of the development and application of porcine models of AKI induced by clinically relevant insults, including ischemia-reperfusion, sepsis, and nephrotoxin exposure. The primary focus of this review is to evaluate the use of pigs for AKI studies by current investigators, including areas where more information is needed.
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Affiliation(s)
- Jianni Huang
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - George Bayliss
- Department of Medicine, Rhode Island Hospital and Alpert Medical School, Brown University, Providence, Rhode Island
| | - Shougang Zhuang
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Medicine, Rhode Island Hospital and Alpert Medical School, Brown University, Providence, Rhode Island
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24
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Pérez de Prado A, Pérez Martínez C, Fernández Vázquez F. Leaving absolutely nothing behind-Is there any room for improvement in drug coated balloons? Int J Cardiol 2021; 331:71-72. [PMID: 33548382 DOI: 10.1016/j.ijcard.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Armando Pérez de Prado
- Fundación Investigación Sanitaria en León - UIC 104, Hospital Universitario de León y Universidad de León, León, Spain.
| | - Claudia Pérez Martínez
- Fundación Investigación Sanitaria en León - UIC 104, Hospital Universitario de León y Universidad de León, León, Spain
| | - Felipe Fernández Vázquez
- Fundación Investigación Sanitaria en León - UIC 104, Hospital Universitario de León y Universidad de León, León, Spain
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25
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Choe JC, Park JH, Lee HC, Park TS, Ahn J, Park JS, Lee HW, Oh JH, Choi JH, Cha KS, Yim C, Jeon S. Histopathologic response after hydrophilic polyethylene glycol-coating stent and hydrophobic octadecylthiol-coating stent implantations in porcine coronary restenosis model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:122. [PMID: 33247775 DOI: 10.1007/s10856-020-06452-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 12/07/2019] [Accepted: 10/27/2020] [Indexed: 06/12/2023]
Abstract
Device-related problems of drug-eluting stents, including stent thrombosis related to antiproliferative drugs and polymers, can cause adverse events such as inflammation and neointimal hyperplasia. Stent surface modification, wherein the drug and polymer are not required, may overcome these problems. We developed hydrophilic polyethylene glycol (PEG)-coating and hydrophobic octadecylthiol (ODT)-coating stents without a drug and polymer and evaluated their histopathologic response in a porcine coronary restenosis model. PEG-coating stents (n = 12), bare-metal stents (BMS) (n = 12), and ODT-coating stents (n = 10) were implanted with oversizing in 34 porcine coronary arteries. Four weeks later, the histopathologic response, arterial injury, inflammation, and fibrin scores were analyzed. A p value < 0.05 was considered statistically significant. There were significant differences in the internal elastic lamina area, lumen area, neointimal area, percent area of stenosis, arterial injury score, inflammation score, and fibrin score among the groups. Compared to the BMS or ODT-coating stent group, the PEG-coating stent group had significantly increased internal elastic lamina and lumen area (all p < 0.001) and decreased neointimal area and percent area of stenosis (BMS: p = 0.03 and p < 0.001, respectively; ODT-coating: p = 0.013 and p < 0.001, respectively). Similarly, the PEG-coating group showed significantly lower inflammation and fibrin scores than the BMS or ODT-coating groups (BMS: p = 0.013 and p = 0.007, respectively; ODT-coating: p = 0.014 and p = 0.008, respectively). In conclusion, hydrophilic PEG-coating stent implantation was associated with lower inflammatory response, decreased fibrin deposition, and reduced neointimal hyperplasia than BMS or hydrophobic ODT-coating stent implantation in the porcine coronary restenosis model.
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Affiliation(s)
- Jeong Cheon Choe
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Jong Ha Park
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Han Cheol Lee
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.
| | - Tae Sik Park
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Jinhee Ahn
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Jin Sup Park
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Hye Won Lee
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Jun-Hyok Oh
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Jung Hyun Choi
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Kwang Soo Cha
- Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Changyong Yim
- Department of Chemical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
| | - Sangmin Jeon
- Department of Chemical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
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26
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Zhang B, Yao R, Hu C, Maitz MF, Wu H, Liu K, Yang L, Luo R, Wang Y. Epigallocatechin gallate mediated sandwich-like coating for mimicking endothelium with sustained therapeutic nitric oxide generation and heparin release. Biomaterials 2020; 269:120418. [PMID: 33143876 DOI: 10.1016/j.biomaterials.2020.120418] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 12/22/2022]
Abstract
In-stent restenosis after stenting is generally characterized by an inflammatory response, excessive proliferation of smooth muscle cells, and delayed healing of the endothelium layer. In this study, inspired by catechol/gallol surface chemistry, a sandwich-like layer-by-layer (LBL) coating was developed using chitosan and heparin as polyelectrolytes, along with the embedding of an epigallocatechin gallate/copper (EGCG/Cu) complex. The embedding of EGCG stabilized the coating by various intermolecular interactions in the LBL coating (e.g., π-π stacking, weak intermolecular crosslinking, and enriched hydrogen bonding) and supported the sustained release of the cargo heparin over 90 days. This design enabled a biomimetic endothelium function in terms of the sustained release of heparin and continuous in situ generation of nitric oxide, driven by the catalytic decomposition of endogenous S-nitrostothiols by copper ions. The result showed enhanced durability of anticoagulation and suppressed inflammatory response. Moreover, the "sandwich-like" coating supported the growth of endothelial cells and up-regulated the protein expression of vascular endothelial growth factor, while effectively suppressing the proliferation and migration of smooth muscle cells (SMCs) via the up-regulation of cyclic guanosine monophosphate. Ex vivo and in vivo experiments demonstrated the effectiveness of the sandwich-like coating in preventing thrombosis formation, suppressing the growth of SMCs, reducing the infiltration and activation of inflammatory cells, and ultimately achieving rapid in situ endothelialization. Hence, the EGCG-assisted sandwich-like coating might be used as a robust and versatile surface modification strategy for implantable cardiovascular devices.
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Affiliation(s)
- Bo Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Ruijuan Yao
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Cheng Hu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Manfred F Maitz
- Max Bergmann Center of Biomaterials, Leibniz Institute of Polymer Research Dresden, Dresden, 01069, Germany; Key Lab. for Advanced Technologies of Materials, Ministry of Education, School of Material Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Haoshuang Wu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Kunpeng Liu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Li Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Rifang Luo
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China.
| | - Yunbing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China.
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27
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Anbalakan K, Toh HW, Ang HY, Buist ML, Leo HL. Assessing the influence of atherosclerosis on drug coated balloon therapy using computational modelling. Eur J Pharm Biopharm 2020; 158:72-82. [PMID: 33075477 DOI: 10.1016/j.ejpb.2020.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/11/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022]
Abstract
Interventional therapies such as drug-eluting stents (DES) and drug-coated balloons (DCB) have significantly improved the clinical outcomes of patients with coronary occlusions in recent years. Despite this marked improvement, ischemic cardiovascular disease remains the most common cause of death worldwide. To address this, research efforts are focused on improving the safety and efficacy of the next generation of these devices. However, current experimental methods are unable to account for the influence of atherosclerotic lesions on drug uptake and retention. Therefore, in this study, we used an integrated approach utilizing both in vitro and in silico methods to assess the performance of DCB therapy. This approach was validated against existing in vivo results before being used to numerically estimate the effect of the atheroma. A bolus release of sirolimus was observed with our coating matrix. This, coupled with the rapid saturation of specific and non-specific binding sites observed in our study, indicated that increasing the therapeutic dose coated onto the balloons might not necessarily result in greater uptake and/or retention. Additionally, our findings alluded to an optimal exposure time, dependent on the coating matrix, for the DCBs to be expanded against the vessel. Moreover, our findings suggest that a biphasic drug release profile might be beneficial for establishing and maintaining the saturation of bindings sites within severely occluded vessels. Ultimately, we have demonstrated that computational methods may be capable of assessing the efficacy of DCB therapy as well as predict the influence of atherosclerotic lesions on said efficacy.
