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Pepe M, Napoli G, Carulli E, Moscarelli M, Forleo C, Nestola PL, Biondi-Zoccai G, Giordano A, Favale S. Autoimmune diseases in patients undergoing percutaneous coronary intervention: A risk factor for in-stent restenosis? Atherosclerosis 2021; 333:24-31. [PMID: 34418682 DOI: 10.1016/j.atherosclerosis.2021.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/25/2021] [Accepted: 08/04/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Despite the relation between autoimmune diseases and increased atherosclerotic risk is established, the influence of autoimmune disorders on in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) is only partly known. ISR is an aberrant reparative process mainly characterized by an increased number of vascular smooth muscle cells and excessive deposition of extracellular proteoglycans and type III collagen. Chronic inflammation, always present in autoimmune diseases, modulates the endothelial response to PCI. Aim of this review is to resume the current evidence on the association between ISR and autoimmune diseases, focusing on pathogenic mechanisms and therapeutic targets. METHODS We conducted a comprehensive review of the literature on the relationship between ISR and insulin-dependent diabetes mellitus (IDDM), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), antiphospholipid-antibodies syndrome (APS), inflammatory bowel diseases (IBD), and Hashimoto's thyroiditis (HT). RESULTS Patients affected with IDDM, RA, SLE, APS, IBD and HT proved to face higher rates of ISR compared to the general population. The endothelial dysfunction seems the principal common pathogenic pathway for ISR and is attributed to both the immune system disorder and the systemic inflammation. Some evidence suggested that methotrexate and anti-tumor necrosis factor treatments can be effective in reducing ISR, while antibodies against vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 showed to reduce neointimal hyperplasia in animal models. CONCLUSIONS Autoimmune diseases are a risk factor for ISR. The study of the potential cardiovascular benefits of the current therapies, mainly anti-inflammatory drugs, and the pursuit of innovative treatments appear of paramount interest.
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Affiliation(s)
- Martino Pepe
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, Bari (BA), 70120, Italy.
| | - Gianluigi Napoli
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, Bari (BA), 70120, Italy
| | - Eugenio Carulli
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, Bari (BA), 70120, Italy
| | - Marco Moscarelli
- Cardiothoracic and Vascular Department, Maria Cecilia Hospital GVM Care & Research, Via Via Corriera 1,Cotignola, 48033, Ravenna, Italy
| | - Cinzia Forleo
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, Bari (BA), 70120, Italy
| | - Palma Luisa Nestola
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, Bari (BA), 70120, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Republica 79, Latina, 04100,Latina, Italy; Mediterranea Cardiocentro, Via Orazio 2, Napoli, 80122, Napoli, Italy
| | - Arturo Giordano
- Invasive Cardiology Unit, "Pineta Grande" Hospital, Via Domitiana km 30, Castel Volturno, 81030, Caserta, Italy
| | - Stefano Favale
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, Bari (BA), 70120, Italy
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Ma H, Dong A. Long non-coding RNA cyclin-dependent kinase inhibitor 2B antisense ribonucleic acid 1 is associated with in-stent restenosis and promotes human carotid artery smooth muscle cell proliferation and migration by sponging miR-143-3p. Exp Ther Med 2021; 21:234. [PMID: 33603842 PMCID: PMC7851615 DOI: 10.3892/etm.2021.9665] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/22/2020] [Indexed: 02/07/2023] Open
Abstract
Carotid angioplasty and stenting (CAS) is an efficient therapeutic approach for carotid stenosis. However, in-stent restenosis (ISR) frequently occurs and seriously affects the therapeutic efficacy of CAS. Certain non-coding (nc)RNAs serve potential roles in ISR development and progression. Thus, the goals of the present study were to investigate novel biomarkers for ISR development and to further uncover the mechanisms underlying the progression of ISR. The expression of long ncRNA cyclin-dependent kinase inhibitor (CDKN)2B-antisense 1 (AS1) and microRNA (miR)-143-3p in patients with ISR and human carotid artery smooth muscle cells (hHCtASMCs) was analyzed using reverse transcription-quantitative PCR. A luciferase reporter assay was performed to examine the interaction between CDKN2B-AS1 and miR-143-3p. The effects of the CDKN2B/miR-143-3p axis on hHCtASMC proliferation and migration were assessed using Cell Counting Kit-8 and Transwell assays. The results indicated that serum CDKN2B-AS1 was increased and miR-143-3p was decreased in patients with ISR as compared with that in patients with no ISR (all P<0.001). CDKN2B-AS1 and miR-143-3p were identified as risk factors for ISR onset (all P<0.05) and knockdown of CDKN2B-AS1 in hHCtASMCs led to inhibited cell proliferation and migration. Furthermore, the luciferase reporter assay and expression analysis indicated that miR-143-3p is a target of CDKN2B-AS1 and may mediate the effects of CDKN2B-AS1 on hHCtASMC proliferation and migration. In conclusion, dysregulation of CDKN2B-AS1 and miR-143-3p may represent risk factors for the occurrence of ISR. The in vitro results suggested that the CDKN2B-AS1/miR-143-3p axis may regulate the proliferation and migration of hHCtASMCs, indicating its potential to be developed as a target for preventative measures and therapies for ISR.
