人体冠状动脉支架的细胞外矩阵变化
Andrew Farb1, Frank D Kolodgie, Jin-Yong Hwang
1Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Circulation
|August 11, 2004
概括
人体冠状动脉支架中的细胞外基质需要超过18个月的时间来愈合,之后发生新极端收缩. 对于预防支架复缩而言,ECM收缩可能是一个目标.
科学领域:
- 心血管研究研究心血管研究
- 生物材料科学 生物材料科学
- 组织病理学 组织病理学
背景情况:
- 支架后的复原包括光滑肌细胞 (SMC) 和细胞外基质 (ECM) 的积累.
- ECM占新极量体积的50%以上,但其人类实体成分尚不清楚.
研究的目的:
- 为了描述人类冠状动脉支架内细胞外基质的组成,随着时间的推移.
- 调查ECM组件的时间变化及其与新极端增生和支架复缩的关系.
主要方法:
- 验尸后人类冠状动脉 (n=45) 的组织学评估,使用支架.
- 对新极端蛋白质甘氨酸,氨酸, I 和 III 型原体, SMC 和 CD44 的分析.
- 根据植入时间 (3-9个月,9-18个月,>18个月) 将支架分为三组.
主要成果:
- 在早期支架 (3-18个月) 中,Neointimal versican和hyaluronan的含量很高,后来下降.
- 迪科林,I型原蛋白和III型原蛋白随着时间的推移呈现出更多的沉积.
- 在超过18个月的支架中,SMC密度和狭窄性降低了.
- CD44染色与巨细胞相关,并且增加了新极值的厚度.
结论:
- 人体冠状动脉支架中的细胞外基质表现出伤口的特征,在18个月前不完全愈合.
- 新极限收缩发生在18个月后,这表明一个动态的愈合过程.
- ECM收缩是一个潜在的治疗点,可以预防支架置.
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