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Díaz-Flores L, Gutiérrez R, García MP, González-Gómez M, Díaz-Flores L, Gayoso S, Carrasco JL, Álvarez-Argüelles H. Ultrastructural Study of Platelet Behavior and Interrelationship in Sprouting and Intussusceptive Angiogenesis during Arterial Intimal Thickening Formation. Int J Mol Sci 2021; 22:ijms222313001. [PMID: 34884806 PMCID: PMC8657547 DOI: 10.3390/ijms222313001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/23/2021] [Accepted: 11/29/2021] [Indexed: 12/13/2022] Open
Abstract
Platelets in atherosclerosis, bypass stenosis, and restenosis have been extensively assessed. However, a sequential ultrastructural study of platelets in angiogenesis during the early phases of these lesions has received less attention. Our objective was the study of platelets in angiogenesis and vessel regression during intimal thickening (IT) formation, a precursor process of these occlusive vascular diseases. For this purpose, we used an experimental model of rat occluded arteries and procedures for ultrastructural observation. The results show (a) the absence of platelet adhesion in the de-endothelialized occluded arterial segment isolated from the circulation, (b) that intraarterial myriad platelets contributed from neovessels originated by sprouting angiogenesis from the periarterial microvasculature, (c) the association of platelets with blood components (fibrin, neutrophils, macrophages, and eosinophils) and non-polarized endothelial cells (ECs) forming aggregates (spheroids) in the arterial lumen, (d) the establishment of peg-and-socket junctions between platelets and polarized Ecs during intussusceptive angiogenesis originated from the EC aggregates, with the initial formation of IT, and (e) the aggregation of platelets in regressing neovessels (‘transitory paracrine organoid’) and IT increases. In conclusion, in sprouting and intussusceptive angiogenesis and vessel regression during IT formation, we contribute sequential ultrastructural findings on platelet behavior and relationships, which can be the basis for further studies using other procedures.
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Affiliation(s)
- Lucio Díaz-Flores
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
- Correspondence: ; Tel.: +34-922-319317; Fax: +34-922-319279
| | - Ricardo Gutiérrez
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
| | - Maria Pino García
- Department of Pathology, Eurofins Megalab–Hospiten Hospitals, 38100 Tenerife, Spain;
| | - Miriam González-Gómez
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
- Instituto de Tecnologías Biomédicas de Canarias, University of La Laguna, 38071 Tenerife, Spain
| | - Lucio Díaz-Flores
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
| | - Sara Gayoso
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
| | - Jose Luis Carrasco
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
| | - Hugo Álvarez-Argüelles
- Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 38071 Tenerife, Spain; (R.G.); (M.G.-G.); (L.D.-F.J.); (S.G.); (J.L.C.); (H.Á.-A.)
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Tanaskovic I, Ilic S, Jurisic V, Lackovic M, Milosavljevic Z, Stankovic V, Aleksic A, Sazdanovic M. Histochemical, immunohistochemical and ultrastructural analysis of aortic wall in neonatal coarctation. Rom J Morphol Embryol 2019; 60:1291-1298. [PMID: 32239107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The neonatal type of coarctation is characterized by the presence of the ductal sling and coarctational shelf placed proximally in relation to the ductal orifice. Those morphological features are not described in detail yet from immunohistochemical and transmission electron microscopy (TEM) aspects, so the aim of this study was to investigate the smooth muscle cells (SMCs) phenotype in aortic intimal thickening, presence of inflammatory cells and contents of intimal and medial, and adventitial connective tissue. We examined samples of coarctation segments excised at surgery after end-to-end anastomosis from 30 patients, ages from 14 days to three months, histochemicaly, immunocytochemically and by TEM. In all samples, it is noticed focal intimal thickening on the posterior aortic wall, with accumulation of SMCs, which show immunoreactivity on alpha-smooth muscle actin (α-SMA) and vimentin (but not on desmin) and also expressed proliferating cell nuclear antigen (PCNA) and S-100 protein. At TEM analysis, those SMCs show a fibroblast-like morphology, so their functions could be to proliferate and secrete extracellular matrix (ECM) components (a synthetic phenotype). In all studied samples of the coarctation, on the posterior wall, the immunocytochemical and TEM examination revealed the presence of SMCs of the synthetic phenotype. Results also showed an increase of the cell number in intima of this part of aortic wall, followed by proliferated SMCs in inner media and absence of inflammatory cells. This finding suggests that proliferation of the SMCs, their synthetic activity and increase of the cell number could lead to formation of the intimal thickening on the posterior wall.
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Affiliation(s)
- Irena Tanaskovic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Serbia;
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Minol JP, Reinsch I, Luik M, Leferink A, Barth M, Assmann A, Lichtenberg A, Akhyari P. Focal induction of ROS-release to trigger local vascular degeneration. PLoS One 2017; 12:e0179342. [PMID: 28614411 PMCID: PMC5470706 DOI: 10.1371/journal.pone.0179342] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/26/2017] [Indexed: 01/04/2023] Open
Abstract
Reactive oxygen species (ROS) play an important role in the process of cardiovascular degeneration. We evaluated the potential of a controlled, local induction of ROS-release by application of rose bengal (RB) and photo energy to induce atherosclerosis-like focal vascular degeneration in vivo. After injection of RB, rats fed with a pro-degenerative diet underwent focal irradiation of the abdominal aorta by a green laser (ROS group), while the controls received irradiation without RB. Aortic tissue was analyzed by histology and immunohistochemistry at 0, 2, 4, 8, 28 and 56 days (n = 5). The intimal surface topography was analyzed by scanning electron microscopy. In the ROS group, an initial thrombus formation had disappeared by day 8. Similarly, ROS-derived products displayed the highest concentrations at day 0. Relative matrix metalloproteinase (MMP) activity achieved a maximum after 8 days (ROS group vs. CONTROL GROUP 1.60 ± 0.11 vs. 0.98 ± 0.01; p < 0.001). After 28 days, no significant differences in any aspect were found between the ROS group and the controls. However, after 56 days, the aortic tissue of ROS animals exhibited relative media-pronounced thickening (ROS vs. CONTROL 2.15 ± 0.19 vs. 0.87 ± 0.10; p < 0.001) with focal calcification and reduced expression of alpha smooth muscle actin (aSMA). The ROS-releasing application of RB and photo energy allowed for the induction of vascular degeneration in a rodent model. This protocol may be used for the focal induction of vascular disease without systemic side effects and can thereby elucidate the role of ROS in the multifactorial processes of vessel degeneration and atherogenesis.
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Affiliation(s)
- Jan-Philipp Minol
- Department of Cardiovascular Surgery, University Hospital, Dusseldorf, Germany
- * E-mail:
| | - Isabella Reinsch
- Department of Cardiovascular Surgery, University Hospital, Dusseldorf, Germany
| | - Maximilian Luik
- Department of Cardiovascular Surgery, University Hospital, Dusseldorf, Germany
| | - Anne Leferink
- Department of Tissue Regeneration, MIRA Institute, University of Twente, Enschede, The Netherlands
| | - Mareike Barth
- Department of Cardiovascular Surgery, University Hospital, Dusseldorf, Germany
| | - Alexander Assmann
- Department of Cardiovascular Surgery, University Hospital, Dusseldorf, Germany
| | - Artur Lichtenberg
- Department of Cardiovascular Surgery, University Hospital, Dusseldorf, Germany
| | - Payam Akhyari
- Department of Cardiovascular Surgery, University Hospital, Dusseldorf, Germany
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Chan AHP, Tan RP, Michael PL, Lee BSL, Vanags LZ, Ng MKC, Bursill CA, Wise SG. Evaluation of synthetic vascular grafts in a mouse carotid grafting model. PLoS One 2017; 12:e0174773. [PMID: 28355300 PMCID: PMC5371373 DOI: 10.1371/journal.pone.0174773] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/15/2017] [Indexed: 11/24/2022] Open
Abstract
Current animal models for the evaluation of synthetic grafts are lacking many of the molecular tools and transgenic studies available to other branches of biology. A mouse model of vascular grafting would allow for the study of molecular mechanisms of graft failure, including in the context of clinically relevant disease states. In this study, we comprehensively characterise a sutureless grafting model which facilitates the evaluation of synthetic grafts in the mouse carotid artery. Using conduits electrospun from polycaprolactone (PCL) we show the gradual development of a significant neointima within 28 days, found to be greatest at the anastomoses. Histological analysis showed temporal increases in smooth muscle cell and collagen content within the neointima, demonstrating its maturation. Endothelialisation of the PCL grafts, assessed by scanning electron microscopy (SEM) analysis and CD31 staining, was near complete within 28 days, together replicating two critical aspects of graft performance. To further demonstrate the potential of this mouse model, we used longitudinal non-invasive tracking of bone-marrow mononuclear cells from a transgenic mouse strain with a dual reporter construct encoding both luciferase and green fluorescent protein (GFP). This enabled characterisation of mononuclear cell homing and engraftment to PCL using bioluminescence imaging and histological staining over time (7, 14 and 28 days). We observed peak luminescence at 7 days post-graft implantation that persisted until sacrifice at 28 days. Collectively, we have established and characterised a high-throughput model of grafting that allows for the evaluation of key clinical drivers of graft performance.
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Affiliation(s)
- Alex H. P. Chan
- The Heart Research Institute, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Richard P. Tan
- The Heart Research Institute, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Praveesuda L. Michael
- The Heart Research Institute, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Bob S. L. Lee
- The Heart Research Institute, Sydney, New South Wales, Australia
| | - Laura Z. Vanags
- The Heart Research Institute, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Martin K. C. Ng
- The Heart Research Institute, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Christina A. Bursill
- The Heart Research Institute, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Steven G. Wise
- The Heart Research Institute, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
- * E-mail:
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Li J, Sun Q, Chen L, Feng J, Han D. Bioinspired One-Dimensional Nano-Wrinkles Guide Liquid Behaviors at the Liquid-Solid Interfaces. J Nanosci Nanotechnol 2016; 16:885-891. [PMID: 27398541 DOI: 10.1166/jnn.2016.10673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Learning from nature concerning how nanostructured surfaces interact with liquids may provide insight into better understanding of inside living biological interfaces bearing these nanostructures and further development of innovative materials contacting water. Here we investigate the dynamic behaviour of water droplet interacting with one-dimensional nano-wrinkles of different size on polydimethylsiloxane (PDMS) surface. The structure design of the variationally one-dimensional nano-wrinkles is inspired by in vivo responding topographic changes in aortic intima, which was characterized with liquid-phase atomic force microscopy. We show here that increasing the amplitude of the wrinkles promotes the spreading and energy dissipation of liquid droplets on the wrinkled interfaces. This result suggests a possible bio-protection mechanism of blood vessels via its structural changes on the aortic intima against elevated flowing blood, and provides a basis for tuning interfacial nanostructure of optimal durability against wearing by the liquid behaviors.