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Affiliation(s)
- Huanhuan Ma
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
| | - Aiqin Dong
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
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Maguire EM, Xiao Q. Noncoding RNAs in vascular smooth muscle cell function and neointimal hyperplasia. FEBS J 2020; 287:5260-5283. [DOI: 10.1111/febs.15357] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 04/21/2020] [Accepted: 05/01/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Eithne Margaret Maguire
- Centre for Clinical Pharmacology William Harvey Research Institute Barts and The London School of Medicine and Dentistry Queen Mary University of London UK
| | - Qingzhong Xiao
- Centre for Clinical Pharmacology William Harvey Research Institute Barts and The London School of Medicine and Dentistry Queen Mary University of London UK
- Key Laboratory of Cardiovascular Diseases at The Second Affiliated Hospital Guangzhou Municipal and Guangdong Provincial Key Laboratory of Protein Modification and Degradation School of Basic Medical Sciences Guangzhou Medical University China
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Zhang J, Gao F, Ni T, Lu W, Lin N, Zhang C, Sun Z, Guo H, Chi J. Linc-POU3F3 is overexpressed in in-stent restenosis patients and induces VSMC phenotypic transformation via POU3F3/miR-449a/KLF4 signaling pathway. Am J Transl Res 2019; 11:4481-4490. [PMID: 31396351 PMCID: PMC6684896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 06/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND With the extensive application of stent implantation in patients undergoing percutaneous coronary interventions (PCI), there are chances that in-stent restenosis (ISR)-a major vascular complication caused by vascular smooth muscle cell (VSMC) phenotypic transformation-might occur. OBJECTIVES This study sought to evaluate the role of lincRNA-POU3F3 on VSMC phenotypic transformation and the underlying mechanism. METHODS VSMCs were used in our research. We first constructed a gene delivery system through an assembly of lipofectamine and a functional plasmid DNA (pDNA) encoding lincRNA-POU3F3 or MicroRNA-449a, and then, transfected it to VSMCs. Moreover, lentivirus-mediated KLF4 inhibitor (KLF4 siRNA) was also used in these cells. Expression of relevant proteins, such as smooth muscle myosin heavy chain (SM-MHC), alpha smooth muscle actin (α-SMA), osteopontin (OPN), and kruppel-like factor 4 (KLF4), was examined by western blot or immunofluorescence (IF) assay. CCK-8 and wound healing assays were performed to assess the growth and migration of VSMCs. qRT-PCR was used to assess linc-POU3F3 and miR-449a levels. Luciferase reporter assay was also performed. RESULTS POU3F3 levels were significantly higher in ISR patients compared to controls. We observed that linc-POU3F3 promoted VSMC proliferation and migration, and induced VSMC phenotypic transformation via POU3F3/miR-449a/KLF4 signaling pathway. CONCLUSION Linc-POU3F3 promotes phenotypic transformation of VSMCs via POU3F3/miR-449a/KLF4 pathway. It may provide a theoretical basis to attenuate ISR via pharmacological inhibition of this biomarker or at least serve as a predictor of diagnosis or prognosis of patients with restenosis.
