球囊拉伤兔髂动脉内膜的组织形态变化的研究

球囊拉伤血管内膜是目前研究血管内膜增厚,管腔狭窄的方便而切实的模型。因此,对其演变过程的形态学研究是必要的。方法：应用ＰＴＣＡ球囊导管拉伤兔髂动脉,用光镜、电镜和扫描电镜观察拉伤后不同时间的动态变化。结果：拉伤后各期变化不同,拉伤后１周内,以血细胞沉积为主,１周后,内膜开始增生,２至４周增生最快。增生活跃的内膜平滑肌细胞来自活化的中膜平滑肌细胞。内皮细胞增生极慢,４周内未见内膜内皮化,呈虫食样改变。结论：球囊拉伤兔髂动脉内膜,可引起血栓形成,炎症反应,平滑肌细胞增生和细胞外基质堆积,导致血管腔狭窄。此研究为今后的工作提供一定的客观依据     

在体导入NOS基因可抑制球囊扩张术后血管内膜增生

在体导入ＮＯＳ基因可抑制球囊扩张术后血管内膜增生血管平滑肌细胞（ＶＳＭＣ）增生、内膜增厚是球囊扩张术后再狭窄的主要发病机制之一。近年来许多实验表明ＮＯ有抑制培养ＶＳＭＣ增殖的作用;口服ＮＯ前体Ｌ－精氨酸可减轻内皮损伤诱导的血管内膜的增生。Ｌ－精氨酸在...     

血管内膜增生过程中核酸代谢相关酶活性变化的研究

目的和方法：应用血管内皮剥脱后再狭窄模型,动态观察胸腹主动脉壁核膜核苷三磷酸酶及核酸代谢和糖代谢相关酶5’—核苷酸酶、腺苷脱氨酶和琥珀酸脱氢酶活性的变化。探讨其与血管平滑肌细胞增生和新生内膜形成的关系。结果：血管内皮剥脱后,胸腹主动脉壁核膜核苷三磷酸酶活性持续升高,与血管内膜增厚程度相平行;血管平滑肌细胞收缩型标志蛋白α-肌动蛋白表达降低及合成型标志蛋白骨桥蛋白表达上调,说明血管平滑肌细胞发生了表型转化,由分化型转变成为去分化型;5’核苷酸酶、腺苷脱氨酶和琥珀酸脱氢酶活性表现为先升后降,三种酶活性均于血管平滑肌细胞增殖旺盛期(术后3～7d)达峰值。结论：细胞内参与mRNA转运及糖、核酸代谢的一系列酶活性的变化是新生内膜形成的生化基础。     

人脐静脉血管平滑肌促内皮细胞组织因子表达的体外实验研究

目的研究血管平滑肌细胞对血管内皮细胞组织因子表达的影响并探讨其临床意义.方法用贴块法培养人脐静脉平滑肌细胞;酶消化法培养人脐静脉内皮细胞;用培养平滑肌细胞条件培养液(SMC-CM)刺激培养的内皮细胞,一步凝固法检测内皮细胞组织因子的活性;Northern blot检测内皮细胞组织因子的mRNA表达;并用酶联免疫吸附试验检测SMC-CM中IL-1α、IL-1β、TNF-α和VEGF的含量.结果 SMC-CM使内皮细胞组织因子活性呈剂量依赖性增强,作用6h增至最高,最高增强约38倍;SMC-CM使内皮细胞组织因子mRNA表达显著增强;SMC-CM中的组织因子诱导剂不耐热,且并非IL-1α、IL-1β、TNF-α和VEGF等已知的组织因子诱导剂.结论血管平滑肌细胞能促进血管内皮细胞组织因子的表达,提示体内增生的平滑肌细胞,如动脉再狭窄新内膜中的平滑肌细胞可能诱导局部血管内皮细胞活化及表达组织因子,在局部血栓形成中起一定作用.     