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Abstract
Vulnerable plaques are a subset of atherosclerotic plaques that are prone to rupture when high stresses occur in the cap. The roles of residual stress, plaque morphology, and cap stiffness on the cap stress are not completely understood. Here, arteries are modeled within the framework of nonlinear elasticity as incompressible cylindrical structures that are residually stressed through differential growth. These structures are assumed to have a nonlinear, anisotropic, hyperelastic response to stresses in the media and adventitia layers and an isotropic response in the intima and necrotic layers. The effect of differential growth on the peak stress is explored in a simple, concentric geometry and it is shown that axial differential growth decreases the peak stress in the inner layer. Furthermore, morphological risk factors are explored. The peak stress in residually stressed cylinders is not greatly affected by changing the thickness of the intima. The thickness of the necrotic layer is shown to be the most important morphological feature that affects the peak stress in a residually stressed vessel.
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Affiliation(s)
- Rebecca Vandiver
- St. Olaf College, 1520 St. Olaf Ave, Northfield, MN 55057, United States.
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Shormanov SV, Kulikov CV. [Hepatic structure remodeling after an experimental pulmonary trunk stenosis and following its operative correction]. Morfologiia 2013; 144:41-46. [PMID: 24592700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Changes in the liver were studied in 25 puppies with experimental pulmonary trunk stenosis of 6-12 months duration and 10 animals after the elimination of this defect. Control group included 10 dogs of the corresponding age. A complex of histological, morphometric, electron microscopic and immunohistochemical methods was used. During the modeling of pulmonary trunk stenosis, the resistance of hepatic afferent vessels to hepatic blood flow was increased due to the venous-arterial and venous-venous reactions. In the arteries, the bundles of smooth myocytes (SM) of the intimal muscle were formed together with the musculo-elastic sphincters, polypoid cushions, while in the branches of the portal vein, the intimal SM bundles and the valves appeared. In the efferent veins, the muscular elevations were hypertrophied. In all the vessels the thickening of the walls was observed, and in the media of the arteries, there were signs of sclerosis and the increased expression of alpha-smooth muscle actin (alpha-SMA). Hepatocytes demonstrated marked ultrastructural changes: mitochondrial matrix swelling, partial destructions of their cristae, dilation of endoplasmic reticulum cisterns. After the elimination of the defect, previously formed vascular adaptation reactions were found to disappear, the tone of the blood vessels in the liver decreased, causing the regression of hypertrophic changes of their media. The number of the arterial blood vessels with intimal muscle, sphincters and cushions decreased. The expression of alpha-SMA in the media of the arteries was also reduced. In hepatic efferent veins, the muscular elevations became attenuated. The dystrophic changes in hepatocytes regressed at both light-microscopic and the ultrastructural level.
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Popescu MR, Zugun FE, Cojocaru E, Tocan L, Folescu R, Zamfir CL. Morphometric study of aortic wall parameters evolution in newborn and child. Rom J Morphol Embryol 2013; 54:399-404. [PMID: 23771088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The largest artery in the human body, intimately connected to the heart, aorta is usually regarded as the major source of oxygenated blood for the circulatory system. The three concentric layers, which surround the aortic lumen-the tunics intima, media and adventitia, transform the aorta in a large elastic duct, which is irregular calibrated according to its segments. The special aortic distensibility is facilitated by its elastic circumferential lamellar complex. Any disturbance of its structural components is able to interfere with its normal and vital activity. Our study intends to reveal that the development of elastic lamellae should be regarded not only as an indispensable step for the aortic wall configuration, but also like a process in a firm connection with the rest of aortic wall components. The transition from intrauterine life to a new stage of life, childhood, has to determine an adequate adaptation of almost all the components of aortic wall, in order to sustain a consistent pulsatile blood flow. Stereological quantitative analysis of thoracic aortic fragments prelevated from newborns and children was performed in order to estimate the dynamic of vascular wall increase. We first estimated the general configuration of the thoracic aortic wall, quantifying the principal constituents; the connective tissue profile, investigated through its main elements, collagen and elastic fibers, supports the idea that each type of fiber has a distinct evolution in different groups of ages and has to be correlated with their involvement in maintaining of the aortic wall mechanical properties. Elastic fibers percentage volume was increased in both examined groups, with a small difference reported in children aorta, while collagen fibers exhibit a slow increase in children aorta. Our morphometric quantitative assessment suggests that further studies have to draw of in a precisely manner the outline of the secretory well defined function of vascular smooth muscle cells; the elucidation of the manner in which the secretory pathway for each type of fiber becomes fully adapted to every stage of aortic development will allow a new perspective in aortic pathology.
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Affiliation(s)
- Mihaela Roxana Popescu
- Discipline of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iassy, Romania
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Bisdas T, Haverich A, Teebken OE. Letter by Bisdas et al regarding article, "Aspirin plus clopidogrel versus aspirin alone after coronary artery bypass grafting: the clopidogrel after surgery for coronary artery disease (CASCADE) trial". Circulation 2011; 124:e194; author reply e195-6. [PMID: 21824931 DOI: 10.1161/circulationaha.110.014589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vásquez J, Mathison Y, Romero-Vecchione E, Suárez C. [Effect of sulodexide on aortic vasodilation capacity and associated morphological changes in rats with streptozotocin-induced diabetes]. Invest Clin 2010; 51:467-477. [PMID: 21365875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Endothelial dysfunction (ED) is observed in patients with hypercholesterolemia, arterial hypertension, obesity and diabetes mellitus. Recent evidences suggest the involvement of glycosaminoglycans (GSG) in ED. We evaluated the effect of sulodexide (SLD), a natural GSG used in albuminuria and ischemic diabetes treatment, on arterial relaxation and vascular morphological changes in a diabetic type I model. Diabetes was induced, in Sprague-Dawley rats by streptozotocine (STZ) administration, 60 mg, i.v. Rats were divided into four groups; I: control, II: diabetics, III: control + SLD, IV: diabetics treated with SLD (15 mg/day). After three months, phenylephrine precontracted aortic rings were used to evaluate acetylcholine (ACh) and sodium nitroprusside (NPS) relaxation capacities. Light microscopy of aorta was done with several staining procedures. In vitro, SLD did not change smooth muscle tone in resting or phenylephrine precontracted aortic rings. In diabetic rats, ACh relaxation was 28.8-35.1% lower than in control rats. Diabetic rats treated with SLD showed aortic ACh relaxation similar to control rats. No significative statistical difference was found in endothelium-independent NPS relaxation, between the different groups. Light microscopy histological studies revealed important morphological alterations, particularly in intima and adventitia layers of aortic artery; those changes were dramatically reversed in SLD treated rats. Our experiments support the conclusion that SLD is a potential drug for improving endothelial dysfunction in diabetes.
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Affiliation(s)
- José Vásquez
- Laboratorio de Estudios Cardiovasculares, Cátedra de Farmacología, Escuela de Medicina "José María Vargas", Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.
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Ulusal I, Tari R, Ozturk G, Aycicek E, Aktar F, Kotil K, Bilge T, Kiriş T. Dose-dependent ultrastructural and morphometric alterations after erythropoietin treatment in rat femoral artery vasospasm model. Acta Neurochir (Wien) 2010; 152:2161-6. [PMID: 20803041 DOI: 10.1007/s00701-010-0775-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Accepted: 08/12/2010] [Indexed: 11/26/2022]
Abstract
PURPOSE Cerebral vasospasm is the common cause of poor outcome after aneurysmal subarachnoid hemorrhage (aSAH). Although many agents are experimentally and clinicaly used to protect or recover from vasospasm, an effective neurotherapeutic drug is still missing. Erythropoietin (EPO) is recently a promising candidate. The aim of this study is to investigate the dose-dependent effects of recombinant human EPO (rhEPO) on arterial wall in a rat femoral artery vasospasm model. METHODS Thirty two animals were divided into four groups: vasospasm without any treatment (group A), vasospasm +250 IU/kg rhEPO group (group B), vasospasm +500 IU/kg rhEPO group (group C), and control group (group D). Rat femoral artery vasospasm model was used. For groups B and C, 7 days of 250 IU/kg and 500 IU/kg intraperitoneal rhEPO in 0.3 ml saline were administered respectively; and for groups A and D, 0.3 ml saline were administered intraperitoneally without any treatment. After 7 days, histological and morphometric analyses were carried out. RESULTS Vasospasm alone group demonstrated the highest vessel wall thicknesses, comparing to other groups (p < 0.001). While for groups B and C, vessel wall thickness values were significantly higher than the control group (p < 0.001), between these two groups, there was no significant difference achieved (p > 0.05). CONCLUSION In our study, there was no significant difference between the two rhEPO treatment groups, but rhEPO treatment was shown to be histologically and morphometrically effective in vasospasm. However, if dosage of EPO treatment is augmented, successful results may be achieved.
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Affiliation(s)
- Ismail Ulusal
- Department of Neurosurgery, Haseki Training and Research Hospital, Istanbul, Turkey
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Ogeng'o JA, Malek AA, Kiama SG. Structural organisation of tunica intima in the aorta of the goat. Folia Morphol (Warsz) 2010; 69:164-169. [PMID: 21154287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The structural organisation of tunica intima in the aorta is important for its integrity, prediction, and diagnosis of atherosclerosis. The goat is a suitable model for cardiovascular studies, but the structure of its tunica intima is scarcely reported. This study, therefore, aimed to describe features of the goat aortic tunica intima by light and transmission electron microscopy. Sixteen healthy male domestic goats (capra hircus) aged between 6 and 24 months were used: 8 for light and 8 for electron microscopy. The animals were euthanised with sodium pentabarbitone 20 mg/mL and fixed with 3% phosphate buffered glutaraldehyde. For light microscopy, specimens from various regions of the aorta were routinely processed for paraffin embedding and 7 mm sections stained with Mason's trichrome. Those for transmission electron microscopy were post fixed in osmium tetroxide, embedded in Durcupan, and ultrathin sections stained with uranyl acetate and counter stained with lead citrate. Endothelium comprises round and squamous cells, linked to the subendothelial material by a simple and sometimes lamellated basement membrane. In the subendothelial zone, a heterogenous population of cells are connected with interlinked collagen and elastic fibres. Both cells and fibres are connected to the internal elastic lamina. The composite structure and interlinkages in the tunica intima permit unitary function and increase mechanical strength, thus enabling it to withstand haemodynamic stress.
