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Published on: December 21, 2014
Plasminogen activators, matrix metalloproteinases and their inhibitors in implanted vascular prostheses
H Urayama1, S Katada, F Kasashima
1First Department of Surgery, Kanazawa University School of Medicine, Kanazawa, Ishikawa, Japan.
Objectives:
To examine the role of plasminogen activators (PAs) and matrix metalloproteinases (MMPs) in the healing of prosthetic grafts.
Methods:
Thirty explanted grafts (16 Dacron and 14 PTFE) were studied immunohistochemically using antibodies to PAs, MMPs, and their inhibitors. The percentages of immunostain-positive multinucleated giant cells (MGC) were related to duration of implantation (early vs late), type of lesion (stenosis vs false aneurysm), graft material (Dacron vs PTFE), and graft status (occluded vs patent).
Results:
All specimens were positive for PAs and MMPs. There were no significant differences in the percentages of MGCs positive for PAs, MMPs, or tissue inhibitor type 2 of MMP (TIMP-2) between the groups. The percentage of TIMP-1 in the aneurysm group (mean, 26%) was significantly lower than that of the stenosis group (mean, 46%) (p<0.05).
Conclusion:
After the implantation of a vascular prosthesis, PAs and MMPs are expressed in cell migration, proliferation and matrix construction. Under-expression of TIMP-1 may be related to the formation of an anastomotic aneurysm.
Insights
Plasminogen activators (PAs) and matrix metalloproteinases (MMPs) are involved in prosthetic graft healing. Lower levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) may contribute to anastomotic aneurysm formation.
Area of Science:
- Biomedical engineering
- Vascular surgery
- Wound healing research
Background:
- Prosthetic grafts are crucial for vascular reconstruction.
- Understanding graft healing mechanisms is vital for improving patient outcomes.
- Plasminogen activators (PAs) and matrix metalloproteinases (MMPs) are key enzymes in tissue remodeling.
Purpose of the Study:
- To investigate the expression and role of PAs and MMPs in the healing process of explanted vascular grafts.
- To correlate the presence of these enzymes and their inhibitors with graft characteristics and clinical outcomes.
Main Methods:
- Immunohistochemical analysis of 30 explanted grafts (Dacron and PTFE).
- Antibodies used against PAs, MMPs, and their inhibitors (TIMP-1, TIMP-2).
- Quantification of positive multinucleated giant cells (MGCs) and correlation with implantation duration, lesion type, graft material, and graft status.
Main Results:
- All grafts expressed PAs and MMPs.
- No significant differences in MGCs positive for PAs, MMPs, or TIMP-2 were observed between groups.
- A significantly lower percentage of TIMP-1 was found in grafts with aneurysms compared to those with stenosis.
Conclusions:
- PAs and MMPs are expressed during vascular prosthesis healing, contributing to cell migration, proliferation, and matrix construction.
- Under-expression of TIMP-1 is potentially linked to the development of anastomotic aneurysms.
- These findings offer insights into the molecular mechanisms of graft healing and complications.
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