Huang Yanming, Salu Koen, Wang Lan, Liu Xiaoshun, Li Shengqiao, Lorenz Gunter, Wnendt Stephan, Verbeken Eric, Bosmans Johan, Van de Werf Frans, De Scheerder Ivan
Department of Cardiology, University of Leuven, U.Z. Gasthuisberg O/N, Herestraat 49, Leuven 3000, Belgium.
J Invasive Cardiol. 2005 Mar;17(3):142-8.
In-stent restenosis remains an unresolved problem which occurs in 5-20% of patients undergoing coronary stenting within the first 3-6 months. Neointimal formation is the main contributor to in-stent restenosis. Stent-induced arterial injury and peri-strut inflammation are involved in the process of neointimal formation by activating cytokines and growth factors which induce smooth muscle cell dedifferentiation, migration, and proliferation. Histopathological studies found that neointimal hyperplasia is principally composed of smooth muscle cells, inflammatory cells, and extracellular matrix. Stent-based delivery of anti-proliferative and/or anti-inflammatory agents have shown beneficial effects on neointimal hyperplasia in experimental studies and clinical trials. Tacrolimus (FK506) is a water-insoluble macrolide immunosuppressant discovered in 1984. It has been widely used in reducing the incidence and severity of allograft rejection after organ transplantation. It has also been used to treat other inflammatory conditions such as atopic dermatitis. In this study, we evaluated the efficacy of stent-based delivery of tacrolimus on inflammation and neointimal formation in an overstretched coronary stent model.
支架内再狭窄仍然是一个尚未解决的问题，在接受冠状动脉支架置入术的患者中，有5%至20%会在最初的3至6个月内出现该问题。新生内膜形成是支架内再狭窄的主要原因。支架诱导的动脉损伤和支架周围炎症通过激活细胞因子和生长因子参与新生内膜形成过程，这些细胞因子和生长因子会诱导平滑肌细胞去分化、迁移和增殖。组织病理学研究发现，新生内膜增生主要由平滑肌细胞、炎症细胞和细胞外基质组成。在实验研究和临床试验中，基于支架递送抗增殖和/或抗炎药物已显示出对新生内膜增生有有益作用。他克莫司（FK506）是1984年发现的一种水不溶性大环内酯类免疫抑制剂。它已被广泛用于降低器官移植后同种异体移植排斥反应的发生率和严重程度。它也被用于治疗其他炎症性疾病，如特应性皮炎。在本研究中，我们评估了在过度扩张的冠状动脉支架模型中，基于支架递送他克莫司对炎症和新生内膜形成的疗效。