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Affiliation(s)
- J A Ogeng'o
- Department of Human Anatomy, University of Nairobi, Kenya.
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Zárate A, Hernández-Valencia M. [Estrogen therapy in menopause. Clinical study in evolution (KEEPS) to explain the risk-benefit dispute to administration]. Ginecol Obstet Mex 2010; 78:191-194. [PMID: 20939224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The Kronos Early Estrogen Prevention Study (KEEPS) is a randomized clinical and controlled study, with the objective of clarifying the controversy that arisen previous studies about the risk-benefit factor with use of estrogens in postmenopausal women. Healthy women aged 42-58 years who are within 36 months of their last menstrual period have been recruited to receive either oral estrogens or patches of estradiol; in addition both groups are given oral micronized progesterone for 11 days of each month. Outcomes will be carotid intimae medial thickness and the accrual of coronary calcium; collaterally subrogate outcomes will be lipoproteins concentrations, coagulation markers, bone densitometry, mammography, skin characteristics and cognitive evaluation. The hypothesis consists in the presence of a window of therapeutic opportunity for the use of estrogens in low dose in healthy women with recent menopause.
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Affiliation(s)
- Arturo Zárate
- Unidad de Investigación Médica en Enfermedades Endocrinas, Diabetes y Metabolismo, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, México, DF.
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Dell'Orbo C, Quacci D, Raspanti M, Congiu T, Reguzzoni M, Protasoni M. Atherosclerotic alterations in human carotid observed by scanning electron microscopy. Ital J Anat Embryol 2010; 115:53-58. [PMID: 21072990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Atherosclerosis involves all the layers of the artery wall, but the events involving the intimal portion are fundamental to understand the evolution and gravity of lesions. This study shows that scanning microscopy is instrumental for better understanding the physiopathology of this disease.
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Affiliation(s)
- Carlo Dell'Orbo
- Laboratory of Human Morphology "L. Cattaneo", Department of Human Morphology, University of Insubria, Varese, Italy
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Ozalp B, Canbaz S, Huseyinova G, Duran E. Histopathological comparison of vascular wall damage created by external cross-clamp and endoluminal balloon occlusion techniques. J Cardiovasc Surg (Torino) 2009; 50:545-553. [PMID: 19734837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Almost all cross-clamps utilized in vascular surgery, even atraumatic clamps, have been shown to cause mechanical damage to the vascular wall. In recent years, surgical procedures using an endoluminal balloon technique have been reported as an alternative occlusion strategy. This study discusses the histopathological characteristics and comparison between vascular wall damage secondary to the two occlusion techniques in the early postoperative period. METHODS Twelve adult rabbits were divided into two experimental groups: the clamp group (N. = 6) and the balloon group (N. = 6). External cross-clamp occlusion was applied to the abdominal aorta for 30 minutes via laparotomy in the clamp group. In the balloon group, occlusion was applied for 30 minutes by inflating the catheter balloon, which was inserted through the iliac artery and advanced into the abdominal aorta. The appropriate aortic segments were subsequently extracted in both groups and tissue samples were examined by light and electron microscopy. Finally, the samples were scored for grade of tissue damage. RESULTS In both experimental groups, tissue damage was apparent. In the investigations carried out under light microscopy, it was observed that the damage caused by balloon occlusion was remarkably less than the damage caused by the cross-clamp technique. In the balloon group, eight tissue samples (66.7%) had grade 1 damage. On the other hand, five tissue samples had grade 3 damage, all of which were in the clamp group. Investigation by electron microscopy revealed that greater intimal, medial, and adventitial damage occurred in the vascular walls of the clamp group samples, and this also corresponded with an increase in immune response and intraluminal thrombosis. CONCLUSION External clamp and internal balloon occlusion techniques applied to the aorta were compared, and widespread intimal and medial damage were observed in both techniques. However, endoluminal occlusion of the aorta should be the technique of choice in properly selected cases, since it results in lower damage grades, and it should also be used if application of an external clamp is technically difficult.
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Affiliation(s)
- B Ozalp
- Department of Cardiovascular Surgery, Faculty of Medicine, Trakya University, Edirne, Turkey
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16
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Adam SK, Das S, Othman F, Jaarin K. Fresh soy oil protects against vascular changes in an estrogen-deficient rat model: an electron microscopy study. Clinics (Sao Paulo) 2009; 64:1113-9. [PMID: 19936186 PMCID: PMC2780529 DOI: 10.1590/s1807-59322009001100012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 08/24/2009] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To observe the effects of consuming repeatedly heated soy oil on the aortic tissues of estrogen-deficient rats. METHODS Thirty female Sprague Dawley rats (200-250 g) were divided equally into five groups. One group served as the normal control (NC) group. The four treated groups were ovariectomized and were fed as follows: 2% cholesterol diet (OVXC); 2% cholesterol diet + fresh soy oil (FSO); 2% cholesterol diet + once-heated soy oil (1HSO); and 2% cholesterol diet + five-times-heated soy oil (5HSO). After four months, the rats were sacrificed, and the aortic tissues were obtained for histological studies. RESULTS After four months of feeding, the NC, FSO and 1HSO groups had a lower body weight gain compared to the OVXC and 5HSO groups. The tunica intima/media ratio in the 5HSO group was significantly thicker (p < 0.05) compared to the NC, OVXC and FSO groups. Electron microscopy showed that endothelial cells were normally shaped in the FSO and NC groups but irregular in the 1HSO and 5HSO groups. A greater number of collagen fibers and vacuoles were observed in the 5HSO group compared to the other treatment groups. CONCLUSIONS Fresh soy oil offered protection in the estrogen-deficient state, as these rats had similar features to those of the NC group. The damage to the tunica intima and the increase in the ratio of tunica intima/media thickness showed the deleterious effect of consuming repeatedly heated soy oil in castrated female rats.
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Affiliation(s)
- Siti Khadijah Adam
- Universiti Kebangsaan Malaysia, Department of Pharmacology, Faculty of Medicine - Kuala Lumpur, Malaysia
| | - Srijit Das
- Universiti Kebangsaan Malaysia, Department of Anatomy, Faculty of Medicine - Kuala Lumpur, Malaysia.
| | - Faizah Othman
- Universiti Kebangsaan Malaysia, Department of Anatomy, Faculty of Medicine - Kuala Lumpur, Malaysia.
| | - Kamsiah Jaarin
- Universiti Kebangsaan Malaysia, Department of Pharmacology, Faculty of Medicine - Kuala Lumpur, Malaysia
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17
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Chertok VM, Kotsiuba AE, Babich EV. [Ultrastructure of the intima of human pial arteries in arterial hypertension]. Morfologiia 2009; 136:50-54. [PMID: 20210098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Ultrastructure of the intima of human pial arteries obtained from 5 male cadavers of practically healthy individuals and from 8 cadavers of the patients with the intravitally diagnosed grade I arterial hypertension (AH) was studied by scanning and transmission electron microscopy. AH was found to be associated with the remodeling of the intimal structural elements in the pial arteries. In most arteries, the changes were detected in the microrelief of the luminal surface and in the permeability of the vascular endothelial lining and of the subendothelial layer. During this remodeling, some endothelial cells were found in the state of structural and functional adaptation to the elevated arterial pressure, while the others were undergoing the dystrophic changes. The latter include the cells containing lipid inclusions, as well as the endothelial cells presumably in the state of apoptosis. The destruction of the intercellular junctions, the disturbances in the endothelium permeability contributed to the development of subendothelial layer edema, resulting in its significant thickening. This layer became looser and contained abundant collagen fibrils.
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18
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Akgün-Dar K, Bolkent S, Yanardag R, Tunali S. Vanadyl sulfate protects against streptozotocin-induced morphological and biochemical changes in rat aorta. Cell Biochem Funct 2008; 25:603-9. [PMID: 16892454 DOI: 10.1002/cbf.1354] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study was to investigate the protective effects of vanadyl sulfate on aorta tissue of normal and streptozotocin (STZ)-induced diabetic rats, morphologically and biochemically. The animals were made diabetic by an intraperitoneal injection of streptozotocin (65 mg/kg) and vanadyl sulfate (100 mg/kg) that was given every day for 60 days by gavage technique to rats. Under the light and transmission electron microscopes, hypertrophy of the vessel wall, focal disruption in the elastic lamellae, an increase in thickness of total aortic wall, tunica intima, subendothelial space and adventitial layer, and a disorganization in smooth muscular cells of the tunica media were observed in diabetic animals. The aorta lipid peroxidation (LPO) levels were significantly increased and the aorta glutathione (GSH) levels were significantly reduced in STZ diabetic rats. In diabetic rats administered vanadyl sulfate for 60 days, aorta LPO levels significantly decreased and the aorta GSH level significantly increased. In conclusion, in vivo treatment with vanadyl sulfate of diabetic rats prevented the morphological and biochemical changes observed in thoracic aorta of diabetic animals.
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MESH Headings
- Animals
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/pathology
- Blood Glucose/metabolism
- Diabetes Mellitus, Experimental/chemically induced
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Experimental/prevention & control
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/pathology
- Endothelium, Vascular/ultrastructure
- Glutathione/metabolism
- Hypoglycemic Agents/administration & dosage
- Hypoglycemic Agents/pharmacology
- Injections, Intraperitoneal
- Lipid Peroxidation/drug effects
- Male
- Microscopy, Electron
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/pathology
- Muscle, Smooth, Vascular/ultrastructure
- Rats
- Streptozocin/administration & dosage
- Streptozocin/toxicity
- Tunica Intima/drug effects
- Tunica Intima/pathology
- Tunica Intima/ultrastructure
- Tunica Media/drug effects
- Tunica Media/pathology
- Tunica Media/ultrastructure
- Vanadium Compounds/administration & dosage
- Vanadium Compounds/pharmacology
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Affiliation(s)
- Kadriye Akgün-Dar
- Department of Biology, Faculty of Science, Istanbul University, Vezneciler, Istanbul, Turkey.