家兔新型动脉粥样硬化狭窄模型的建立及其动态观察

目的　为血管成形术后再狭窄的研究提供非球囊扩张和动脉造影的简单易行的新型动脉粥样硬化斑块狭窄动物模型。方法　选择日本大耳白兔 18只 (含正常组 6只 ) ,用电刺激血栓形成仪刺激颈总动脉并在术后高脂饲料喂养 6周 ,模型分别于术后 3天、1周、3周、6周处死颈总动脉取材 ,常规病理切片行HE、弹力V G染色 ,光学显微镜观察病理变化。结果　术后 1周内动脉有血栓形成 ,内皮剥脱和部分内弹力板断裂 ,内皮细胞增生 ,中膜局部平滑肌细胞有少量水肿、消失 ,外膜有中性粒细胞浸润 ;术后 3周以上则内膜明显增生 ,内膜下脂质沉积 ,中膜平滑肌细胞核有轻度减少 ,纤维组织及基质增生 ,以损伤部位更明显 ,外膜刺激部位有轻度增厚。术后 6周 6只动物颈总动脉均形成管腔狭窄。结论　用电刺激加高脂饲料喂养的方法可成功建立动脉粥样硬化狭窄的动物模型 ;该模型的病理表现与人类动脉粥样硬化的病理过程相似 ,且避免了二次球囊造模法形成的血管盲端     

Egr-1的诱骗性寡脱氧核苷酸抑制大鼠颈总动脉损伤后MMP-2的表达

目的观察局部转染早期生长反应因子-1(early growth response factor-1,Egr-1)的特异诱骗寡脱氧核苷酸(decoy oligodeoxynucleotides,decoy ODNs)对球囊损伤颈总动脉后基质金属蛋白酶-2(MMP-2)蛋白表达的影响及内膜增生的情况,初步探讨Egr-1,decoy ODNs抑制球囊损伤后内膜增生的机制。方法 96只健康雄性Wistar大鼠,随机分为4组,分别为假手术组、对照组、杂码组和诱骗组,每组24只。除假手术组外均应用2F球囊导管行颈总动脉球囊损伤术,术中采用转染试剂FuGENE6介导的Egr-1decoy ODNs转染至损伤后大鼠血管中,与假手术组、对照组、杂码组相比较。术后3、7、14、21d每组处死6只动物。应用HE染色和免疫组织化学方法观察大鼠颈总动脉球囊损伤后内膜增生情况和MMP-2蛋白的表达及转染Egr-1decoy ODNs后对它们的影响。结果 (1)、内膜损伤后3d内膜增厚不明显,7d内膜开始增厚,14、21d时内膜明显增厚。(2)、在假手术组近腔面中膜可见MMP-2有少量散在阳性表达;在对照组及杂码组动脉损伤后3d,在近腔面中膜,有少量阳性表达,与假手术组相比,阳性表达指数上升。7d时在新生内膜和靠近新生内膜处中膜表达明显,14d后表达逐渐下降。(3)转染decoy ODNs治疗后,在各个时间点内膜增厚程度减轻,MMP-2蛋白表达减少,与对照组比较差异有显著性(P<0.01)。结论血管球囊损伤后,内膜7d开始增生,14d、21d增生更明显,而MMP-2在7d时表达明显,之后逐渐下降,Egr-1decoy ODNs能抑制MMP-2的表达,从而减轻血管损伤后内膜的增生。     

靶向毒素DT-VEGF的构建、表达与活性分析

肿瘤的快速生长依赖于新生血管的形成。血管内皮生长因子（VEGF）是血管发生和形成过程中的主要介质,其特异性受体在正常组织和肿瘤组织的表达率存在数个数量级的差异,因此可以将毒素分子转运至增生的肿瘤上皮组织中抑制肿瘤血管增生,从而抑制肿瘤的生长。将白喉毒素的前389个氨基酸基因片段与VEGF165通过一短肽相连构建为融合蛋白基因,在大肠杆菌中表达,获得纯化蛋白。实验证实该融合蛋白对血管内皮细胞有特异性杀伤作用,并研究了其对鸡胚尿囊膜新生血管的抑制作用。     