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Affiliation(s)
- Karthic Anbalakan
- Department of Biomedical Engineering, National University of Singapore, Singapore 117576, Singapore.
| | - Han Wei Toh
- Department of Biomedical Engineering, National University of Singapore, Singapore 117576, Singapore; National Heart Research Institute Singapore, National Heart Center Singapore 169609, Singapore
| | - Hui Ying Ang
- Department of Biomedical Engineering, National University of Singapore, Singapore 117576, Singapore; National Heart Research Institute Singapore, National Heart Center Singapore 169609, Singapore
| | - Martin Lindsay Buist
- Department of Biomedical Engineering, National University of Singapore, Singapore 117576, Singapore.
| | - Hwa Liang Leo
- Department of Biomedical Engineering, National University of Singapore, Singapore 117576, Singapore.
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28
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Bobi J, Garabito M, Solanes NÚ, Cidad P, Ramos-Pérez V, Ponce A, Rigol M, Freixa X, Pérez-Martínez C, Pérez de Prado A, Fernández-Vázquez F, Sabaté M, Borrós S, López-López JR, Pérez-García MT, Roqué M. Kv1.3 blockade inhibits proliferation of vascular smooth muscle cells in vitro and intimal hyperplasia in vivo. Transl Res 2020; 224:40-54. [PMID: 32522668 DOI: 10.1016/j.trsl.2020.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 11/16/2022]
Abstract
The modulation of voltage-gated K+ (Kv) channels, involved in cell proliferation, arises as a potential therapeutic approach for the prevention of intimal hyperplasia present in in-stent restenosis (ISR) and allograft vasculopathy (AV). We studied the effect of PAP-1, a selective blocker of Kv1.3 channels, on development of intimal hyperplasia in vitro and in vivo in 2 porcine models of vascular injury. In vitro phenotypic modulation of VSMCs was associated to an increased functional expression of Kv1.3 channels, and only selective Kv1.3 channel blockers were able to inhibit porcine VSMC proliferation. The therapeutic potential of PAP-1 was then evaluated in vivo in swine models of ISR and AV. At 15-days follow-up, morphometric analysis demonstrated a substantial reduction of luminal stenosis in the allografts treated with PAP-1 (autograft 2.72 ± 1.79 vs allograft 10.32 ± 1.92 vs allograft + polymer 13.54 ± 8.59 vs allograft + polymer + PAP-1 3.06 ± 1.08 % of luminal stenosis; P = 0.006) in the swine model of femoral artery transplant. In the pig model of coronary ISR, using a prototype of PAP-1-eluting stent, no differences were observed regarding % of stenosis compared to control stents (31 ± 13 % vs 37 ± 18%, respectively; P = 0.372) at 28-days follow-up. PAP-1 treatment was safe and did not impair vascular healing in terms of delayed endothelialization, inflammation or thrombosis. However, an incomplete release of PAP-1 from stents was documented. We conclude that the use of selective Kv1.3 blockers represents a promising therapeutic approach for the prevention of intimal hyperplasia in AV, although further studies to improve their delivery method are needed to elucidate its potential in ISR.
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Affiliation(s)
- Joaquim Bobi
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) and Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Manel Garabito
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) and Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - NÚria Solanes
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) and Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Cidad
- Departamento de Bioquímica y Biología Molecular y Fisiología and Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid and CSIC, Valladolid, Spain
| | - Víctor Ramos-Pérez
- Grup d'Enginyeria de Materials (GEMAT), Institut Químic de Sarrià (IQS), Universitat Ramon Llull (URL), Barcelona, Spain
| | - Alberto Ponce
- Grup d'Enginyeria de Materials (GEMAT), Institut Químic de Sarrià (IQS), Universitat Ramon Llull (URL), Barcelona, Spain
| | - Montserrat Rigol
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) and Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Freixa
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) and Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Claudia Pérez-Martínez
- Grupo Cardiovascular (HemoLeon), Fundación Investigación Sanitaria en León y del Instituto de Biomedicina (IBIOMED), Universidad de León, Hospital Universitario de León, León, Spain
| | - Armando Pérez de Prado
- Grupo Cardiovascular (HemoLeon), Fundación Investigación Sanitaria en León y del Instituto de Biomedicina (IBIOMED), Universidad de León, Hospital Universitario de León, León, Spain
| | - Felipe Fernández-Vázquez
- Grupo Cardiovascular (HemoLeon), Fundación Investigación Sanitaria en León y del Instituto de Biomedicina (IBIOMED), Universidad de León, Hospital Universitario de León, León, Spain
| | - Manel Sabaté
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) and Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Salvador Borrós
- Grup d'Enginyeria de Materials (GEMAT), Institut Químic de Sarrià (IQS), Universitat Ramon Llull (URL), Barcelona, Spain; CIBER of Biomaterials Bioengineering and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - José Ramón López-López
- Departamento de Bioquímica y Biología Molecular y Fisiología and Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid and CSIC, Valladolid, Spain
| | - Mª Teresa Pérez-García
- Departamento de Bioquímica y Biología Molecular y Fisiología and Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid and CSIC, Valladolid, Spain
| | - MercÈ Roqué
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) and Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
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Cherian A, Joseph J, Nair MB, Nair SV, Maniyal V, Menon D. Successful Reduction of Neointimal Hyperplasia on Stainless Steel Coronary Stents by Titania Nanotexturing. ACS OMEGA 2020; 5:17582-17591. [PMID: 32715243 PMCID: PMC7377224 DOI: 10.1021/acsomega.0c02045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
Bare metal stents (BMSs) of stainless steel (SS) were surface engineered to develop nanoscale titania topography using a combination of physical vapor deposition and thermochemical processing. The nanoleafy architecture formed on the stent surface remained stable and adherent upon repeated crimping and expansion, as well as under flow. This titania nanoengineered stent showed a preferential proliferation of endothelial cells over smooth muscle cells in vitro, which is an essential requirement for improving the in vivo endothelialization, with concurrent reduction of intimal hyperplasia. The efficacy of this surface-modified stent was assessed after implantation in rabbit iliac arteries for 8 weeks. Significant reduction in neointimal thickening and thereby in-stent restenosis with complete endothelial coverage was observed for the nanotextured stents, compared to BMSs, even without the use of any antiproliferative agents or polymers as in drug-eluting stents. Nanotexturing of stents did not induce any inflammatory response, akin to BMSs. This study thus indicates the effectiveness of a facile titania nanotopography on SS stents for coronary applications and the possibility of bringing this low-priced material back to clinics.
