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Zhang M, Lotfollahzadeh S, Elzinad N, Yang X, Elsadawi M, Gower AC, Belghasem M, Shazly T, Kolachalama VB, Chitalia VC. Alleviating iatrogenic effects of paclitaxel via antiinflammatory treatment. Vasc Med 2024:1358863X241231942. [PMID: 38623630 DOI: 10.1177/1358863x241231942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Paclitaxel (PTX) is touted as an essential medicine due to its extensive use as a chemotherapeutic agent for various cancers and an antiproliferative agent for endovascular applications. Emerging studies in cardio-oncology implicate various vascular complications of chemotherapeutic agents. METHODS We evaluated the inflammatory response induced by the systemic administration of PTX. The investigation included RNAseq analysis of primary human endothelial cells (ECs) treated with PTX to identify transcriptional changes in pro-inflammatory mediators. Additionally, we used dexamethasone (DEX), a well-known antiinflammatory compound, to assess its effectiveness in counteracting these PTX-induced changes. Further, we studied the effects of PTX on monocyte chemoattractant protein-1 (MCP-1) levels in the media of ECs. The study also extended to in vivo analysis, where a group of mice was injected with PTX and subsequently harvested at different times to assess the immediate and delayed effects of PTX on inflammatory mediators in blood and aortic ECs. RESULTS Our RNAseq analysis revealed that PTX treatment led to significant transcriptional perturbations in pro-inflammatory mediators such as MCP-1 and CD137 within primary human ECs. These changes were effectively abrogated when DEX was administered. In vitro experiments showed a marked increase in MCP-1 levels in EC media following PTX treatment, which returned to baseline upon treatment with DEX. In vivo, we observed a threefold increase in MCP-1 levels in blood and aortic ECs 12 h post-PTX administration. Similar trends were noted for CD137 and other downstream mediators like tissue factor, vascular cell adhesion molecule 1, and E-selectin in aortic ECs. CONCLUSION Our findings illustrate that PTX exposure induces an upregulation of atherothrombotic mediators, which can be alleviated with concurrent administration of DEX. Considering these observations, further long-term investigations should focus on understanding the systemic implications associated with PTX-based therapies and explore the clinical relevance of DEX in mitigating such risks.
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Affiliation(s)
- Mengwei Zhang
- Department of Medicine, Renal Section, Boston University School of Medicine, Boston, MA, USA
| | - Saran Lotfollahzadeh
- Department of Medicine, Renal Section, Boston University School of Medicine, Boston, MA, USA
| | - Nagla Elzinad
- Department of Medicine, Renal Section, Boston University School of Medicine, Boston, MA, USA
| | - Xiaosheng Yang
- Department of Medicine, Renal Section, Boston University School of Medicine, Boston, MA, USA
| | - Murad Elsadawi
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Adam C Gower
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Clinical and Translational Science Institute, Boston University School of Medicine, Boston, MA, USA
| | - Mostafa Belghasem
- Department of Biomedical Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA
| | - Tarek Shazly
- College of Engineering & Computing, University of South Carolina, Columbia, SC, USA
| | - Vijaya B Kolachalama
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Computer Science and Faculty of Computing & Data Sciences, Boston University, Boston, MA, USA
| | - Vipul C Chitalia
- Department of Medicine, Renal Section, Boston University School of Medicine, Boston, MA, USA
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
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Ren K, Wang J, Li Y, Li Z, Zhou Z, Wu K, Li Y, Ge X, Ren J, Han X. Paclitaxel-coated balloon catheter for benign esophageal stenosis in a rabbit model. Sci Rep 2024; 14:2551. [PMID: 38291135 PMCID: PMC10827726 DOI: 10.1038/s41598-024-53078-0] [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: 07/31/2023] [Accepted: 01/27/2024] [Indexed: 02/01/2024] Open
Abstract
Most patients with benign esophageal stenosis require multiple or even continuous balloon dilation treatments to achieve symptom relief. In this study, eighteen rabbits were used to establish an esophageal benign stenosis model and were divided into a control group (n = 6), a balloon group (n = 6) and a PTX-coated balloon group (n = 6) to evaluate the feasibility and effectiveness of paclitaxel (PTX)-coated balloons for the rabbit esophageal benign stenosis model. The weight and esophageal diameter were recorded every 2 weeks until 8 weeks post-surgery. Hematoxylin-eosin staining, Masson's trichrome staining and immunohistochemical staining were performed for pathological analysis. Four weeks post-operation, there was a significant difference in weight between the control group and the balloon group (p = 0.01) and between the control group and the PTX balloon group (p = 0.01). There was a significant difference in the esophageal diameter between the balloon group and the PTX balloon group at 8 weeks post-operation (p = 0.02). Four weeks post-operation, the degree of inflammatory cell infiltration in the PTX balloon group was significantly lower than that in the control group (p = 0.002) and balloon group (p = 0.001). The degree of collagen deposition in the PTX balloon group was significantly lower than that in the control group (p = 0.002) and balloon group (p = 0.03). Eight weeks post-operation, the percentage of cells positive for TGF-β (p < 0.001), the degree of inflammatory cell infiltration (p = 0.02) and the degree of collagen deposition (p = 0.02) in the PTX balloon group were significantly lower than those in the balloon group. Therefore, PTX-coated balloons may alleviate the local inflammatory response and collagen deposition when used during dilation treatment of benign esophageal stenosis.