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19
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Drăghia F, Drăghia AC, Onicescu D. Electron microscopic study of the arterial wall in the cerebral aneurysms. Rom J Morphol Embryol 2008; 49:101-103. [PMID: 18273512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The ultrastructural modifications were observed in electron microscopy of the congenital aneurysm of the internal carotid artery with subarachnoid hemorrhage. The tunica intima very enlarged contains in the endothelial cells numerous microvesicles of pinocytosis, and rare cell organelles. The internal elastic lamina presented ruptured or absence zones. The luminal face of the cells appeared irregular with large evaginations and deep and narrow invaginations. Under the endothelial lining, large masses of extracellular matrix with different degrees of edema, and fragmented collagen fibrils realize a metabolic barrier between the tunica intima and media. The muscle fibers of the tunica media and the myofilaments in each myocyte are in reduced number.
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Affiliation(s)
- F Drăghia
- Department of Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
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20
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Hudorovic N. ICVTS on-line discussion A. Valves and primary varicose veins. Interact Cardiovasc Thorac Surg 2007; 6:224. [PMID: 17669816 DOI: 10.1510/icvts.2006.136937a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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21
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Guérin P, Gouëffic Y, Heymann MF, Pillet P, Al Habash O, Crochet D, Pacaud P, Loirand G. Direct stenting limits sirolimus-eluting stent edge neointimal thickening. J Vasc Surg 2007; 46:354-9. [PMID: 17664110 DOI: 10.1016/j.jvs.2007.04.063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Accepted: 04/22/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The use of sirolimus eluting stent (SES) has strongly limited the incidence of in-stent restenosis that still remains a problem at the stent edge. The aim of this study was to analyze the neointimal thickening after implantation of SES and to assess the influence of the stent implantation procedure on the neointimal thickening in the in-stent segment and at the edge of the stent in an ex-vivo model of stented human artery. METHODS Both balloon expandable SES and the corresponding bare metal stent (BMS) were used in a model of human mammary artery culture. Stents were implanted either directly or after predilatation (10 atm, 60 seconds) and analysis of arterial segments were performed at 28 days poststenting. Cell proliferation and neointimal thickening were assessed by immunohistochemistry, western blotting, and histomorphometry, both in the in-stent segment and at the edge of the stent. Neointimal thickening was expressed as the ratio ([neointimal area/neointimal area + media area]). RESULTS The in-stent neointimal thickening was dramatically inhibited in the SES group compared with the BMS group whatever the stenting technique was (predilatation: 0.22 +/- 0.05 vs 0.30 +/- 0.10; P < .04; direct stenting 0.16 +/- 0.04 vs 0.30 +/- 0.13; P <.01). This effect of SES was associated with a smallest expression of the small G protein RhoA and an increase of p27kip expression. In the BMS group, predilatation and direct stenting gave similar in-stent neointimal thickening. In contrast, in the SES group, in-stent neointimal thickening was significantly reduced when direct stenting was performed (0.16 +/- 0.04 [direct stenting] vs 0.22 +/- 0.05 [predilatation], P < .03). At the stent edge, a similar neointimal thickening was observed with both type of stent when predilatation was performed on the entire segment of the artery. Direct stenting significantly reduced the neointimal thickness at the stent edge when SES where used (0.06 +/- 0.01 [direct stenting] vs 0.19 +/- 0.06 [predilatation]; P < .001) but not in the BMS group. CONCLUSION These results confirm the efficiency of sirolimus released form SES to inhibit RhoA expression and to increase p27kip level in the arterial wall and show the benefit of direct stenting to limit the edge effect with SES.
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Affiliation(s)
- Patrice Guérin
- Inserm, U533, l'institut du thorax, Université de Nantes, Nantes, France.
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22
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Kablak-Ziembicka A, Przewlocki T, Tracz W, Pieniazek P, Musialek P, Stopa I, Zalewski J, Zmudka K. Diagnostic value of carotid intima-media thickness in indicating multi-level atherosclerosis. Atherosclerosis 2007; 193:395-400. [PMID: 16908024 DOI: 10.1016/j.atherosclerosis.2006.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Revised: 06/21/2006] [Accepted: 07/06/2006] [Indexed: 10/24/2022]
Abstract
UNLABELLED Carotid intima-media thickness (CIMT) is an indicator of atherosclerosis, but its association with multi-level involvement is sparsely investigated. Study aimed to examine interrelation between CIMT and number of arterial territories with significant (>50%) stenoses, including coronary, supraaortic, renal and iliac/femoral arteries. METHODS AND RESULTS Study formed 415 patients (294 men), aged 62.9+/-9.3 years referred to coronary angiography. CIMT assessment was performed in common, bulb and internal carotid segments, and expressed as the mean aggregate value. In all patients, both coronary, renal angiography and supraaortic, iliac/femoral arteries ultrasound was performed. Group I formed 102 patients without significant lesions in any of investigated territories; group II formed 131 patients with single territory; group III formed 102 patients with two territory and group IV formed 80 patients with three to four territory involvements. CIMT correlated with increasing number of involved territories (r=0.751, p<0.001). Aggregate CIMT, previous myocardial infarction, creatinine level, hypertension, hs-CRP, smoking were independent predictors of multi-level involvement (p<0.001, R=0.768). ROC curves showed that CIMT cut-off value of 1.308 mm could distinguish 0-1 from two to three level involvement with sensitivity of 81.6%, specificity 88.8%, PPV 85.1%, NPV 86.3% (odds ratio 35.9, range 20-65). CONCLUSIONS CIMT increases with number of involved territories. CIMT is an independent predictor of significant multi-level atherosclerosis, showing high sensitivity and specificity for indicating more advanced territorial atherosclerotic involvement.
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Affiliation(s)
- Anna Kablak-Ziembicka
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Collegium Medicum Jagiellonian University, School of Medicine, 31-202 Krakow, Poland.
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23
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Abstract
The use of covered stents in children is limited by the need for a large long sheath for delivery and the impossibility of redilation once implanted. The authors developed a reexpandable covered stent implantable in children through a small sheath and evaluated its clinical feasibility in mini piglets. An original Palmaz stent was covered with a polyurethane membrane that could be stretched up to 700%. Under general anesthesia, the authors implanted the covered stents in six mini piglets using a long sheath with a diameter approximately 1 French larger than the recommended size required to deliver an uncovered Palmaz stent. The implantation technique was similar to conventional stent implantation. In six piglets, the stent could be redilated from 7.5 to 8.7 mm 28-70 days after implantation. Macroscopic and microscopic examination showed intimal coverage of the coating with minimal inflammatory reaction around the stent. Our newly designed reexpandable stent covered with a polyurethane membrane is promising for use in children.
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MESH Headings
- Angioplasty, Balloon/adverse effects
- Angioplasty, Balloon/instrumentation
- Animals
- Aorta, Thoracic/diagnostic imaging
- Aorta, Thoracic/surgery
- Aorta, Thoracic/ultrastructure
- Aortic Rupture/etiology
- Aortic Rupture/pathology
- Blood Vessel Prosthesis Implantation
- Coated Materials, Biocompatible/pharmacology
- Equipment Design
- Femoral Artery/diagnostic imaging
- Femoral Artery/surgery
- Femoral Artery/ultrastructure
- Graft Occlusion, Vascular/etiology
- Graft Occlusion, Vascular/pathology
- Microscopy, Electron
- Models, Animal
- Models, Cardiovascular
- Polyurethanes/pharmacology
- Stents/adverse effects
- Swine
- Tunica Intima/diagnostic imaging
- Tunica Intima/surgery
- Tunica Intima/ultrastructure
- Ultrasonography, Interventional
- Vascular Patency
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Affiliation(s)
- Norihisa Horita
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan.
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24
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Xu YM, Qi ST, Zeng SW, Shi XF, Li WQ, Huang GL, Zhuang BR. [Optical and scanning electron microscopic observation of a novel small-caliber vascular graft in canine models]. Nan Fang Yi Ke Da Xue Xue Bao 2007; 27:866-9. [PMID: 17584657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To observe the histopathological changes of a novel small-caliber vascular graft after implantation in canine theca interna under scanning electron microscope. METHOD A 3 cm segment of the vascular graft (diameter of 4 mm) was implanted in an end-to-end fashion to bridge the severed carotid artery in 19 healthy dogs. Color Doppler sonography was performed 2 weeks after the operation to observe the patency rate of artificial blood vessel. At 1, 8, 12 and 24 week postimplantation, the arteries (4, 4, 6 and 5, respectively) were collected for optical and scanning electron microscopies after angiography to observe the patency of the arteries. RESULTS Of the total of 19 arteries, occlusion occurred in 1 at 12 weeks and 1 at 24 weeks. Optical and electron microscopies showed that 1 week after implantation, slight fibroplasias and formation of red thrombus could be seen at the vascular anastomosis without endothelial cell lining. At 8 weeks, the host tissue grew into the lumen of the graft through the pores to form uniform neointima consisting of plenty of collagen fibers, but still without endothelial cells. At 12 weeks, discontinuous endothelial cells were seen to grow on the surface of the neointima. In the middle segment of the vascular graft, immature endothelial cells were found to grow in clusters. The structure of the neointima was loose in comparison with that at the anastomosis, with occasional inflammation cells. Twenty-four weeks after grafting, endothelial cells grew over the entire inner wall of the patent graft, and the surface of the neointima at the anastomosis was lined with continuous endothelial cells. CONCLUSION The vascular graft can be useful for reconstruction of canine carotid artery defect and achieves good endothelialization 24 weeks after implantation.
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Affiliation(s)
- Yi-min Xu
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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25
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26
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Yoshikai M, Itoh T, Kamohara K, Yunoki J, Fumoto H. Intimal injury of ultrasonically skeletonized internal thoracic artery by a vessel clamp: morphological analysis. Interact Cardiovasc Thorac Surg 2007; 6:331-4. [PMID: 17669858 DOI: 10.1510/icvts.2006.145367] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The skeletonized internal thoracic artery (ITA) has several advantages over a pedicled one in coronary artery bypass grafting. A skeletonized ITA, which lacks surrounding tissue, thus seems more susceptible to the mechanical force exerted by a vessel clamp than the pedicled ITA. The purpose of this study was to assess the detrimental effect of vessel clamps on the intimal integrity of the ultrasonically skeletonized ITA. We skeletonized twelve ITAs with an ultrasonic scalpel in patients who underwent coronary artery bypass grafting, and thereafter two types of clamp, namely a metal clamp and a fibrous jaw clamp, were applied to the terminal portion of the ITA for 30 min. The intimal integrity of the ITAs was morphologically assessed using scanning electron microscopy. A metal clamp can cause serious intimal injury which disrupts the internal elastic lamina, and thus should be avoided for the temporary clamping of the skeletonized ITA. A fibrous jay clamp, however, hardly ever causes intimal injury, and its clinical use for the temporary clamping of the ultrasonically skeletonized ITA is therefore recommended. Vessel clamps can cause intimal injury of the ultrasonically skeletonized ITA, and the degree of the injury depends on the type of the clamp used.