大鼠颈动脉再狭窄模型的建立及其病理机制的初步研究

目的:建立再狭窄动物模型,探讨再狭窄的发生规律及病理机制.方法:模拟临床经皮冠状动脉成形术(Percutaneous Transluminal Coronary Angioplasty,PTCA)过程,造成大鼠颈动脉扩张及血管内膜的损伤,在此基础上系统地观测术后不同时相点内膜、中膜的增生以及细胞增殖的动态变化规律,以及血管内皮修复情况.结果:新生内膜于术后28天增厚达高峰,增生的血管内膜细胞中以α-Atin染色细胞为主,提示血管内膜的增生大多来自中膜的平滑肌细胞.损伤动脉壁细胞增殖,中膜增厚在14时达到高峰与术后即刻比较有显著性差异(P＜0.05),但35天中膜面积与术后第一天比较无显著性差异(P＞0.05.血管回缩管腔明显变窄.血管外弹力板周径和内弹力板周径在手术后当天有明显增加,与对侧比较差异显著(P＜0.05).但随后开始出现收缩性重构并在第14-28天达到高峰.手术后35天与对侧比较无显著性差异(P＞0.05).血管内膜剥脱后血管内膜第14天即可以见到部分再内皮化,28天血管内膜基本完全再内皮化.结论:损伤动脉狭窄的主要原因为血管的收缩性重构和内膜过度增生.     

抑制VEGF基因表达对大肠癌细胞HT-29的增殖影响

选择血管内皮生长因子（VEGF）基因为靶基因,设计两组针对VEGF mRNA的小干扰RNA．合成DNA寡核苷酸链,体外转录合成siRNA．以人大肠癌细胞系HT-29为靶细胞,应用脂质体转染的方法,将siRNA导入细胞．MTT法检测siRNA对细胞增殖率的影响,RT—PCR法比较转染前后VEGFmRNA表达水平的变化．ELISA法检测细胞培养液中VEGF蛋白分泌量的变化．结果表明,两组siRNA转染后均能有效地抑制HT-29细胞的生长,VEGF mRNA的表达量大幅度减少;相对应的VEGF蛋白水平也显著降低,而作为阴性对照的错义序列组siRNA转染后则无上述作用．     

新型金属蛋白酶ADAMTS-7促进体内和体外血管平滑肌细胞增殖

血管平滑肌细胞增殖和迁移对动脉粥样硬化和血管成型术后再狭窄的发生具有重要作用.本课题组之前的研究发现,含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶ADAMTS-7能够通过调节血管平滑肌细胞迁移直接促进新生内膜的形成.然而ADAMTS-7是否影响血管平滑肌细胞增殖尚不清楚.本研究发现,腔内给予腺病毒造成在体ADAMTS-7过表达能够明显促进大鼠血管损伤7天后新生内膜的形成.PCNA阳性细胞比例在过表达ADAMTS-7的血管内膜和中膜中明显增多.此外,利用血管外膜涂抹小干扰RNA的技术沉默ADAMTS-7体内表达.结果表明,与对照组相比,敲低ADAMTS-7能够明显抑制内膜增厚和内膜平滑肌细胞增殖,但是并不影响中膜细胞.3H掺入实验结果表明,过表达ADAMTS-7能够明显促进体外培养的原代血管平滑肌细胞增殖,基因沉默则抑制其增殖.综上所述,新型金属蛋白酶ADAMTS-7能够在体内和体外促进血管平滑肌细胞增殖.本研究结果提示,ADAMTS-7可能成为防治动脉粥样硬化和血管成型术后的再狭窄的新作用靶点.     

17-AAG对大鼠颈总动脉球囊损伤后内膜增生的影响及其作用机制

目的:研究17-丙烯胺-17去甲氧格尔德霉素(17-Allylamino-17-emethoxy-geldanamycin, 17-AAG)对球囊损伤后大鼠颈总动脉内膜增生的影响及可能作用机制。方法:将清洁级雄性SD大鼠36只按照随机数字法分为假手术组(Sham组)12只、球囊损伤组(Balloon injury, BI组)12只及17-AAG治疗组(17-AAG组)12只。采用2F Fogarty球囊建立大鼠颈总动脉球囊损伤组模型,17-AAG治疗组大鼠在建模后腹腔注射17-AGG(20 mg/kg 2d)。各组大鼠于球囊损伤3周后取损伤段颈总动脉,通过HE染色观察血管内膜形态学改变并评估内膜增生情况,免疫组化染色(Immunohistochemical staining,IHS)法检测血管壁增殖细胞核抗原(Proliferating cell nuclear antigen,PCNA)的表达,评估血管平滑肌细胞的增殖情况。流式细胞术检测血管平滑肌细胞的凋亡情况。结果:BI组、17-AAG组大鼠球囊损伤后颈总动脉内膜出现不同程度增生,内膜/中膜面积比(Intima area/Membrane area,I/M)均较Sham组显著升高(P0.05);17-AAG组的I/M较BI组明显下降(P0.05)。BI组、17-AAG组颈总动脉PCNA表达水平较Sham组明显升高(P0.05),较BI组显著降低(P0.05)。BI组、17-AAG组大鼠血管平滑肌细胞凋亡率较Sham组显著升高(P0.05);17-AAG组大鼠血管平滑肌细胞凋亡程度较BI组明显升高(P0.05)。结论:17-AAG对球囊损伤后颈总动脉内膜增生存在抑制作用,其机制可能是通过提高血管平滑肌细胞凋亡率影响其增殖程度。     