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Affiliation(s)
- Aleena
Mary Cherian
- Amrita
Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin, 682041 Kerala, India
| | - John Joseph
- Amrita
Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin, 682041 Kerala, India
| | - Manitha B. Nair
- Amrita
Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin, 682041 Kerala, India
| | - Shantikumar V. Nair
- Amrita
Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin, 682041 Kerala, India
| | - Vijayakumar Maniyal
- Department
of Cardiology, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin, 682041 Kerala, India
| | - Deepthy Menon
- Amrita
Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Ponekkara P.O, Cochin, 682041 Kerala, India
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Zuo K, Koh LB, Charles CJ, Yim EKF, Lim J, Li RR, Leo HL, Cui F, Ho P. Measurement of the Luminal Diameter of Peripheral Arterial Vasculature in Yorkshire×Landrace Swine by Using Ultrasonography and Angiography. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2020; 59. [PMID: 32532364 PMCID: PMC7338873 DOI: 10.30802/aalas-jaalas-19-000153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 01/06/2020] [Accepted: 01/31/2020] [Indexed: 06/11/2023]
Abstract
To select animals of appropriate size for preclinical studies of cardiovascular devices, reference knowledge of the cardiovascularanatomy relative to body weight is crucial. We measured the luminal diameters of the arteries (carotid, femoral, and iliac arteries) that are the common access vessels for endovascular and vascular procedures in Yorkshire×Landrace swine. Measurements were performed by using both ultrasound and angiographic methods and were correlated with body weight. Results showed no statistically significant difference between the left and right vessels in the diameters of the carotid,femoral, and iliac arteries. The diameters of the measured arteries showed high correlation with animal weight in pigs thatweighed less than 70 kg.
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Affiliation(s)
| | | | - Christopher J Charles
- Department of Surgery, and
- Cardiovascular Research Institute, Yong Loo Lin School of Medicine, National University of Singapore
| | - Evelyn KF Yim
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Renee R Li
- Department of Surgery, and
- Cardiovascular Research Institute, Yong Loo Lin School of Medicine, National University of Singapore
| | - Hwa Liang Leo
- Department of Biomedical Engineering, National University of Singapore
| | - Fangsen Cui
- Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), Singapore; and
| | - Pei Ho
- Department of Surgery, and
- Department of Cardiac, Thoracic, and Vascular Surgery, National University Health System, Singapore
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Ramot Y, Nedvetzki S, Rosenfeld S, Rousselle SD, Nyska A, Emanuel N. D-PLEX 100 in an Abdominal Surgery Incision Model in Miniature Swine: Safety Study. Toxicol Pathol 2020; 48:677-685. [PMID: 32525456 DOI: 10.1177/0192623320928902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Surgical site infections (SSIs) are a common surgical-related complication. To avoid these complications, a new biodegradable polymer-lipid encapsulation matrix that provides controlled release of doxycycline (doxycycline/polymer-lipid encapsulation matrix [D-PLEX]) has been developed. The aim of this comprehensive study was to evaluate the potential safety of D-PLEX100 in abdominal surgical site. D-PLEX100 was administered into incisions of abdominal surgical site in Yucatan miniature swine, which were followed for up to 6 months and compared to sham-control swine. The D-PLEX100 mass did not migrate from the incisional site, and there was no evidence for systemic toxicity or other safety concerns. Surgical incision sites, including the peritoneal surface, were fully healed at 6 months in all animals. Most of the D-PLEX100 mass was absorbed during the first 3 months, and by 6 months, D-PLEX100 was fully absorbed. Toxicokinetic evaluation revealed that doxycycline concentrations were evident at 30 minutes and persisted to 8 days (71 mg/kg) or at least 15 days (284 mg/kg) and were no longer present in plasma by day 29. This study supports the safety of D-PLEX100 and its favorable degradability profile. A clinical study is being performed to assess the safety and the efficacy of D-PLEX100 to prevent human abdominal SSIs.
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Affiliation(s)
- Yuval Ramot
- Hadassah Medical Center, Hebrew University of Jerusalem, the Faculty of Medicine, Jerusalem, Israel
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32
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Wang D, Xu X, Zhao M, Wang X. Accelerated miniature swine models of advanced atherosclerosis: A review based on morphology. Cardiovasc Pathol 2020; 49:107241. [PMID: 32554057 DOI: 10.1016/j.carpath.2020.107241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/27/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022] Open
Abstract
In order to accelerate development of atherosclerosis(AS) in miniature swine models, varieties of strategies and methods have been explored. In addition to traditional methods such as high cholesterol feeding and balloon injury, new methods such as familial hypercholesterolemia induced by gene editing and intramural injection have been applied in recent years. Although it has been claimed that these methods have successfully aggravated lesion areas and stenosis, lesion features induced by different strategies have shown heterogeneity in morphology. In addition, time consumption, high cost, and unavailability are problems that restrict application of these AS models. Here, we summarize strategies and methods to accelerate AS models and further analyze their values, advantages, and shortcomings.
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Affiliation(s)
- Dayang Wang
- Cardiovascular Department, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China.
| | - Xiaoqing Xu
- Third Department of Neurology, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China.
| | - Mingjing Zhao
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - Xian Wang
- Cardiovascular Insititute, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China.
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Zheng JF, Qiu H, Tian Y, Hu XY, Luo T, Wu C, Tian Y, Tang Y, Song LF, Li L, Xu L, Xu B, Gao RL. Preclinical Evaluation of a Novel Sirolimus-Eluting Iron Bioresorbable Coronary Scaffold in Porcine Coronary Artery at 6 Months. JACC Cardiovasc Interv 2020; 12:245-255. [PMID: 30732729 DOI: 10.1016/j.jcin.2018.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/30/2018] [Accepted: 10/09/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the operability, 6-month efficacy, and safety of the novel sirolimus-eluting iron bioresorbable coronary scaffold (IBS) system compared with a cobalt-chromium everolimus-eluting stent (EES) (XIENCE Prime stent) in porcine coronary arteries. BACKGROUND Bioresorbable scaffolds have been considered the fourth revolution in percutaneous coronary intervention. However, the first-generation bioresorbable scaffold showed suboptimal results. METHODS Forty-eight IBS and 48 EES were randomly implanted into nonatherosclerotic swine. The operability, efficacy, and safety of the IBS and EES were evaluated using coronary angiography, optical coherence tomography, micro-computed tomography, scanning electron microscopy, and histopathologic evaluation at 7, 14, 28, 90, and 180 days after implantation. RESULTS The operability of the ultrathin IBS (∼70 μm) was comparable with that of the EES, except for its visibility. There was no statistically significant difference in area stenosis between the IBS and EES from 28 to 180 days. The IBS maintained its integrity up to 90 days without corrosion, while corrosion was observed in a few struts in 2 of 10 IBS at 180 days. The percentage of endothelialization of IBS was higher than that of XIENCE Prime stents within 14 days after implantation. The fibrin score was higher in the IBS group at 28 days but comparable with the EES group at 90 and 180 days. No scaffold or stent thrombosis was seen in either group. No abnormal histopathologic changes in scaffolded or stented vessel segments and 5 main remote organs were observed in either group. CONCLUSIONS Preclinical results suggest that the novel IBS has comparable operability, mid-term efficacy, and safety with the EES, and its corrosion profile in porcine coronary arteries is reasonable, which could support initial clinical study of the IBS.