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Affiliation(s)
- Masaru Yoshikai
- Department of Cardiovascular Surgery, Shin-Koga Hospital, 120 Tenjin-cho, Kurume, Fukuoka 830-8577, Japan.
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Fernández-Miranda C. Nuevas perspectivas en la medición del riesgo cardiovascular: exploraciones para detectar la aterosclerosis subclínica y marcadores de inflamación. Med Clin (Barc) 2007; 128:344-51. [PMID: 17376362 DOI: 10.1157/13099803] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Among the new technologies for the detection of subclinical atherosclerosis, ankle-brachial index, carotid ultrasonography, computed tomography detection of coronary calcifications and high-resolution nuclear magnetic resonance are those of greatest clinical usefulness. These explorations are especially useful for patients with an intermediate cardiovascular risk, or a 10-20% risk according to the National Cholesterol Education Program-Adult Treatment Panel III or 3-4% according to the SCORE project. This is because they allow the identification of high-risk patients who need a more intense treatment. In addition, high-sensitivity C-reactive protein concentrations may be considered as a new marker for the evaluation of cardiovascular risk. In this article, the current state of knowledge about these explorations and the guidelines of the main scientific societies are reviewed, and the practical conclusions of the working group are provided.
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Affiliation(s)
- Consuelo Fernández-Miranda
- Unidad de Lípidos y Aterosclerosis, Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain
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28
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Elsharawy MA, Naim MM, Abdelmaguid EM, Al-Mulhim AA. Role of saphenous vein wall in the pathogenesis of primary varicose veins. Interact Cardiovasc Thorac Surg 2006; 6:219-24. [PMID: 17669815 DOI: 10.1510/icvts.2006.136937] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
UNLABELLED Varicose veins may be due to weakness of the vein wall as a result of structural problems. There are conflicting findings in the literature about these problems especially concerning collagen, elastin and smooth muscle cells content. The aim of this study was to look at the structural abnormalities of varicose veins (with and without valvular incompetence). MATERIALS AND METHODS We studied 70 specimens of long saphenous veins from 35 patients (24 with varicose and 11 with normal veins). Two specimens were taken from each vein approximately 3-4 cm from the saphenofemoral junction. Vein specimens were processed for histological and electron microscopic studies. Both qualitative and quantitative analyses were performed to assess the degree of wall changes. Using the image analyzer, contents of collagen, elastin and smooth muscle cells, in addition to intimal and medial thickness, were measured. RESULTS Light microscopy revealed significant increase in intimal and medial thickness and collagen content of media and significant decrease in elastin content in varicose veins compared with normal veins. There was no statistical significant difference between varicose veins with and without saphenofemoral valve incompetence. Electron microscopy showed marked degenerative changes in intima and media of varicose veins. CONCLUSION The findings in our study supported the theory of primary weakness of the vein wall as a cause of varicosity. This weakness is due to intimal changes, disturbance in the connective tissue components and smooth muscle cells.
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Affiliation(s)
- Mohamed A Elsharawy
- Department of Surgery, College of Medicine, King Faisel University, P. O. Box 40081, Al-Khober, 31952, Eastern Province, Kingdom of Saudi Arabia.
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Castellino FJ, Ganopolsky JG, Noria F, Sandoval-Cooper MJ, Ploplis VA. Focal arterial inflammation is augmented in mice with a deficiency of the protein C gene. Thromb Haemost 2006; 96:794-801. [PMID: 17139375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Increased risk of thrombosis, with propitious conditions for fibrin deposition, along with upregulation of inflammation, are important factors that enhance plaque formation in atherosclerosis. Evidence supporting the role of anticoagulant protein C (PC) as an inflammatory agent has emerged, supplementing its well-known function as an anticoagulant. Thus, we sought to examine whether a PC deficiency would lead to an enhanced response to an acute arterial hyperplasic challenge. The presentation of early arterial inflammation was studied using a copper/silicone arterial cuff model of accelerated focal neointimal remodeling in mice with a heterozygous total deficiency of PC (PC+/-). Increased inflammation, cell proliferation, cell migration, fibrin elevation, and tissue necrosis were observed in the treated arteries of PC+/- mice, as compared to arteries of equally challenged age- and gender-matched WT mice. These results indicate that PC+/- mice subjected to this challenge displayed enhanced focal arterial inflammation and thrombosis, leading to larger neointimas and subsequent localized occlusion, as compared to their WT counterparts.
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Affiliation(s)
- Francis J Castellino
- W M Keck Center for Transgene Research and Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556, USA.
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30
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Schwenger V, Keller T, Hofmann N, Hoffmann O, Sommerer C, Nahm AM, Morath C, Zeier M, Krumme B. Color Doppler indices of renal allografts depend on vascular stiffness of the transplant recipients. Am J Transplant 2006; 6:2721-4. [PMID: 17049059 DOI: 10.1111/j.1600-6143.2006.01524.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A resistance index (RI) of 0.8 or higher was shown to be a strong predictor of kidney allograft and patient survival. Uncertainties persist since the intrarenal RI is closely associated with the vascular stiffness of the allograft recipient. To clarify the diagnostic value of RI further, we analyzed parameters of vascular stiffness of the recipient and intrarenal RI of the renal allograft. In a prospective study laboratory and clinical parameters, pulse wave velocity (PWV), intima media thickness (IMT) and RI were obtained in 76 kidney allograft patients. We found that the RI values significantly correlated with the PWV (p < 0.05) and the recipients age (p < 0.01) but not with the donor age and renal function. Using multiple regression analysis recipient age, PWV, pulse pressure (PP) and IMT were identified as independent factors influencing RI values. For a more correct interpretation of the RI values in renal allografts parameters of vascular stiffness such as IMT, PP or PWV should be included.
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Affiliation(s)
- V Schwenger
- Division of Nephrology, University Medical Hospital, Heidelberg, Germany.
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31
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Abstract
PURPOSE Impaired endothelial function has been implicated as an initial step in the pathogenesis of atherosclerosis leading to cardiovascular disease (CVD). Aerobic exercise improves vascular function and reduces risk of CVD morbidity and mortality; however, the effects of resistance training on vascular function remains unclear. Thus, the aim of this study was to examine the effects of 1 yr of resistance training (RT) on vascular structure and function in overweight but otherwise healthy eumenorrheic women. METHODS Study participants consisted of 30 (15 control, 15 RT) overweight (BMI > 25 kg x m(-2)) women, aged 24-44 yr, studied before and after a 1-yr RT intervention. Vascular structure and function were assessed via noninvasive ultrasound imaging of the carotid and brachial arteries, respectively. Body composition, blood pressure, and fasting blood lipids and glucose also were measured. RESULTS The RT group demonstrated a significant mean improvement in one-repetition maximum bench press following 1 yr of RT (P < 0.05). There also was a significant increase in lean body mass in the RT group compared with the control group (P = 0.04). There were no training-associated changes in blood pressure, fasting blood lipids, glucose, or insulin levels. Although there was no change in carotid artery intimamedia thickness, peak flow-mediated dilation significantly improved in the RT group (P < 0.05). CONCLUSION The principal significant finding in this study was the initial demonstration that RT alone can improve brachial artery endothelial function in overweight eumenorrheic women.
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Liu L, Liu J, Zhu M, Hu S. Experimental study of one-shot vascular anastomostic device for proximal vein graft anastomoses. Ann Thorac Surg 2006; 82:303-6. [PMID: 16798234 DOI: 10.1016/j.athoracsur.2006.01.099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Revised: 01/16/2006] [Accepted: 01/24/2006] [Indexed: 12/01/2022]
Abstract
PURPOSE A new type of sutureless aortic-vein-graft vascular anastomostic device, One-Shot Vascular Anastomostic Device (Horologe Factory of Jinan City, Shandong Province, China) has been recently designed to create a one-shot anastomosis between the aorta and vein grafts for coronary artery bypass grafting surgery. DESCRIPTION Twelve pigs were scheduled for the test of the feasibility of the One-Shot Vascular Anastomostic Device for artery to vein graft anastomosis. In each animal one proximal anastomosis was performed by means of the One-Shot Vascular Anastomostic Device and the distal end was sutured in a conventional manner to serve as the animal own control. The anastomosis incorporating the abdominal main artery to the segment of a free external carotid vein to the external iliac artery is for the simulation of the aorta-vein anastomosis. EVALUATION The mean duration of the completion of the proximal anastomosis was 1.2 +/- 1.2 minutes (range, 0.3-5.0 minutes). There was a significant difference between the control groups (p < 0.01). All vein grafts were still functioning at the end of the procedure. Pathologic studies and angiography demonstrated that the results were satisfactory. CONCLUSIONS This device enables rapid and safe completion of vascular anastomostic procedure. The vein graft was functioning well and incorporated into the vessel intima smoothly.
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Affiliation(s)
- Luqi Liu
- Cardiac Department of Shandong Provincial Qianfoshan Hospital, Shandong University, Shandong Province, China.
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Yang HW, Wu RB, Guo HM, Zheng SY. [Perivenous support with autologous pericardium inhibits neointimal thickening in canine vein grafts]. Nan Fang Yi Ke Da Xue Xue Bao 2006; 26:1006-8. [PMID: 16864099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To observe the effect of perivenous support with autologous pericardium on neointimal thickening in canine vein grafts. METHODS An autologous pericardium graft of 7 cm x 4 cm was harvested in right anterolateral thoracotomy. Two equal segments of the jugular vein were transplanted to both sides of the femoral arteries in 12 dogs, and on one side of the vein graft, perivenous support with autologous pericardium was applied. The vein grafts were harvested 2 and 4 weeks after operation and the thickness and area of the neointima calculated using computerized image analysis system. Scanning electron microscopy and PCNA immunohistochemistry were also performed. RESULTS The thickness and area of the neointima were significantly greater in the control grafts than in the grafts with perivenous support (P<0.05), and the proliferation of vascular smooth muscle cells in the supported graft was less active (P<0.05). Electron microscopy showed extensive destruction of the endothelium in the control graft, but only slight damage was found in the graft with perivenous support. CONCLUSION Perivenous support of the vein graft with autologous pericardium can reduce intimal and medial hyperplasia in the graft.