The origin of neointimal cells in the rat carotid artery after balloon angioplasty

At present the issue of a possible role of circulating stem cells and precursors in pathological vascular wall remodeling after angioplasty remains unsolved. Therefore the origin of neointimal cells was examined in the rat carotid artery after balloon angioplasty using morphological and immunocytochemical approaches. It is shown that at the early stages (1-7 days) after vessel injury acute inflammatory response arises in the arterial wall recruiting neutrophils, monocytes, macrophages as well as large amounts of low-differentiated blood-derived cells. At the late stages (10-28 days), at the area of injured intima, a new hyperplastic intima (neointima) is formed, which consists of cells carrying specific smooth muscle markers--alpha-actin and smoothelin. The study on cell proliferative behaviour in the injured vessel wall by bromodeoxyuridine showed that in the process of neointima formation blood-born rather than resident cells are involved. Probably, early smooth muscle and endothelial precursor cells penetrate into injured area with blood stream, where they proliferative and differentiate into mature cells.     

PDGF-D contributes to neointimal hyperplasia in rat model of vessel injury

In this study, we determined the role of PDGF-D, a new member of the PDGF family, in a rat model of balloon injured artery made with a 2F catheter in Sprague-Dawley male rats. PDGF-D expression was studied in the injured and control segments of abdominal aorta. The function of PDGF-D was evaluated in rat vascular smooth muscle cells stably transfected with PDGF-D gene. We found that in normal abdominal aorta, PDGF-D was highly expressed in adventia, moderate in endothelia, and unidentified in media. Stable transfection of PDGF-D gene into vascular smooth muscle cells increased the cell migration by 2.2-fold, and the proliferation by 2.3-fold, respectively, and MMP-2 production and activity as well. These results support the fact that PDGF-D is involved in the formation of neointimal hyperplasia induced by balloon catheter injury and may serve as a target in preventing vascular restenosis after coronary angioplasty.     

The involvement of vascular endothelial growth factor and flt-1 in the process of neointimal proliferation in pig coronary arteries following stent implantation

To clarify the role of vascular endothelial growth factor (VEGF) in the process of restenosis, a Palmaz-Schatz stent was implanted in the left anterior descending coronary artery of male pigs at 2 weeks after balloon injury (balloon/artery ratio 1.2:1). The animals were euthanized at 1, 2, and 4 weeks after stenting, and western blot and immunohistochemical analysis were performed using VEGF, fms-like tyrosine kinase (flt)-1, and platelet-derived growth factor (PDGF) antibodies. The expressions of VEGF and flt-1 protein in the neointima were observed as early as 1 week after stenting and remained for up to 4 weeks, while re-endothelialization was complete at 2 weeks. These protein expressions were demonstrated in proliferated smooth muscle cells throughout the entire period after stenting and, in addition, they were observed in the macrophages and endothelial cells of microvessels around stent struts at 4 weeks. The expression pattern of VEGF corresponded with that of PDGF, a growth factor well-known to induce neointimal proliferation. The cell proliferative activity, measured by the proliferating cell nuclear antigen index, around the struts remained high until 4 weeks after stenting, while that in the other areas declined at 4 weeks. These results suggest that VEGF is involved in the process of restenosis not only through its angiogenic properties and induction of monocyte chemotaxis, but also by a synergistic effect with PDGF.     