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Affiliation(s)
- Jian-Feng Zheng
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Qiu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
| | - Yuan Tian
- Urumqi Friendship Hospital, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Xiao-Ying Hu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Tong Luo
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Wu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Tian
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yue Tang
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Lai-Feng Song
- Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Li Li
- Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Liang Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Run-Lin Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
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Boorman S, Douglas H, Driessen B, Gillespie MJ, Schaer TP. Fatal Ovarian Hemorrhage Associated With Anticoagulation Therapy in a Yucatan Mini-Pig Following Venous Stent Implantation. Front Vet Sci 2020; 7:18. [PMID: 32083102 PMCID: PMC7002391 DOI: 10.3389/fvets.2020.00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 01/10/2020] [Indexed: 01/10/2023] Open
Abstract
Swine models are commonly utilized in endovascular research for development of intravascular interventions and medical device development. As part of a pilot study for a venous vascular stent device, a 5-year-old female Yucatan mini-pig underwent bilateral external iliac vein stent placement under general anesthesia. To reduce thrombotic complications by reduction of thrombus formation on wires, sheaths, and catheters, the pig was heparinized with a total of 300 IU/kg of heparin, establishing an activated clotting time (ACT) of 436 s. The ACT had returned to below 200 s by the end of the procedure. To prevent postoperative thrombosis, the pig received an anticoagulation therapy protocol consisting of enoxaparin, clopidogrel, and aspirin. There were no complications during the immediate postoperative period. However, the pig died 4 days after surgery. Necropsy established the cause of death as abdominal exsanguination due to severe, acute, intra-ovarian hemorrhage, most likely related to ovulation. Life-threatening ovarian hemorrhage is occasionally seen in women with congenital or acquired bleeding disorders; to our knowledge this is the first report of fatal ovarian hemorrhage in an animal enrolled in a pre-clinical research trial.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, College of Veterinary Medicine, JT Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, United States
| | - Hope Douglas
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Bernd Driessen
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Matthew J Gillespie
- Department of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Thomas P Schaer
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
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35
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Park JK, Kim SS, Kim HK, Nah JW, Kim HB, Bae IH, Park DS, Shim JW, Lee MY, Kim JS, Koo BS, Jeong KJ, Jin YB, Kim SU, Lee SR, Na JY, Sim DS, Hong YJ, Lim KS, Jeong MH. Poly-l-lactide Polymer-Based Triple Drug-Eluting Stent with Abciximab, Alpha-Lipoic Acid and Sirolimus in Porcine Coronary Restenosis Model. Macromol Res 2020. [DOI: 10.1007/s13233-020-8004-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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36
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Traxler D, Hemetsberger R, Spannbauer A, Zlabinger K, Gugerell A, Lukovic D, Mandic L, Pavo N, Winkler J, Gyöngyösi M. Reduced histologic neo in-stent restenosis after use of a paclitaxel-coated cutting balloon in porcine coronary arteries. Histol Histopathol 2019; 35:653-663. [PMID: 31646547 DOI: 10.14670/hh-18-177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The incidence of in-stent restenosis (ISR) has declined dramatically, but once it develops, no current treatment option, such as drug-eluting stents, drug-coated balloons, or cutting balloons (CBs), prevents re-narrowing of the stented atherosclerotic artery. In this preclinical study, we aimed to improve the efficacy of ISR treatment by coating CBs with paclitaxel (paclitaxel-eluting cutting balloon; PECB) and to characterize the histological features of neo-ISRs that arise after ISR treatment. ISR was induced by bare metal stent (BMS) implantation in coronary arteries in pigs. After one month of follow-up, the BMS-induced ISR was treated with either CB or PECB. After another month, we performed quantitative coronary angiography, explanted the treated arteries and assessed histopathological and histomorphometric parameters. In addition, we compared the histological features of neo-ISRs with pre-treatment ISRs. Injury, inflammation, fibrin deposition, and endothelialization scores were similar between the CB and PECB groups at one month after ISR treatment. Neointimal area (0.87±0.61 vs. 1.95±1.14 mm², p=0.02), mean neointimal thickness (0.40±0.39 vs. 0.99±0.56 mm, p=0.01), and percent area stenosis (27.3±20.4 vs. 48.3±22.9%, p=0.04) were decreased in PECB-treated coronary arteries compared to CB-treated arteries, respectively. Density of cells (predominantly smooth muscle cells; SMCs) was increased in neo-ISRs (3.51±3.05×10³ vs. 6.35±2.57×10³ cells/mm², p<0.01), but significantly more CD68⁺ and CD20⁺ cells were found in the pre-treatment ISRs. In conclusion, PECB treatment of ISRs led to better results in terms of smaller neointimal area and %area stenosis of the neo-ISR. SMC density was increased in neo-ISRs in contrast with higher percentage of CD68⁺ and CD20⁺ cells in pre-treatment ISRs.
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Affiliation(s)
- Denise Traxler
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Rayyan Hemetsberger
- Internal Medicine I - Cardiology, Nephrology, Intensive Care and Rhythmology, St. Johannes Hospital Dortmund, Dortmund, Germany
| | - Andreas Spannbauer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Katrin Zlabinger
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Alfred Gugerell
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Dominika Lukovic
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Ljubica Mandic
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Noemi Pavo
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Johannes Winkler
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Mariann Gyöngyösi
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
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Nakazaki M, Oka S, Sasaki M, Kataoka-Sasaki Y, Onodera R, Komatsu K, Iihoshi S, Hiroura M, Kawaguchi A, Kocsis JD, Honmou O. Prevention of neointimal hyperplasia induced by an endovascular stent via intravenous infusion of mesenchymal stem cells. J Neurosurg 2019; 133:1773-1785. [PMID: 31585431 DOI: 10.3171/2019.7.jns19575] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/01/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In-stent restenosis after percutaneous transluminal angioplasty and stenting (PTAS) due to neointimal hyperplasia is a potential cause of clinical complications, including repeated revascularization and ischemic events. Neointimal hyperplasia induced by an inflammatory response to the stent strut may be a possible mechanism of in-stent restenosis. Intravenous infusion of bone marrow-derived mesenchymal stem cells (MSCs) has been reported to show therapeutic efficacy for cerebral stroke, presumably by an antiinflammatory effect. This study aimed to determine whether MSCs can reduce or prevent neointimal hyperplasia induced by an endovascular stent. METHODS In this study, two types of bare metal stents were deployed using a porcine (mini-pig) model. One stent was implanted in the common carotid artery (CCA), which is considered quite similar to the human CCA, and the other was inserted in the superficial cervical artery (SCA), which is similar in size to the human middle cerebral artery. Angiographic images, intravascular ultrasound (IVUS) imaging, and microscopic images were used for analysis. RESULTS Angiographic images and IVUS studies revealed that intravenous infusion of MSCs immediately after deployment of stents prevented in-stent stenosis of the CCA and SCA. Histological analysis also confirmed that inflammatory responses around the stent struts were reduced in both the stented CCA and SCA in the mini-pig. CONCLUSIONS Intravenous infusion of MSCs inhibited the inflammatory reaction to an implanted stent strut, and prevented progressive neointimal hyperplasia in the stented CCA and SCA in a porcine model. Thus, MSC treatment could attenuate the recurrence of cerebral ischemic events after stenting.