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Affiliation(s)
- Hong-wei Yang
- Department of Cardiovascular Surgery, Shenzhen Second People's Hospital, Shenzhen 518000, China.
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Abstract
BACKGROUND AND PURPOSE Hypertension promotes carotid intima-media thickening. We reviewed the randomized controlled trials that evaluated the effects of an antihypertensive drug versus placebo or another antihypertensive agent of a different class on carotid intima-media thickness. METHODS We searched the PubMed and the Web of Science databases for randomized clinical trials, published in English before 2005, and included 22 trials. RESULTS In 8 trials including 3329 patients with diabetes or coronary heart disease, antihypertensive treatment initiated with an angiotensin-converting enzyme (ACE) inhibitor, a beta-blocker, or a calcium-channel blocker (CCB), compared with placebo or no-treatment, reduced the rate of intima-media thickening by 7 microm/year (P=0.01). In 9 trials including 4564 hypertensive patients, CCBs, ACE inhibitors, an angiotensin II receptor blocker or an alpha-blocker, compared with diuretics or beta-blockers, in the presence of similar blood pressure reductions, decreased intima-media thickening by 3 microm/year (P=0.03). The overall beneficial effect of the newer over older drugs was largely attributable to the decrease of intima-media thickening by 5 microm/year (P=0.007) in 4 trials of CCBs involving 3619 patients. In 5 trials including 287 patients with hypertension or diabetes, CCBs compared with ACE inhibitors did not differentially affect blood pressure, but attenuated intima-media thickening by 23 microm/year (P=0.02). The treatment induced changes in carotid intima-media thickness correlated with the changes in lumen diameter (P=0.02), but not with the differences in achieved blood pressure (P>0.53). CONCLUSIONS CCBs reduce carotid intima-media thickening. This mechanism might contribute to their superior protection against stroke.
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Affiliation(s)
- Ji-Guang Wang
- Studies Coordinating Centre, Hypertension and Cardiovascular Rehabilitation Unit, Department of Cardiovascular Diseases, University of Leuven, Belgium.
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Brenner D, Labreuche J, Touboul PJ, Schmidt-Petersen K, Poirier O, Perret C, Schönfelder J, Combadière C, Lathrop M, Cambien F, Brand-Herrmann SM, Amarenco P. Cytokine polymorphisms associated with carotid intima-media thickness in stroke patients. Stroke 2006; 37:1691-6. [PMID: 16741188 DOI: 10.1161/01.str.0000226565.76113.6c] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Carotid intima-media thickness (IMT) reflects generalized atherosclerosis and is predictive of future vascular events. Evidence exists that carotid IMT is heritable, and genetic studies can provide clues in the pathogenesis of atherosclerosis. METHODS We recruited 470 white ischemic stroke patients, measured common carotid artery (CCA) IMT, and analyzed 54 polymorphisms with suspected roles in atherosclerosis. RESULTS Among the polymorphisms tested, the angiotensin-converting enzyme insertion/deletion, osteopontin (OPN) T-443C, monocyte chemoattractant protein-1 (MCP-1) G-927C, and MCP-1 A-2578G polymorphisms were associated with CCA-IMT in age-gender-adjusted analysis. In multivariate analysis, the association between the OPN and MCP-1 polymorphisms remained significant. The OPN-443C allele was associated with increased IMT in the dominant model (0.053 mm for the TC and CC genotypes; P=0.001). The MCP-1-927C allele was associated with increased IMT in the additive model (0.040 mm for each C allele; P=0.001), and the MCP-1-2578 G allele was associated with decreased IMT in the recessive model (0.088 mm for the GG genotype; P=0.002). CONCLUSIONS The OPN and MCP-1 genes, coding for 2 cytokines with known roles in atherosclerosis, may contribute to increased carotid IMT and warrant further study.
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Affiliation(s)
- David Brenner
- Department of Neurology and Stroke Centre, Bichat University Hospital, Denis Diderot University and Medical School, Paris, France
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Dichtl W, Stocker EM, Mistlberger K, Debbage P, Yan ZQ, Alber HF, Frick M, Dulak J, Pachinger O, Weidinger F. Countervailing effects of rapamycin (sirolimus) on nuclear factor-κB activities in neointimal and medial smooth muscle cells. Atherosclerosis 2006; 186:321-30. [PMID: 16185698 DOI: 10.1016/j.atherosclerosis.2005.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2004] [Revised: 08/04/2005] [Accepted: 08/12/2005] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Local application of rapamycin (sirolimus) by drug-eluting stents prevents lumen obliteration after angioplasty by inhibition of neointimal hyperplasia. The effects of rapamycin on neointimal smooth muscle cells (niSMC) which are responsible for the occurrence of restenosis have not been investigated so far. METHODS AND RESULTS Rat niSMC and medial SMC (mSMC) were obtained from balloon catheter-injured arteries. The niSMC exhibited higher basal NF-kappaB activity and TNF-alpha mRNA levels. Nuclear protein binding to NF-kappaB-DNA was attenuated in niSMC by incubation with rapamycin (0.1 and 1 microg/ml) for 24 and 48 h. In contrast in mSMC, 0.1 microg/ml rapamycin had no effect and at 1 microg/ml even increased nuclear protein binding to NF-kappaB-DNA. After 12 h incubation, rapamycin (0.001-10 microg/ml) induced IkappaB-alpha protein in niSMC, whereas in mSMC it stimulated IkappaB-alpha at much lower levels. Prolonged rapamycin treatment (1 microg/ml for 72 h) had no effect on TNF-alpha mRNA level and NF-kappaB activity in niSMC, whereas it led to their increase in mSMC. Vascular endothelial growth factor (VEGF) secretion was higher in mSMC than in niSMC; rapamycin decreased VEGF levels in both cell types. Ultrastructural analysis suggested that rapamycin caused early signs of degeneration in niSMC, but enhanced protein synthesis in mSMC. CONCLUSIONS This study shows that rapamycin influences the inflammatory phenotypes of SMC in opposite directions: it reduces the high basal NF-kappaB activity in niSMC and enhances NF-kappaB activity and TNF-alpha expression in mSMC. In addition, rapamycin inhibits VEGF production regardless of the phenotype of SMC. These findings shed light on molecular mechanisms and structural changes underlying therapeutic applications of rapamycin in prevention of restenosis, inhibition of chronic transplant arteriosclerosis and reduction of secondary malignoma formation due to immunosuppression.
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Affiliation(s)
- Wolfgang Dichtl
- Clinical Department of Cardiology, Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
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Tsivgoulis G, Vemmos K, Papamichael C, Spengos K, Manios E, Stamatelopoulos K, Vassilopoulos D, Zakopoulos N. Common carotid artery intima-media thickness and the risk of stroke recurrence. Stroke 2006; 37:1913-6. [PMID: 16728693 DOI: 10.1161/01.str.0000226399.13528.0a] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Increased common carotid artery intima-media thickness (CCA-IMT) has been associated with an increased risk of myocardial infarction and stroke. We investigated the relationship between CCA-IMT and recurrent stroke in a cohort of ischemic stroke patients. METHODS High-resolution B-mode ultrasonographic measurements of the CCA-IMT were performed in a consecutive series of 238 patients hospitalized in our institution with first-ever ischemic stroke. Stroke risk factors and secondary prevention therapies were documented. Patients were followed-up prospectively and the outcome event of interest was recurrent stroke. RESULTS During a mean follow-up period of 28.9 months (range: 6 to 60 months), 27 recurrent strokes were documented. Patients who experienced recurrent cerebrovascular events had significantly (P=0.005) higher CCA-IMT values (1.01 mm, 95% CI:0.92 to 1.11 mm) than subjects who were free of stroke recurrence (0.88 mm, 95% CI:0.85 to 0.91 mm). After adjustment for baseline characteristics, risk factors and stroke subtypes and secondary prevention therapies increasing CCA-IMT was found to be an independent predictor of stroke recurrence. For each increment of 0.1 mm in CCA-IMT the probability of experiencing recurrent stroke increased by 18.0% (95% CI:2.0% to 36.0%, P=0.027). CONCLUSIONS Increased CCA-IMT values are associated with a higher risk of long-term stroke recurrence.
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Affiliation(s)
- Georgios Tsivgoulis
- Department of Neurology, University of Athens, Eginition Hospital, Athens, Greece.
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Pearte CA, Furberg CD, O'Meara ES, Psaty BM, Kuller L, Powe NR, Manolio T. Characteristics and baseline clinical predictors of future fatal versus nonfatal coronary heart disease events in older adults: the Cardiovascular Health Study. Circulation 2006; 113:2177-85. [PMID: 16651468 DOI: 10.1161/circulationaha.105.610352] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although >80% of annual coronary heart disease (CHD) deaths occur in adults aged >65 years and the population is aging rapidly, CHD event fatality and its predictors in the elderly have not been well described. METHODS AND RESULTS The first myocardial infarction (MI) or CHD death among the 5888 adults aged > or =65 years occurring during enrollment in the Cardiovascular Health Study during 1989-2001 was identified and adjudicated. Characteristics measured at examinations before the event were examined for associations with case fatality (death before hospitalization or hospital discharge) and for differences in predictors by demographics or clinical history. During a median follow-up of 8.2 years, 985 CHD events occurred, of which 30% were fatal. Case fatality decreased slightly over time, ranging from 28% to 30% per year in the early 1990s versus 23% by 2000-2001; with adjustment for age at MI and gender, there was a 6% lower odds of fatality with each successive year (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.90 to 0.98). Case fatality was similar by race and gender but higher with age and prior CHD (MI, angina, or revascularization). When considered alone, many subclinical disease measures, such as common carotid intima-media thickness, ankle-arm index, left ventricular mass by ECG, and a major ECG abnormality, and traditional risk factors, such as diabetes and hypertension, were associated with fatality. In multivariable analysis, independent predictors of fatality were prior congestive heart failure (OR, 3.20; 95% CI, 2.32 to 4.41), prior CHD rather than only history of MI (OR, 2.51; 95% CI, 1.84 to 3.43), diabetes (OR, 1.66; 95% CI, 1.10 to 2.31), and age (OR, 1.21 per 5 years; 95% CI, 1.07 to 1.37), adjusted for gender and each other. Prior congestive heart failure, regardless of left ventricular systolic function, age, gender, or prior CHD, conferred a > or =3-fold increased risk of fatality in almost all subgroups. CONCLUSIONS Among community-dwelling older adults, CHD case fatality remains substantial, with easily identifiable risk factors that may be different from those that predict incident disease. In the elderly in whom the risk/benefit of therapies may be influenced by multiple competing comorbidities and care needs, risk stratification possibly may be improved further by focusing more aggressive care on specific patients, especially those with a history of congestive heart failure or prior CHD.