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Affiliation(s)
- Kewei Ren
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China.
- Engineering Technology Research Center for Minimally Invasive, Interventional Tumors of Henan Province, Zhengzhou, Henan, 450052, People's Republic of China.
| | - Jianan Wang
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Department of Interventional Radiotherapy, Zhoukou Center Hospital, Zhoukou, 46000, People's Republic of China
| | - Yahua Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
| | - Zongming Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
| | - Zihe Zhou
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
| | - Kunpeng Wu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
| | - Yifan Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
| | - Xiaoyong Ge
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
| | - Jianzhuang Ren
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
| | - Xinwei Han
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China.
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, People's Republic of China.
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, People's Republic of China.
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Donati T, De Donato G, Tshomba Y. Endovascular therapies for aorto-iliac and femoro-popliteal arterial disease: Buridan's ass and the journey towards patient-tailored plaque therapy (PTPT). Eur Heart J 2023; 44:951-953. [PMID: 36721970 DOI: 10.1093/eurheartj/ehac796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Tommaso Donati
- Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianmarco De Donato
- Vascular Surgery Unit Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Yamume Tshomba
- Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Zenunaj G, Traina L, Acciarri P, Mario Cosacco A, Alesiani F, Baldazzi G, Gasbarro V. Primary Drug-Coated Balloon Versus Drug-Eluting Stent for Native Atherosclerotic Femoropopliteal Lesions: A Systematic Review and Meta-Analysis. Ann Vasc Surg 2023; 92:294-303. [PMID: 36746268 DOI: 10.1016/j.avsg.2023.01.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/29/2022] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND In this systematic review and meta-analysis, we aimed to compare drug-coated balloon (DCB) to drug-eluting stent (DES) angioplasty as a primary option in patients with femoropopliteal lesions in terms of primary patency and freedom from clinically driven target lesion revascularization (cdTLR) and major adverse limb events (MALE). METHODS A comprehensive literature search was performed using the PubMed and Embase databases. All studies written in English language and reporting data presenting a comparison between patients receiving primary percutaneous balloon angioplasty using the DCB versus primary percutaneous stenting with DES for native femoropopliteal lesions were included in this meta-analysis. RESULTS There were 984 patients with 1,078 femoropopliteal lesions, of which procedures with DCB and DES were performed in 514 and 564 lesions, respectively. Overall, majority patients were men with a mean age of 70.9 years, and there were no significant differences between the 2 groups regarding the cardiovascular comorbidities. With regards to the procedural strategy, there was significant heterogeneity in the DCB group. This included adjunctive procedures such as atherectomy besides the angioplasty of the target vessel, which was reported in 1 study as a part of 32.1% of the procedures in the DCB group. Provisional bare metal stents (pBMS) for residual stenosis and dissection were used in 4 studies with a percentage varying from 14.8 to 25.3%. Overall, at 1 year, all outcomes were similar for all the end points; however, where adjunctive procedures were performed (atherectomy + pBMS) in the DCB group, the outcomes were better (primary patency p.001, freedom cdTLR p.001, and freedom form MALE p.002). In studies where no adjunctive procedures were performed in the DCB group, the results favored the DES group for the primary patency (p.026) and freedom from cdTLR (p.044). CONCLUSIONS DES seems to be superior in terms of cdTLR and primary patency at 1 year when compared to the procedures performed solely with DCB. For DCB to achieve optimal results, further adjunctive procedures such as pBMS and atherectomy are needed. More studies are needed to confirm the superiority of the primary stenting with DES at the femoropopliteal segment.
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Affiliation(s)
- Gladiol Zenunaj
- Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Italy; Università degli Studi di Ferrara, Italy.
| | - Luca Traina
- Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Italy
| | | | | | - Francesca Alesiani
- Università degli Studi di Ferrara, Medicina Traslazionale e per la Romagna, Italy
| | - Giulia Baldazzi
- Università degli Studi di Ferrara, Medicina Traslazionale e per la Romagna, Italy
| | - Vincenzo Gasbarro
- Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Italy; Università degli Studi di Ferrara, Italy
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