Smyth S S, Reis E D, Zhang W, Fallon J T, Gordon R E, Coller B S
Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
Circulation. 2001 May 22;103(20):2501-7. doi: 10.1161/01.cir.103.20.2501.
Intimal hyperplasia contributes to restenosis after percutaneous vascular interventions. Both beta(3)-integrins, alpha(V)beta(3) and alpha(IIb)beta(3) (glycoprotein IIb/IIIa), and leukocytes have been implicated in neointimal formation, based in part on the results obtained using antagonists to 1 or both receptors in animal models.
The responses in wild-type mice, beta(3)-integrin-deficient mice, and P-selectin-deficient mice were studied in a model of transluminal endothelial injury of the femoral artery. At 4 weeks, beta(3)-integrin-deficient mice were not protected from developing intimal hyperplasia, whereas P-selectin-deficient mice were protected. Within 1 hour of injury, several layers of platelets deposited on the arteries of wild-type mice and a single layer of platelets deposited on the vessels of beta(3)-integrin-deficient mice; in both cases, leukocytes were recruited to the platelet layer. In P-selectin-deficient mice, the platelet layer was less compact and extended further into the lumen but did not recruit leukocytes.
In a model of transluminal arterial injury, absence of early leukocyte recruitment and not deficiency of beta(3)-integrins correlated with a reduction in neointimal formation. Blockade of P-selectins may be an effective therapeutic strategy to decrease restenosis after percutaneous vascular interventions.
内膜增生导致经皮血管介入术后再狭窄。β3整合素,即αVβ3和αIIbβ3(糖蛋白IIb/IIIa)以及白细胞均与新生内膜形成有关,部分基于在动物模型中使用一种或两种受体拮抗剂所获得的结果。
在股动脉腔内内皮损伤模型中研究野生型小鼠、β3整合素缺陷型小鼠和P-选择素缺陷型小鼠的反应。4周时,β3整合素缺陷型小鼠并未免受内膜增生的影响,而P-选择素缺陷型小鼠则受到保护。损伤后1小时内,野生型小鼠动脉上沉积了几层血小板,β3整合素缺陷型小鼠血管上沉积了单层血小板;在这两种情况下,白细胞均被募集到血小板层。在P-选择素缺陷型小鼠中,血小板层较疏松并进一步延伸至管腔,但未募集白细胞。
在腔内动脉损伤模型中,早期白细胞募集的缺失而非β3整合素的缺乏与新生内膜形成的减少相关。阻断P-选择素可能是减少经皮血管介入术后再狭窄的有效治疗策略。