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Affiliation(s)
- Camille A Pearte
- Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
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Houkin K, Nakayama N, Nonaka T, Koyanagi I. The 5-hydroxytryptamine2A receptor antagonist sarpogrelate hydrochloride inhibits acute platelet aggregation in injured endothelium. J Int Med Res 2006; 34:65-72. [PMID: 16604825 DOI: 10.1177/147323000603400108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In this study, the effect of sarpogrelate hydrochloride, a 5-hydroxytryptamine2A receptor antagonist, on platelet aggregation at the site of injured carotid artery endothelium was examined. The rat common carotid artery was clamped for 30 min to induce endothelial injury. Sarpogrelate hydrochloride was administered before and after the injury, and the effects were compared with those in rats receiving sham operation only and those receiving clipping injury but no sarpogrelate hydrochloride. The animals were killed 24 h after the procedure. The common carotid artery was examined by scanning electron microscopy and stained immunochemically for factor VIII. Sarpogrelate hydrochloride treatment was associated with reduced aggregation of platelets on electron microscopy and lower expression of factor VIII at the injured intima. Sarpogrelate hydrochloride has an inhibitory effect on platelet aggregation at the intima in the acute stage after injury, suggesting that this drug may be used to prevent early ischaemic complications after surgical or endovascular arterial intervention.
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Affiliation(s)
- K Houkin
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
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Beller CJ, Kosse J, Radovits T, Krempien R, Gross ML, Berger I, Hagl S, Szabó G. Adjunct brachytherapy: a new concept to prevent intimal hyperplasia after surgical endarterectomy? Eur J Cardiothorac Surg 2006; 29:334-42. [PMID: 16423534 DOI: 10.1016/j.ejcts.2005.12.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2005] [Revised: 11/28/2005] [Accepted: 12/05/2005] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Endarterectomy represents a therapeutical option for patients with advanced coronary artery disease. The mid-term results are compromised by restenosis due to neointima formation. The aim of this study was to evaluate a new treatment concept - endarterectomy with consecutive gamma-irradiation - in a rat model. METHODS Male Sprague-Dawley rats underwent left carotid endarterectomy with removal of intima: control (n=10) or were irradiated with 15 Gray (Gy) (n=13) or 20 Gy (n=10) postoperatively and compared with sham-operated rats (n=10). After 3 weeks, carotid arteries were perfusion-fixed and vessel compartment areas were measured. Transmission electron microscopy and immunohistochemical staining were used to confirm neointima formation. RESULTS Three weeks after endarterectomy, neointimal hyperplasia was found in the control group (0.07+/-0.04 mm(2)). After irradiation, a dose-dependent reduction of neointima was observed (0.003 mm(2) at 15 Gy and 0.0007 mm(2) at 20 Gy, P<0.0001). However, immunohistochemical staining revealed that thin re-endothelialization after irradiation was not inhibited. CONCLUSIONS Gamma-irradiation significantly suppressed neointimal hyperplasia in a rat model of surgical endarterectomy. Despite inhibition of intimal hyperplasia, re-endothelialization after adjuvant brachytherapy was present. Adjuvant brachytherapy may be therefore a new concept to prevent restenosis after endarterectomy in patients.
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Affiliation(s)
- Carsten J Beller
- Department of Cardiac Surgery, University of Heidelberg, INF 110, 69120 Heidelberg, Germany.
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van den Berg BM, Spaan JAE, Rolf TM, Vink H. Atherogenic region and diet diminish glycocalyx dimension and increase intima-to-media ratios at murine carotid artery bifurcation. Am J Physiol Heart Circ Physiol 2006; 290:H915-20. [PMID: 16155109 DOI: 10.1152/ajpheart.00051.2005] [Citation(s) in RCA: 144] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It was hypothesized that endothelial glycocalyx perturbation contributes to increased vulnerability of the arterial wall exposed to atherogenic risk factors. Glycocalyx and intima-to-media ratios (IMR) were studied at a low- and a high-risk region within the murine carotid artery (common region) and internal carotid branch (sinus region) in control C57BL/6J (C57BL6) and age-matched C57BL/6J/apoE*3-Leiden (apoE*3; on an atherogenic diet) mice. Electron micrographs revealed significantly thinner glycocalyces [73 (SD 36) vs. 399 (SD 174) nm, P < 0.05] and greater IMR [0.096 (SD 0.045) vs. 0.044 (SD 0.023), P < 0.05] at the sinus region of C57BL6 mice than in the common region. Thinner glycocalyces [100 (SD 27) vs. 399 (SD 174) nm, P < 0.05] and greater IMR [0.071 (SD 0.024) vs. 0.044 (SD 0.023), P < 0.05] were also observed in the common region of age-matched apoE*3 mice on an atherogenic diet for 6 wk vs. C57BL6 mice on a normal diet. Greater IMR were due to greater intima layers, without significant changes in media layer dimension. In addition, atherogenic diet resulted in increased endothelial cell thickness at the sinus region [0.85 (SD 0.49) vs. 0.53 (SD 0.28) μm, P < 0.05] but not at the common region [0.66 (SD 0.37) vs. 0.62 (SD 0.32) μm]. It is concluded that both regional and diet-induced increases in atherogenic risk are associated with smaller glycocalyx dimensions and greater IMR and that vascular sites with diminished glycocalyx are more vulnerable to proinflammatory and atherosclerotic sequelae.
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Affiliation(s)
- Bernard M van den Berg
- Dept. of Medical Physics, Academic Medical Center, Univ. of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
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Abstract
Thromboembolic events (TE) associated with circulatory support devices are a major source of mortality and morbidity. Clinically, the lowest TE rates are claimed with devices that incorporate textured blood-contacting materials. The textured materials currently used in circulatory assist devices are composed of small, attached fibers that form the boundaries of connected cavities. These cavities entrap blood components to form a "neointimal" layer, which is believed to minimize thromboembolic events. We believe that the three-dimensional surface topography of blood-contacting materials is a major controlling factor in the formation of a stable neointimal layer upon the material. Particle-cast cavities were used to form geometric features in segmented polyurethane. This microtextured material was incorporated as part of a flexible blood-contacting surface in a blood pump that was implanted as a left ventricular assist device in calves. The structure, thickness, stability, and development of the neointimal layer were then evaluated. These preliminary studies have shown that a stable neointimal layer can be formed upon the particle-cast surfaces. The results also indicate that the cavity size on the particle-cast surfaces has a significant effect on neointimal adhesion. The methods employed can be used in the design of future circulatory support devices.
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Affiliation(s)
- Conrad M Zapanta
- Division of Artificial Organs, Department of Surgery, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033, USA
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Cagiannos C, Abul-Khoudoud OR, DeRijk W, Shell DH, Jennings LK, Tolley EA, Handorf CR, Fabian TC. Rapamycin-coated expanded polytetrafluoroethylene bypass grafts exhibit decreased anastomotic neointimal hyperplasia in a porcine model. J Vasc Surg 2005; 42:980-8. [PMID: 16275457 DOI: 10.1016/j.jvs.2005.06.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2005] [Accepted: 06/20/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We tested the hypothesis that rapamycin coated onto, and eluted from, expanded polytetrafluoroethylene (ePTFE) grafts would diminish neointimal hyperplasia in a porcine model. METHODS Rapamycin (also called sirolimus) was coated onto the luminal surface of 6-mm-internal-diameter thin-walled ePTFE grafts by using an adhesive polymer that allows timed release of the drug. An adhesive polymer that allows timed release of rapamycin from ePTFE was developed with commercially available chemicals and applied on 6-mm ePTFE grafts. Graft integrity was characterized by scanning electron microscopy, and rapamycin levels were quantified by using high-performance liquid chromatography. Twenty-two mongrel pigs were randomized into three groups: untreated ePTFE (n = 6), adhesive-only coated ePTFE (n = 6), or adhesive- and rapamycin-coated ePTFE (n = 10). End-to-side unilateral aortoiliac bypasses were performed by using 6-mm-internal-diameter ePTFE grafts and standardized anastomotic lengths. Unilateral end-to-side aortoiliac ePTFE grafts (6-mm internal diameter) were inserted by using polypropylene sutures, 6-0 proximally and 7-0 distally; all anastomoses were 12 mm long. All animals received aspirin (325 mg orally) daily. All animals were given oral aspirin (325 mg) daily beginning on the day before surgery. At 28 days, the animals were killed, and the grafts were explanted in continuity with the adjacent aortic cuff and the outflow iliac artery. Variables compared between groups included graft patency, distal anastomotic length and cross-sectional narrowing, and intimal thickness at the arterial-graft junction indexed to the adjacent graft thickness. Microscopic analysis was performed with hematoxylin and eosin and Masson trichrome stains on paraffin sections. A pathologist blinded to experimental groups graded sections for collagen deposition, neointima formation, inflammatory cellular infiltrates, medial necrosis, and aneurysmal degeneration. RESULTS All animals survived until they were killed without clinical evidence of limb ischemia or graft infection. Preplanned t tests in the context of one-way analysis of variance showed no difference in outcome measures between the untreated ePTFE and adhesive-only coated ePTFE groups; therefore, they were combined in further comparisons with the adhesive- and rapamycin-coated ePTFE group. The Rapamycine eluting expanded polytetrafluoroethylene group had longer anastomoses (85.6% vs 60.6% of the initial anastomotic length maintained; P < .0001) and less cross-sectional narrowing in the outflow graft (16.2% vs 28.5%; P = .0007) when compared with the other two groups by using two-tailed Student t tests. There was no evidence of medial necrosis or aneurysmal degeneration. All patent grafts had complete endothelialization on hematoxylin and eosin sections. Rapamycin was detectable and quantifiable in the arterial wall at 28 days after implantation. CONCLUSIONS Rapamycin can be coated onto and eluted from ePTFE by using a nonionic polymer and a simple coating technique. At 4 weeks after implantation, the rapamycin-eluting ePTFE grafts demonstrate gross, pathologic, and morphometric features of diminished neointimal hyperplasia when compared with non-drug-eluting ePTFE. Four weeks after implantation in a porcine model, rapamycin-eluting ePTFE grafts demonstrated gross, pathologic, and morphometric features of diminished neointimal hyperplasia when compared with untreated and adhesive-only coated ePTFE grafts. CLINICAL RELEVANCE Rapamycin-eluting ePTFE grafts decrease neointimal hyperplasia in a porcine model. Further studies are needed to evaluate whether patency will be improved. Rapamycin-eluting ePTFE grafts may allow the use of prosthetic grafts in situations in which autologous vein is unavailable and in which neointimal hyperplasia is pronounced, such as in small-diameter (<6-mm) vessels typical of infrapopliteal interventions.