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Affiliation(s)
- Masahito Nakazaki
- 1Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, and
- 4Department of Neurology, Yale University School of Medicine, New Haven, Connecticut; and
- 5Center for Neuroscience and Regeneration Research, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Shinichi Oka
- 1Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, and
| | - Masanori Sasaki
- 1Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, and
- 4Department of Neurology, Yale University School of Medicine, New Haven, Connecticut; and
- 5Center for Neuroscience and Regeneration Research, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Yuko Kataoka-Sasaki
- 1Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, and
| | - Rie Onodera
- 1Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, and
| | - Katsuya Komatsu
- 2Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido
| | - Satoshi Iihoshi
- 2Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido
| | - Manabu Hiroura
- 3NIPRO Life Science Site, NIPRO Corporation, Kusatsu, Shiga, Japan
| | - Akira Kawaguchi
- 3NIPRO Life Science Site, NIPRO Corporation, Kusatsu, Shiga, Japan
| | - Jeffery D Kocsis
- 4Department of Neurology, Yale University School of Medicine, New Haven, Connecticut; and
- 5Center for Neuroscience and Regeneration Research, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Osamu Honmou
- 1Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, and
- 4Department of Neurology, Yale University School of Medicine, New Haven, Connecticut; and
- 5Center for Neuroscience and Regeneration Research, VA Connecticut Healthcare System, West Haven, Connecticut
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Huang C, Zhang W, Zhu Y. Drug-eluting stent specifically designed to target vascular smooth muscle cell phenotypic modulation attenuated restenosis through the YAP pathway. Am J Physiol Heart Circ Physiol 2019; 317:H541-H551. [PMID: 31298560 DOI: 10.1152/ajpheart.00089.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Vascular smooth muscle cell (SMC) phenotypic modulation contributes to the development of restenosis. A sorafenib-eluting stent was specifically designed to target SMC phenotypic modulation to inhibit in-stent restenosis in the present study. SMC contractile protein from the freshly isolated rat aorta was expressed at a high level, but its expression was dramatically reduced after SMCs were cultured in 10% FBS for 1 wk. After sorafenib treatment, SMC contractile protein expression was markedly upregulated. We further observed that Yes-associated protein (YAP) expression was attenuated after sorafenib treatment in a dose-dependent manner. Overexpression of YAP by lentivirus reversed the expression of sorafenib-induced SMC contractile protein and increased the expression of cyclin D. Mechanistically, sorafenib regulated the serum response factor-myocardin (SRF-Myocd) complex through competitive binding of YAP to Myocd and increased SRF binding to CArG-containing regions of SMC-specific contractile genes within intact chromatin, thereby controlling the activity of smooth muscle-specific gene transcription. In a rabbit carotid model, the sorafenib-eluting stent (SFES) dramatically inhibited in-stent restenosis and upregulated SMC contractile protein expression. Overexpression of YAP blocked the antirestenosis effect of SFES and repressed contractile smooth muscle-specific genes in vivo, indicating that SFES attenuated in-stent restenosis through YAP-mediated SMC phenotypic modulation. We demonstrated that SFES attenuated in-stent restenosis through YAP-mediated SMC phenotypic modulation. Targeting SMC phenotypic modulation by drug-eluting stent represents an attractive therapeutic approach for the treatment of occlusive vascular diseases.NEW & NOTEWORTHY In the present study, we demonstrated that sorafenib regulates smooth muscle cell (SMC) phenotypic modulation from a proliferative to a contractile state. Sorafenib induced a myocardin-serum response factor interaction and increased SMC contractile gene transcription through the Yes-associated protein pathway. Moreover, local delivery of sorafenib regulating SMC phenotypic modulation represents a promising strategy in the design of drug-eluting stents.
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Affiliation(s)
- Chen Huang
- Department of Vascular Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Wenwen Zhang
- Department of Vascular Surgery, the Second Affiliated Hospital of Nanchang University Medical School, Nanchang, China
| | - Yuelin Zhu
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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Early-Stage Vascular Response between Bare Metal Stent and Drug-Free Bioresorbable Vascular Scaffold in the Small-Sized Peripheral Artery: A Preclinical Study in Porcine Femoral Arteries. Ann Vasc Surg 2019; 60:388-396. [PMID: 31200063 DOI: 10.1016/j.avsg.2019.03.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 03/11/2019] [Accepted: 03/14/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND The clinical benefits and outcomes of the interventional treatment of small-sized infrapopliteal arteries using stent implantation remain uncertain. The aim of this study was to compare the safety and efficacy of drug-free bioresorbable vascular scaffold (BVS) with that of bare metal stent (BMS) in endovascular treatment of small-sized peripheral arteries. METHODS In this study, drug-free BVS and BMS were used in eight porcine models. We compared the angiographic and histomorphometric findings in the two groups at 4 weeks. In each pig, BVS and BMS of adequate sizes were implanted in the small branch (<3 mm) of the femoral artery. Angiography, intravascular ultrasound (IVUS), and histomorphometric analysis were performed at 4 weeks. RESULTS In the 4-week follow-up angiography and IVUS examination, the minimal luminal diameter was smaller and diameter stenosis was more severe in the BVS group. Histomorphometric findings indicated that the lumen area in the BVS group was smaller (0.34 ± 0.28 mm2 vs. 1.40 ± 0.52 mm2, P < 0.001), whereas the neointimal area (2.70 ± 1.28 mm2 vs. 1.76 ± 0.66 mm2, P = 0.013), area stenosis (85.18 ± 13.14 % vs. 54.99 ± 16.13 %, P < 0.001), inflammatory score (2.07 ± 0.861 vs. 28 ± 0.39, P = 0.003), and fibrin scores (1.24 ± 0.70 vs. 0.79 ± 0.72, P = 0.043) were significantly higher in the BVS group. The injury score was higher in the BMS group. In histopathologic findings, restenosis was mainly due to recoil and distortion of the scaffold in the BVS group. CONCLUSIONS Compared with BMS, drug-free BVS was not feasible for small-sized peripheral arteries based on the angiographic, IVUS, and histomorphometric results primarily due to insufficient mechanical support.