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Affiliation(s)
- Jie Zhang
- The First Clinical Medical College, Wenzhou Medical UniversityWenzhou 325000, Zhejiang, China
| | - Feidan Gao
- Department of Cardiology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang UniversityShaoxing 312000, Zhejiang, China
| | - Tingjuan Ni
- Department of Cardiology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang UniversityShaoxing 312000, Zhejiang, China
| | - Wenqiang Lu
- Department of Cardiology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang UniversityShaoxing 312000, Zhejiang, China
| | - Na Lin
- Department of Cardiology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang UniversityShaoxing 312000, Zhejiang, China
| | - Chuanjing Zhang
- Department of Cardiology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang UniversityShaoxing 312000, Zhejiang, China
| | - Zhenzhu Sun
- Department of Cardiology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang UniversityShaoxing 312000, Zhejiang, China
| | - Hangyuan Guo
- The First Clinical Medical College, Wenzhou Medical UniversityWenzhou 325000, Zhejiang, China
- Department of Cardiology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang UniversityShaoxing 312000, Zhejiang, China
| | - Jufang Chi
- The First Clinical Medical College, Wenzhou Medical UniversityWenzhou 325000, Zhejiang, China
- Department of Cardiology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang UniversityShaoxing 312000, Zhejiang, China
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Liu J, Liu Y, Jia K, Huo Z, Huo Q, Liu Z, Li Y, Han X, Wang R. Clinical analysis of lectin-like oxidized low-density lipoprotein receptor-1 in patients with in-stent restenosis after percutaneous coronary intervention. Medicine (Baltimore) 2018; 97:e0366. [PMID: 29702981 PMCID: PMC5944531 DOI: 10.1097/md.0000000000010366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
In-stent restenosis (ISR) is the most common complication associated with percutaneous coronary intervention (PCI). Although some studies have reported an association between lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and ISR, not enough clinical validation data are available to support this link. Here, we report our cross-sectional study aimed at exploring the feasibility of LOX-1 as a biomarker for the prognostic diagnosis of patients undergoing PCI.Three groups were included: ISR group, including 99 patients with ISR diagnosed with coronary arteriography (CAG) after PCI; lesion group, comprising 87 patients with coronary artery stenosis (<50%) diagnosed with CAG after PCI; and control group, consisting of 96 volunteers with no coronary artery disease. The levels of LOX-1 were measured in each patient by using an enzyme-linked immunosorbent assay, and their general information as well as laboratory parameters were recorded and followed up during a period of 2 years.LOX-1 levels gradually increased after PCI along with the progression of the lesion in the 3 groups. The levels of LOX-1 were significantly higher in the ISR group than in the other 2 groups (P < .001). LOX-1 levels were correlated with the levels of uric acid (UA) (r = 0.289, P = .007), creatinine (CREA) (r = .316, P = .003), and high-density lipoprotein cholesterol (HDL-C) (r = -0.271, P = .012), whereas no statistically significant correlation was detected with the Gensini score (r = 0.157, P = .141). The sensitivity and specificity of LOX-1 were 81.5% and 55.7%, respectively, with the most optimal threshold (5.04 μg/L). The area under curve (AUC) of the receiver operator characteristic (ROC) curve of LOX-1 was 0.720, and LOX-1 had the highest AUC compared with CREA, UA, and HDL-C, both individually and in combination.A high level of LOX-1 in the early period after PCI has a certain predictive power and diagnostic value for ISR. However, the level of LOX-1 is not related to the Gensini score of coronary artery after PCI, and CREA and UA, which are weakly related to LOX-1, have no obvious synergy in the diagnosis of ISR with LOX-1.
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Affiliation(s)
- Junfeng Liu
- Department of Clinical Laboratory, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Science and Beijing Union Medical College
| | - Yunde Liu
- School of Laboratory Medicine, Tianjin Medical University
| | - Kegang Jia
- Department of Clinical Laboratory, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Science and Beijing Union Medical College
| | - Zhixiao Huo
- The Second People's Hospital of Tianjin, Tianjin, China
| | - Qianyu Huo
- School of Laboratory Medicine, Tianjin Medical University
| | - Zhili Liu
- School of Laboratory Medicine, Tianjin Medical University
| | - Yongshu Li
- Department of Clinical Laboratory, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Science and Beijing Union Medical College
| | - Xuejing Han
- Department of Clinical Laboratory, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Science and Beijing Union Medical College
| | - Rong Wang
- School of Laboratory Medicine, Tianjin Medical University
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Association between VEGF Gene Polymorphisms and In-Stent Restenosis after Coronary Intervention Treated with Bare Metal Stent. DISEASE MARKERS 2017; 2017:9548612. [PMID: 28484288 PMCID: PMC5412144 DOI: 10.1155/2017/9548612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/19/2017] [Accepted: 02/23/2017] [Indexed: 12/19/2022]
Abstract
Background. In-stent restenosis (ISR) is the gradual narrowing of the vessel lumen after coronary stent implantation due to the increase in vascular smooth muscle cell proliferation. Vascular endothelial growth factor (VEGF) protein plays an important role in this process. Our aim was to analyze the association of single nucleotide polymorphisms of the VEGF gene (rs2010963 and rs6999447) with the occurrence of ISR after coronary artery bare metal stent (BMS) implantation. Methods. 205 patients with a history of BMS implantation and a repeated coronarography were prospectively enrolled. Patients were assigned to diffuse restenosis group (n = 105) and control group (n = 100) and VEGF genotypes were determined. Results. Diffuse ISR was significantly more frequently observed in patients with homozygous normal genotype of rs2010963 polymorphism, and this polymorphism was independently associated with diffuse ISR. Conclusions. RS2010963 is associated with higher incidence of development of diffuse coronary ISR in patients treated with BMS implantation.
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