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Affiliation(s)
- Catherine Cagiannos
- Department of Surgery, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
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Wentzel JJ, Krams R, Slager CJ. Letter regarding article by Korshunov and Berk, "Strain-dependent vascular remodeling: the 'Glagov phenomenon' is genetically determined". Circulation 2005; 111:e119; author reply e119. [PMID: 15753223 DOI: 10.1161/01.cir.0000157072.64410.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ishimura E, Taniwaki H, Tabata T, Tsujimoto Y, Jono S, Emoto M, Shoji T, Inaba M, Inoue T, Nishizawa Y. Cross-sectional association of serum phosphate with carotid intima-medial thickness in hemodialysis patients. Am J Kidney Dis 2005; 45:859-65. [PMID: 15861351 DOI: 10.1053/j.ajkd.2005.02.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Although an increased serum phosphate concentration is a significant risk factor for vascular calcification, it is unclear whether serum phosphate level is a risk factor for increased arterial wall thickness in hemodialysis patients. METHODS Using B-mode ultrasonography, we examined intima-medial thickness (IMT) of the carotid artery of hemodialysis patients and analyzed risk factors for increased IMT with regard to the effect of serum phosphate. Seven hundred sixteen hemodialysis patients were enrolled (547 patients without diabetes, 169 patients with diabetes; 441 men, 275 women; age, 60 +/- 8.5 years). RESULTS IMT of patients with diabetes was significantly greater than that of patients without diabetes (0.859 +/- 0.250 versus 0.783 +/- 0.178 mm; P < 0.0001). For the group of all patients, IMT correlated weakly, but significantly, with serum phosphate level (r = 0.093; P = 0.0127). In multiple regression analysis of the group of all patients, greater serum phosphate level (beta = 0.166; P < 0.0001) was shown to be a significant independent risk factor for increased carotid IMT, in addition to other significant independent risk factors, including advanced age, higher blood pressure, greater non-high-density lipoprotein cholesterol level, and the presence of diabetes (R2 = 0.1119; P < 0.00001). In multiple regression analyses performed separately for hemodialysis patients without and with diabetes, greater phosphate level and advanced age were significant independent risk factors for increased IMT, independent of other confounding risk factors. CONCLUSION These results show that in addition to advanced age, greater serum phosphate level is a significant and independent factor associated with advanced arteriosclerosis in hemodialysis patients with and without diabetes, suggesting that phosphate levels should be controlled appropriately to prevent an increase in arterial wall thickness in hemodialysis patients.
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Affiliation(s)
- Eiji Ishimura
- Department of Nephrology, Osaka City University Graduate School of Medicine, Osaka, Japan.
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Abstract
Intimal sarcoma (IS) is defined as a malignant tumor arising in the tunica intima of large blood vessels. In systemic circulation, the majority of IS develop in the aorta, where close to three fourths of published cases lack specific differentiation and are called undifferentiated intimal sarcomas (UIS). The remaining cases are intima-associated sarcomas of recognized types, also called differentiated intimal sarcomas (DIS). In this report, we further characterize UIS, including its immunohistochemical profile and results of comparative genomic hybridization. A total of 14 cases of UIS were collected from 17 medical institutions, including slides, blocks, electron photomicrographs, clinical abstracts, and reports of surgical pathology specimens and autopsies. The patients, 7 women and 7 men, were 41 to 85 years of age (median, 65.6 years). Twelve tumors arose from the aorta, one from the left external iliac and femoral arteries, and one in a large systemic vein (the venous tumor was included due to histologic similarity with the arterial lesions). Tumors ranged from 1 cm to over 10 cm in diameter. Histopathology was that of a largely necrotic, poorly differentiated epithelioid and pleomorphic malignant neoplasm relating to the tunica intima. Usually there was only a thin layer of viable tumor cells overlying a large thrombus. All tumors stained at least focally with the endothelial markers CD31 and Fli-1; however, there was otherwise considerable variability in immunophenotype. The distinctive histopathologic appearance of the primary luminal lesion was lost whenever tumor invaded outside the vessel wall (into adventitia and beyond) or in metastatic sites. Such extravascular tumors assumed a variety of patterns reminiscent of undifferentiated pleomorphic sarcoma (UPS; in older literature also known as pleomorphic malignant fibrous histiocytoma, MFH) or other distinct types of sarcomas, including osteosarcoma, angiosarcoma, and rhabdomyosarcoma. The results of comparative genomic hybridization were nonspecific. Eleven patients died of the disease, in an average of 11 months after diagnosis. Three patients are still alive and free of disease at 4, 16, and 27 years. UIS of large systemic vessels represents a distinct clinical entity where intraluminal sarcoma presents with thrombosis and occlusion of large vessels. It is associated with a highly characteristic, although not entirely specific, histology and immunohistochemical phenotype. The histogenesis of UIS is not certain; however, it seems that the cell of origin must leave the confines of the vessel wall to show altered morphology. Although there are rare long-term survivors, UIS behaves as a fully malignant neoplasm that is almost uniformly associated with metastases and tumor-related death.
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Affiliation(s)
- Matjaz Sebenik
- Department of Pathology, Staten Island University Hospital, Staten Island, NY 10305, USA.
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Wang L, Chen J, Sun Y, Zhang F, Zhu J, Hu S, Wang DH. Regulation of connexin expression after balloon injury: possible mechanisms for antiproliferative effect of statins. Am J Hypertens 2005; 18:1146-53. [PMID: 16245407 DOI: 10.1016/j.amjhyper.2005.03.746] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Statins, the 3-hydroxy-3-methylglutaryl-cooenzyme A (HMG-CoA) reductase inhibitors, have been shown to inhibit the migration of macrophages and smooth muscle cell proliferation leading to an antiproliferative effect. Although this beneficial effect of statins has been suggested to be independent of lipid lowering properties, the possible mechanisms responsible for this action is largely unknown. Gap junctions, which serve as channels for direct intercellular exchange of ions, secondary messengers, and small signaling molecules, play an important role in tissue homeostasis and regulation of growth, differentiation, and development. This study was designed to test the hypothesis that expression of the component proteins of gap junctions, connexins 40 and 43 (Cx40 and Cx43), is upregulated in arteries subjected to balloon injury and that this upregulation can be suppressed by statin therapy. Male New Zealand white rabbits were subjected to injury in which an angioplasty catheter was introduced into the right iliac artery from the femoral artery under fluoroscopic guidance. Five groups of rabbits (n = 6 to 7) were treated for 2 weeks with one of the following: balloon injury (BL); BL+lovastatin (BL+L, 10 mg/kg/day); BL+fluvastatin (BL+F, 10 mg/kg/day); sham operation (Sham); and control (Con). Immunohistochemistry studies showed that Cx40 and Cx43 were expressed in normal smooth muscle cells (SMC) throughout the media. Reverse transcription-polymerase chain reaction and Western blot analysis showed that Cx40 and Cx43 mRNA and protein expression was elevated after injury (P < .001 for both proteins and both assays), and these elevations were suppressed by lovastatin and fluvastatin to a similar degree (P < .05 for both drugs and both assays). Immunostaining of Cx40 and Cx43 was consistently enhanced in the neointimal area after injury and lovastatin and fluvastatin reduced staining of these proteins in the lessened neointimal layer. Transmission electron microscopy revealed that there were abundant gap junctions between neointimal SMC as well as fewer and smaller gap junctions after statin treatment. Therefore, balloon injury causes upregulation of Cx40 and Cx43 in neointimal SMC. Lovastatin and fluvastatin suppress upregulated Cx40 and Cx43 expression and reduce neointimal proliferation, suggesting that Cx40 and Cx43 may play a role in statin-induced antiproliferative effect.
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Affiliation(s)
- Lihong Wang
- Department of Cardiovascular Sciences, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China
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Noa M, Mendoza S, Más R. Effect of D-003 on intimal thickening and circulating endothelial cells in rabbit cuffed carotid artery. J Med Food 2005; 8:237-41. [PMID: 16117617 DOI: 10.1089/jmf.2005.8.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
D-003 is a mixture of very-high-molecular-weight aliphatic primary acids purified from sugar-cane (Saccharum officinarum L.) wax, in which octacosanoic acid is the most abundant component. Previous experimental studies have shown that D-003 not only shows cholesterol-lowering and anti-platelet effects, but also reduces thromboxane B2 and increases prostacyclin levels. It acts by inhibiting cholesterol biosynthesis. The positioning of a non-occlusive silicone collar around the rabbit carotid artery results in the formation of a neointima. Collars were placed around the left carotid for 15 days. The contralateral artery was sham-operated. We included three experimental groups: A control group received vehicle, and two others received D-003 at 5 and 25 mg/kg until sacrificed. Samples of arteries were examined by light microscopy. To evaluate intimal thickening the cross-sectional areas of intima and media were measured. Neointima was significantly reduced in D-003-treated animals compared with controls. Furthermore, the circulating endothelial cell has been studied in this experimental model with endothelium damage. The results demonstrate the protective effect of D-003 on vascular endothelium of the studied rabbits. It is concluded that the protective effect of D-003 against neointima formation and circulating endothelial cells in this experimental model could represent potential beneficial pleiotropic effects in the anti-atherogenic profile of this substance, beyond its cholesterol-lowering and anti-platelet effects independently demonstrated.
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Affiliation(s)
- Miriam Noa
- Laboratory of Histology, Department of Pharmacology, Center of Natural Products, National Center for Scientific Research, Havana City, Cuba.
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