阿托伐他汀防鼠颈动脉再狭窄与血清VEGF相关性实验研究

目的:探讨阿托伐他汀防再狭窄效应与促内皮生长作用最强的细胞因子——血管内皮生长因子(VEGF)血清浓度的相关性。方法:24只健康SD大鼠均分为假手术组、模型组与阿托伐他汀组,后两组行颈总动脉球囊损伤造模,损伤前及1周后分别测VEGF血清浓度,4周后观察再狭窄程度。结果:(1)模型组与阿托伐他汀干预组1周后VEGF血清浓度均显著升高,其中阿托伐他汀干预组VEGF增幅高于模型组;(2)阿托伐他汀干预组VEGF增幅与再狭窄程度呈线性负相关。结论:他汀类药物防治再狭窄的机制可能涉及促泌VEGF从而加速内皮修复。     

Targeted Inhibitory Effect of Lenti-SM22alpha-p27-EGFP Recombinant Lentiviral Vectors on Proliferation of Vascular Smooth Muscle Cells without Compromising Re-Endothelialization in a Rat Carotid Artery Balloon Injury Model

Aims

In-stent restenosis remains a serious problem after the implantation of drug-eluting stents, which is attributable to neointima formation and re-endothelialization. Here, we tried to find a new method which aims at selectively inhibiting proliferation of vascular smooth muscle cells (VSMC) proliferation without inhibition of re-endothelialization.

Methods and Results

We used the smooth muscle-specific SM22alpha promoter in a recombinant lentiviral vector to drive overexpression of cell-cycle inhibitor, p27, in VSMCs. p27 effectively inhibited VSMC proliferation mediated by cell cycle arrest at the G0/G1 checkpoint. The SM22alpha-p27 lentiviral vector inhibited VSMC proliferation more effectively than paclitaxel. Rats infected with Lenti-SM22alpha-p27 had a significantly lower intima/media (I/M) ratio and also showed inhibition of restenosis on day 28 after balloon injury. Moreover, the repair of injured endothelium, and re-endothelialization of the carotid artery wall, was not affected by the smooth muscle cell-specific expression of p27.

Conclusion

A recombinant lentiviral vector carrying the SM22alpha promoter was used to effectively infect and selectively overexpress p27 protein in VSMCs, leading to inhibition of intimal hyperplasia without compromising endothelial repair.     

Expression and function of periostin-like factor in vascular smooth muscle cells

In injured blood vessels activated vascular smooth muscle cells (VSMCs) migrate from the media to the intima, proliferate and synthesize matrix proteins. This results in occlusion of the lumen and detrimental clinical manifestations. We have identified a novel isoform of the periostin family of proteins referred to as periostin-like factor (PLF). PLF expression in VSMCs was increased following treatment with mitogenic compounds, suggesting that PLF plays a role in VSMC activation. Correspondingly, proliferation of the cells was significantly reduced with anti-PLF antibody treatment. PLF expression increased VSMC migration, an essential cellular process leading to vascular restenosis after injury. PLF protein was localized to neointimal VSMC of rat and swine balloon angioplasty injured arteries, as well as in human arteries with transplant restenosis, supporting the hypothesis that PLF is involved in VSMC activation and vascular proliferative diseases. Taken together, these data suggest a role for PLF in the regulation of vascular proliferative disease. migration; proliferation     

Intramural delivery of Sirolimus prevents vascular remodeling following balloon injury

OBJECTIVE: Several studies have demonstrated that Sirolimus-eluting stents reduce restenosis in patients with coronary artery disease. Here, we tested whether direct delivery of Sirolimus into the vessel wall during balloon angioplasty can modify vascular remodeling over several weeks. METHODS AND RESULTS: During angioplasty of the rabbit iliac artery we administered an intramural infusion of Sirolimus or its vehicle directly through a balloon catheter into the vessel wall. After 3 weeks neointimal formation was decreased (0.71+/-0.1 vs. 1.4+/-0.12 intima/media ratio), and this process was attributed to the inhibitory properties of Sirolimus on ECM deposition and smooth muscle cell proliferation. Sirolimus also significantly reduced the deposition of elastin, collagen III and fibronectin within the vascular wall. In parallel, proteomic profiles of arterial wall segments were obtained and 485 protein spots were consistently matched between non-dilated and dilated vessels. Differential expression of 12 proteins were observed between the groups and direct sequencing of digested peptides was performed. Local delivery of sirolimus during angioplasty attenuated the expression of structural proteins that included lamin A, vimentin, alpha-1-antitrypsin, and alpha-actin. CONCLUSIONS: Local administration of Sirolimus during angioplasty prevents smooth muscle cell proliferation associated with vascular remodeling as well as the expression of extracellular matrix and structural proteins. Therefore, local injection of Sirolimus during balloon inflation may be an alternative therapeutic approach for preventing restenosis in small stenotic vessels (i.e., <2.5 mm).