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Intimal hyperplasia after balloon injury is attenuated by blocking selectins

M K Barron¹, R S Lake, A J Buda

¹Cardiology Section, Tulane University Medical Center, New Orleans, La 70112-2699, USA.

|December 13, 1997

Summary

Blocking cell adhesion molecules like E-selectin and L-selectin after balloon angioplasty significantly reduces restenosis. This targeted approach favorably impacts the vascular injury response, improving outcomes.

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Area of Science:

Cardiovascular Biology
Vascular Inflammation
Regenerative Medicine

Background:

Cell adhesion molecules mediate platelet and leukocyte interaction with the vascular endothelium following injury.
Restenosis post-balloon angioplasty is a significant vascular injury response.
The specific role of cell adhesion in restenosis remains incompletely understood.

Purpose of the Study:

To investigate the expression of E-selectin and L-selectin after balloon angioplasty in an animal model.
To determine the therapeutic effect of blocking these selectins on the vascular injury response and restenosis.

Main Methods:

Balloon angioplasty was performed on the iliac arteries of New Zealand White rabbits.
Immunohistochemistry and flow cytometry were used to assess E-selectin and L-selectin expression.

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Selectin blockade was achieved using a sialyl-Lewis(x) analogue, followed by long-term outcome assessment.

Main Results:

E-selectin expression peaked 24-48 hours post-injury, while L-selectin expression on leukocytes increased significantly at 48 hours.
Selectin blockade resulted in a larger lumen area and smaller intima area compared to controls.
Animals receiving selectin blockade showed reduced intima/media ratio and percent area stenosis.

Conclusions:

E-selectin and L-selectin are demonstrably expressed following balloon-induced vascular injury.
Blocking these selectins demonstrates a beneficial effect on mitigating the vascular injury response and preventing restenosis.