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40
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Kim HK, Kim HB, Lee JM, Kim SS, Bae IH, Park DS, Park JK, Shim JW, Na JY, Lee MY, Kim JS, Sim DS, Hong YJ, Nam CW, Doh JH, Park J, Koo BK, Kim SU, Lim KS, Jeong MH. Influence of Local Myocardial Infarction on Endothelial Function, Neointimal Progression, and Inflammation in Target and Non-Target Vascular Territories in a Porcine Model of Acute Myocardial Infarction. J Korean Med Sci 2019; 34:e145. [PMID: 31099195 PMCID: PMC6522891 DOI: 10.3346/jkms.2019.34.e145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 05/02/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Patients with acute myocardial infarction (AMI) have worse clinical outcomes than those with stable coronary artery disease despite revascularization. Non-culprit lesions of AMI also involve more adverse cardiovascular events. This study aimed to investigate the influence of AMI on endothelial function, neointimal progression, and inflammation in target and non-target vessels. METHODS In castrated male pigs, AMI was induced by balloon occlusion and reperfusion into the left anterior descending artery (LAD). Everolimus-eluting stents (EES) were implanted in the LAD and left circumflex (LCX) artery 2 days after AMI induction. In the control group, EES were implanted in the LAD and LCX in a similar fashion without AMI induction. Endothelial function was assessed using acetylcholine infusion before enrollment, after the AMI or sham operation, and at 1 month follow-up. A histological examination was conducted 1 month after stenting. RESULTS A total of 10 pigs implanted with 20 EES in the LAD and LCX were included. Significant paradoxical vasoconstriction was assessed after acetylcholine challenge in the AMI group compared with the control group. In the histologic analysis, the AMI group showed a larger neointimal area and larger area of stenosis than the control group after EES implantation. Peri-strut inflammation and fibrin formation were significant in the AMI group without differences in injury score. The non-target vessel of the AMI also showed similar findings to the target vessel compared with the control group. CONCLUSION In the pig model, AMI events induced endothelial dysfunction, inflammation, and neointimal progression in the target and non-target vessels.
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Affiliation(s)
- Hyun Kuk Kim
- Department of Internal Medicine and Cardiovascular Center, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea
| | - Han Byul Kim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Joo Myung Lee
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Soo Kim
- Department of Internal Medicine and Cardiovascular Center, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea
| | - In Ho Bae
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
- Korea Cardiovascular Stent Research Institute, Jangseong, Korea
- Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Dae Sung Park
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
- Korea Cardiovascular Stent Research Institute, Jangseong, Korea
- Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
- Research Institute of Medical Sciences, Chonnam National University, Gwangju, Korea
| | | | - Jae Won Shim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
- Korea Cardiovascular Stent Research Institute, Jangseong, Korea
- Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Joo Young Na
- Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Korea
| | - Min Young Lee
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Korea
| | - Joong Sun Kim
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Doo Sun Sim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
- Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
| | - Young Joon Hong
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Chang Wook Nam
- Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Joon Hyung Doh
- Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Jonghanne Park
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Bon Kwon Koo
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
- Institute on Aging, Seoul National University, Seoul, Korea
| | - Sun Uk Kim
- Futuristic Animal Resource and Research Center, Korea Research Institute of Bioscience and Biotechnology, Ochang, Korea
| | - Kyung Seob Lim
- Futuristic Animal Resource and Research Center, Korea Research Institute of Bioscience and Biotechnology, Ochang, Korea.
| | - Myung Ho Jeong
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
- Korea Cardiovascular Stent Research Institute, Jangseong, Korea
- Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare, Gwangju, Korea.
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Local intravascular delivery of low-density-lipoprotein cholesterol corresponds with increased intimal thickening in a healthy porcine coronary model. A prelude to development of a model of atherosclerosis. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2019; 15:81-90. [PMID: 31043989 PMCID: PMC6488843 DOI: 10.5114/aic.2019.83774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 12/27/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction Preclinical, vascular response studies are limited due to lack of underlying disease. The available cholesterol-diet-based and genetic atherosclerotic models are not satisfactory due to long breeding, unpredictable lesion formation, low plaque volume and degree of stenosis. Aim To evaluate the vascular response to local, intramural delivery of human, highly atherogenic lipids into healthy domestic swine (DS) coronary arteries. Material and methods A total of 24 coronary artery segments of 10 DS were enrolled. Following balloon injury (plain old balloon angioplasty – POBA), segments were assigned to local delivery of 2 ml of human LDL from apheresis (400 mg/dl, n = 9), 0.9% NaCl (control, n = 7) or to POBA alone. The solutions were infused with a modified, triple micro-needle catheter into the vessel wall. After 28 days, optical coherence tomography (OCT), virtual histology IVUS (VH-IVUS) and near-infra-red spectroscopy (NIRS) were performed. Following euthanasia, vessel segments were harvested for pathological evaluation. Results At 28 days the % area stenosis in OCT was highest in the LDL group (23.6 ±13 vs. 10.8 ±7 vs. 8.1 ±7%; p = 0.02). The presence of necrotic core (LDL: 55.5%, control: 37.5% and POBA: 42.8%; p = 0.77) and dense calcium (LDL: 33.3%, control: 28.5%, POBA: 37.5%; p = 0.94) in VH-IVUS were comparable between groups. The lipid core burden index in NIRS was negative in all cases. In pathology, the injury was comparable between groups (LDL: 1.6 ±0.4, control: 1.7 ±0.8, POBA: 1.7; p = 0.8) and specimens showed no signs of necrotic or lipid core. The tissue consisted of smooth muscle cells (SMC)/proteoglycan-rich lesions and inflammatory cells. Conclusions Local delivery of saturated human LDL into the coronary artery wall was feasible and resulted in a higher degree of stenosis caused by intimal thickening. A discrepancy between histopathological findings and virtual histology intravascular ultrasound (VH-IVUS) was also noted.
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Sperling C, Waliszewski MW, Kherad B, Krackhardt F. Comparative preclinical evaluation of a polymer-free sirolimus-eluting stent in porcine coronary arteries. Ther Adv Cardiovasc Dis 2019; 13:1753944719826335. [PMID: 30803407 PMCID: PMC6376525 DOI: 10.1177/1753944719826335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background: Polymer-free drug-eluting stents (DES) without permanent-polymer coating may be associated with rapid vessel healing, providing a rationale to reduce dual-antiplatelet therapy (DAPT). The aim of the current study was to compare vessel healing of a polymer-free sirolimus-eluting stent (PF-SES), its bare metal stent (BMS) analogue to a permanent polymer-based sirolimus-eluting stent (SES) with proven effectiveness in porcine coronary arteries. Material and methods: An ultrathin-strut cobalt–chromium PF-SES, its BMS analogue and an SES with a permanent polymer were used to study vessel healing and their antistenotic potential. Stents were implanted in porcine coronary arteries for histopathologic analysis at 7, 28 and 180 days. In an additional in vitro study, the thrombogenicity of PF-SES was compared with a fluoropolymer-coated everolimus-eluting stent (EES) which demonstrated low stent thrombosis rates in numerous studies. Results: In the animal study, neointimal growth and injury scores were minimal and inflammation scores were low in the neointima and adventitia in all study groups. After 28 days, neointimal area was lowest in PF-SES when compared with SES and BMS (1.48 ± 0.55 mm² versus 2.43 ± 0.69 mm² versus 1.90 ± 0.85 mm², respectively, p < 0.05) and endothelialization of luminal surfaces was nearly complete in all groups, though SES show the least coverage with occasional adherent luminal inflammatory cells (p > 0.05). At 180 days, neointimal area and thickness were most pronounced in SES (p < 0.05) and comparable with BMS implantations, which were characterized by nearly completed vessel healing. PF-SES and BMS had complete endothelialization, absence of fibrin and sustained low inflammatory reaction when compared with the permanent polymer-based SES (inflammation score: PF-SES 0.41 ± 0.74 versus SES 2.52 ± 1.72 versus BMS 0.30 ± 0.65, respectively, p < 0.05 BMS versus SES). Granuloma formation and fibrin accumulation were most pronounced in SES but did not reach statistical significance, p > 0.05). In the in vitro thrombogenicity study, the PF-SES confirmed comparable antithrombogenic properties with regard to the parameters fibrin and platelet binding, and platelet aggregation when compared with the EES. Conclusions: As compared with BMS, the ultrathin-strut cobalt–chromium PF-SES showed similar endothelialization at 28 days and comparable healing characteristics at 180 days efficacious inhibition of neointimal proliferation in porcine coronary arteries with low inflammation responses and a BMS-like endothelialization at 180 days. In addition, in an in vitro model, the PF-SES also confirmed low thrombogenicity as compared with the EES.
