Feldman L J, Aguirre L, Ziol M, Bridou J P, Nevo N, Michel J B, Steg P G
U460 INSERM, Faculté Xavier Bichat, Paris, France.
Circulation. 2000 Feb 29;101(8):908-16. doi: 10.1161/01.cir.101.8.908.
Intimal hyperplasia after stent implantation is the main cause of in-stent restenosis. Activated monocytes play a key role in intimal growth. The anti-inflammatory cytokine interleukin-10 (IL-10) is a potent monocyte deactivator, endogenously produced in the atherosclerotic plaque. We tested the hypothesis that exogenous IL-10 may limit postangioplasty intimal hyperplasia after balloon angioplasty or stenting.
Hypercholesterolemic rabbits were treated with recombinant human IL-10 (rhuIL-10) for 3 days after balloon angioplasty or 28 days after stent implantation. High IL-10 serum levels and intense deactivation of circulating monocytic cells, assessed by inhibition of IL-1beta release by lipopolysaccharide-stimulated whole blood, were detected for at least 8 hours after rhuIL-10 intravenous injection (ELISA). Morphometric analyses, performed 28 days after injury, indicated that rhuIL-10 reduced intimal growth by approximately 50% after balloon angioplasty or stenting, resulting in more preserved lumen in stented arteries. Moreover, rhuIL-10 reduced macrophage infiltration by 67% and proliferative activity by 81% in the intima and the media. No toxic effect was detected except minor changes in blood cell count.
The anti-inflammatory cytokine rhuIL-10 reduces postinjury intimal hyperplasia. The potent attenuation of in-stent intimal growth by rhuIL-10 and its favorable toxicity profile suggest that rhuIL-10 may be useful in the prevention of in-stent restenosis.
支架植入术后内膜增生是支架内再狭窄的主要原因。活化的单核细胞在内膜生长中起关键作用。抗炎细胞因子白细胞介素-10(IL-10)是一种有效的单核细胞失活剂,在动脉粥样硬化斑块中内源性产生。我们测试了外源性IL-10可能限制球囊血管成形术或支架置入术后血管成形术后内膜增生的假说。
高胆固醇血症兔在球囊血管成形术后3天或支架植入后28天接受重组人IL-10(rhuIL-10)治疗。通过脂多糖刺激的全血抑制IL-1β释放评估,在rhuIL-10静脉注射后至少8小时检测到高IL-10血清水平和循环单核细胞的强烈失活(ELISA)。损伤后28天进行的形态计量学分析表明,rhuIL-10在球囊血管成形术或支架置入术后使内膜生长减少约50%,导致支架置入动脉的管腔更完整。此外,rhuIL-10使内膜和中膜中的巨噬细胞浸润减少67%,增殖活性减少81%。除血细胞计数有轻微变化外,未检测到毒性作用。
抗炎细胞因子rhuIL-10可减少损伤后内膜增生。rhuIL-10对支架内内膜生长的有效抑制及其良好的毒性特征表明,rhuIL-10可能有助于预防支架内再狭窄。