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Affiliation(s)
| | - Matthias W Waliszewski
- Medical Scientific Affairs, B. Braun Melsungen AG, Berlin, Germany.,Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Behrouz Kherad
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Krackhardt
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, D-13353 Berlin, Germany
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McKittrick CM, McKee S, Kennedy S, Oldroyd K, Wheel M, Pontrelli G, Dixon S, McGinty S, McCormick C. Combining mathematical modelling with in vitro experiments to predict in vivo drug-eluting stent performance. J Control Release 2019; 303:151-161. [PMID: 30878363 DOI: 10.1016/j.jconrel.2019.03.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/08/2019] [Accepted: 03/10/2019] [Indexed: 11/15/2022]
Abstract
In this study, we developed a predictive model of in vivo stent based drug release and distribution that is capable of providing useful insights into performance. In a combined mathematical modelling and experimental approach, we created two novel sirolimus-eluting stent coatings with quite distinct doses and release kinetics. Using readily measurable in vitro data, we then generated parameterised mathematical models of drug release. These were then used to simulate in vivo drug uptake and retention. Finally, we validated our model predictions against data on drug kinetics and efficacy obtained in a small in vivo evaluation. In agreement with the in vivo experimental results, our mathematical model predicted consistently higher sirolimus content in tissue for the higher dose stents compared with the lower dose stents. High dose stents resulted in statistically significant improvements in three key efficacy measures, providing further evidence of a basic relationship between dose and efficacy within DES. However, our mathematical modelling suggests a more complex relationship is at play, with efficacy being dependent not only on delivering an initial dose of drug sufficient to achieve receptor saturation, but also on the consequent drug release rate being tuned to ensure prolonged saturation. In summary, we have demonstrated that our combined in vitro experimental and mathematical modelling framework may be used to predict in vivo DES performance, opening up the possibility of an in silico approach to optimising the drug release profile and ultimately the effectiveness of the device.
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Affiliation(s)
- Craig M McKittrick
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Sean McKee
- Department of Mathematics & Statistics, University of Strathclyde, Glasgow, UK
| | - Simon Kennedy
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | - Marcus Wheel
- Department of Mechanical & Aerospace Engineering, University of Strathclyde, Glasgow, UK
| | | | | | - Sean McGinty
- Division of Biomedical Engineering, University of Glasgow, Glasgow, UK.
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Friedemann MC, Mehta NA, Jessen SL, Charara FH, Ginn-Hedman AM, Kaulfus CN, Brocklesby BF, Robinson CB, Jokerst S, Glowczwski A, Clubb FJ, Weeks BR. Introduction to Currently Applied Device Pathology. Toxicol Pathol 2019; 47:221-234. [PMID: 30844339 DOI: 10.1177/0192623319826585] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pathologic evaluation is crucial to the study of medical devices and integral to the Food and Drug Administration and other regulatory entities' assessment of device safety and efficacy. While pathologic analysis is tailored to the type of device, it generally involves at a minimum gross and microscopic evaluation of the medical device and associated tissues. Due to the complex nature of some implanted devices and specific questions posed by sponsors, pathologic evaluation inherently presents many challenges in accurately assessing medical device safety and efficacy. This laboratory's experience in numerous collaborative projects involving veterinary pathologists, biomedical engineers, physicians, and other scientists has led to a set of interrelated assessments to determine pathologic end points as a means to address these challenges and achieve study outcomes. Thorough device evaluation is often accomplished by utilizing traditional paraffin histology, plastic embedding and microground sections, and advanced imaging modalities. Combining these advanced techniques provides an integrative, comprehensive approach to medical device pathology and enhances medical device safety and efficacy assessment.
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Affiliation(s)
- Molly C Friedemann
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Nicole A Mehta
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Staci L Jessen
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Fatima H Charara
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Anne-Marie Ginn-Hedman
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Courtney N Kaulfus
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Breanna F Brocklesby
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Cedric B Robinson
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Steven Jokerst
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Alan Glowczwski
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Fred J Clubb
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Brad R Weeks
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
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Plasma nitriding under low temperature improves the endothelial cell biocompatibility of 316L stainless steel. Biotechnol Lett 2019; 41:503-510. [PMID: 30820710 DOI: 10.1007/s10529-019-02657-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To evaluate the effects of the surface modification of 316L stainless steel (SS) by low-temperature plasma nitriding on endothelial cells for stent applications. RESULTS X-ray diffraction (XRD) confirmed the incorporation of nitrogen into the treated steel. The surface treatment significantly increased SS roughness and hydrophilic characteristics. After 4 h the cells adhered to the nitride surfaces and formed clusters. During the 24 h incubation period, cell viability on the nitrided surface was higher compared to the polished surface. Nitriding reduced late apoptosis of rabbit aorta endothelial cell (RAEC) on the SS surface. CONCLUSION Low temperature plasma nitriding improved the biocompatible of stainless steel for use in stents.
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Rousselle SD, Wicks JR, Tabb BC, Tellez A, O’Brien M. Histology Strategies for Medical Implants and Interventional Device Studies. Toxicol Pathol 2019; 47:235-249. [DOI: 10.1177/0192623319827288] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Histology of medical devices poses a variety of unique challenges. Comprehensive histologic assessment of medical devices often requires spatial context and high-quality retention of the device–tissue interface. However, the composition of many medical devices is often not amenable to traditional paraffin embedding and thus alternative specialized methodologies such as hard resin embedding must be used. Hard resin embedding requires specialized laboratory technical expertise and equipment, and the fixation techniques and resin composition used markedly impact the feasibility of immunohistochemistry. For the continuity of spatial context during histologic evaluation, additional imaging methods such as macrophotography, radiography, micro-Computerized Tomography (microCT), or magnetic resonance imaging (MRI) can be used to guide sectioning and to complement histologic findings. Although standardized approaches are scarce for medical devices, important considerations specific to medical device histology are discussed, including general specimen preparation, special considerations for devices by organ system, and the challenges of immunohistochemistry. Histologic preparation of medical devices must be thoughtful, thorough, and tailored to achieve optimal histologic outcomes for complex, valuable, and often limited implant specimens.
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Affiliation(s)
| | | | | | - Armando Tellez
- Alizée Pathology, Thurmont, Maryland, USA
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
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Ijichi T, Nakazawa G, Torii S, Nagamatsu H, Yoshikawa A, Souba J, Isobe A, Hagiwara H, Ikari Y. Comparisons of early vascular reactions in biodegradable and durable polymer-based drug-eluting stents in the porcine coronary artery. PLoS One 2019; 14:e0209841. [PMID: 30629613 PMCID: PMC6328177 DOI: 10.1371/journal.pone.0209841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 12/12/2018] [Indexed: 11/18/2022] Open
Abstract
Current drug-eluting stents have abluminal polymer coating; however, thrombus formation in these compared with that in uniformly coated stents remains controversial. We evaluated thrombus formation and early endothelialization after using abluminal biodegradable polymer-coated sirolimus- (BP-SES), and everolimus-eluting stents (BP-EES) versus a durable polymer-coated everolimus-eluting stent (DP-EES) in an in vivo setting. BP-SES, BP-EES, and DP-EES (n = 6 each) were implanted in coronary arteries of 12 mini-pigs that were then sacrificed after 7 and 10 days. Stents were stained with hematoxylin and eosin, and a combined Verhoeff and Masson trichrome stain. Areas of fibrin deposition were digitally detected and measured with off-line morphometric software. Stents were investigated for re-endothelialization by transmission electron microscopy. At 7 days, histological analysis revealed the lowest area of fibrin deposition in BP-SES (BP-SES vs. BP-EES vs. DP-EES; 0.10 ± 0.06 mm2 vs. 0.15 ± 0.07 mm2 vs. 0.19 ± 0.06 mm2, p = 0.0004). At 10 days, the area of fibrin deposition was significantly greater in DP-EES (0.13 ± 0.04 mm2 vs. 0.14 ± 0.05 mm2 vs. 0.19 ± 0.08 mm2, p = 0.007). Endothelial cells in BP-SES demonstrated a significantly greater number of tight junctions than those in DP-EES according to by transmission electron microscopy for both days (p<0.05). Various parameters, including an inflammatory reaction and neointimal formation, were comparable among the groups at 7 and 10 days. An abluminal biodegradable polymer-coated SES showed the least fibrin deposition and greatest endothelial cell recovery at an early stage following implantation in the coronary arteries of mini-pigs.
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Affiliation(s)
- Takeshi Ijichi
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
- * E-mail:
| | - Sho Torii
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Ayako Yoshikawa
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Junko Souba
- TERUMO Corporation Evaluation Center, Kanagawa, Japan
| | - Atsushi Isobe
- TERUMO Corporation Evaluation Center, Kanagawa, Japan
| | | | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
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Perkins LEL, Rippy MK. Balloons and Stents and Scaffolds: Preclinical Evaluation of Interventional Devices for Occlusive Arterial Disease. Toxicol Pathol 2018; 47:297-310. [DOI: 10.1177/0192623318815604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Atherosclerosis places a significant burden on humankind; it is the leading cause of mortality globally, and for those living with atherosclerosis, it can significantly impact quality of life. Fortunately, treatment advances have effectively reduced the morbidity and mortality related to atherosclerosis, with one such modality being percutaneous intervention (PCI) to open occluded arteries. Over the 40-year history of PCI, preclinical models have played a critical role in demonstrating proof of concept, characterizing the in vivo behavior (pharmacokinetics, degradation) and providing a reasonable assurance of biologic safety of interventional devices before entering into clinical trials. Further, preclinical models may provide insight into the potential efficacy of these devices with the appropriate study design and end points. While several species have been used in the evaluation of interventional devices, the porcine model has been the principal model used in the evaluation of safety of devices for both coronary and endovascular treatments. This article reviews the fundamentals of permanent stents, transient scaffolds, and drug-coated balloons and the models, objectives, and methods used in their preclinical evaluation.
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Ishikawa O, Tanaka M, Konno K, Hasebe T, Horikawa A, Iijima A, Saito N, Takahashi K. Swine model of in-stent stenosis in the iliac artery evaluating the serial time course. Exp Anim 2018; 67:501-508. [PMID: 30068792 PMCID: PMC6219888 DOI: 10.1538/expanim.18-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to propose a new animal model evaluating the serial time course
of in-stent stenosis by repeated carotid artery catheterization in the same animal. 16
bare-metal stents were implanted in the normal external and internal iliac artery of 8
miniature pigs. Repeated measurements were performed in the same animal every 2 weeks for
12 weeks through carotid artery catheterization. The time course and peak neointimal
proliferation were evaluated by intravascular ultrasound. Health of all animals was
assessed by clinical and hematological examinations. As a result, 7 times of carotid
artery catheterization was performed per pig, but all animals remained healthy without
both any complications and hematological inflammatory abnormalities. The time course of
neointimal proliferation of each stent was observed from the stage of hyperplasia to
partial regression. The peak neointimal proliferation varied from 6 to 12 weeks despite
implantation of identical stents using the same deployment method. In conclusion, repeated
carotid artery catheterization to the same animal is feasible without animal health
deterioration. This model should be useful to evaluate the time course of neointimal
proliferation after stent deployment in preclinical study.
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Affiliation(s)
- Osamu Ishikawa
- Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Minoru Tanaka
- Department of Transfusion Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kenjiro Konno
- Center for iPS Cell Research and Application, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Terumitsu Hasebe
- Department of Radiology, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji-shi, Tokyo 192-0032, Japan
| | - Ayumi Horikawa
- Department of Transfusion Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akira Iijima
- Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Koki Takahashi
- Department of Transfusion Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Langhof H, Chin WWL, Wieschowski S, Federico C, Kimmelman J, Strech D. Preclinical efficacy in therapeutic area guidelines from the U.S. Food and Drug Administration and the European Medicines Agency: a cross-sectional study. Br J Pharmacol 2018; 175:4229-4238. [PMID: 30153701 DOI: 10.1111/bph.14485] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/28/2018] [Accepted: 08/06/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND PURPOSE Therapeutic area guidelines (TAGs) published by the EMA and the FDA offer guidance in planning the launch of a trial in a certain indication. We assessed and compared the guidance on preclinical efficacy of all available TAGs from EMA and FDA. EXPERIMENTAL APPROACH EMA and FDA websites and databases were searched for all TAGs. A mixed deductive and inductive approach was applied to analyse and cluster content for preclinical efficacy. KEY RESULTS A total of 114 EMA and 120 FDA TAGs were identified, covering 126 indications. Our core finding is that 75% of EMA TAGs and 58% from the FDA TAGs do not offer any guidance on preclinical efficacy. TAGs varied widely on the extent, nature and detail of guidance. CONCLUSIONS AND IMPLICATIONS Guidance on preclinical efficacy in a consistent, comprehensive and explicit way that still allows for justified deviations is an important but neglected aspect of transparency for drug development. This transparency would help sponsors in designing preclinical studies and in negotiating more efficiently with regulators.
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Affiliation(s)
- Holger Langhof
- Charité - University Medicine Berlin, QUEST - Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Berlin, Germany.,Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - William Wei Lim Chin
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Susanne Wieschowski
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Carole Federico
- STREAM (Studies of Translation, Ethics and Medicine), Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - Jonathan Kimmelman
- STREAM (Studies of Translation, Ethics and Medicine), Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - Daniel Strech
- Charité - University Medicine Berlin, QUEST - Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Berlin, Germany.,Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
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