Furuyama Tadashi, Komori Kimihiro, Shimokawa Hiroaki, Matsumoto Yasuharu, Uwatoku Toyokazu, Hirano Katsuya, Maehara Yoshihiko
Department of Surgery and Science, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan.
J Vasc Surg. 2006 Jun;43(6):1249-56. doi: 10.1016/j.jvs.2006.02.035.
Rho kinase plays an important role in vascular smooth muscle cell (VSMC) contraction and other cellular functions, such as proliferation, migration, and apoptosis. Recent studies have demonstrated that long-term inhibition of Rho kinase suppresses coronary artery spasm and vascular lesion formation after arterial injury. In the cardiovascular surgery field, intimal thickening in vein grafts is the major cause of late graft failure, for which no effective treatment has yet been developed. In this study, we examined whether long-term inhibition of Rho kinase suppresses intimal thickening in autologous vein grafts in rabbits.
Male rabbits were randomly divided into two groups and received normal chow (control group) or a special chow containing 0.09% fasudil (fasudil group). After oral administration, fasudil is metabolized to a specific Rho kinase inhibitor, hydroxyfasudil. Each group underwent reversed autologous vein graft surgery with the internal jugular vein into the left common carotid artery. At 1, 2, and 4 weeks after the operation, we examined the extent of intimal thickening of the graft and VSMC proliferation and apoptosis.
The intimal thickening was significantly suppressed in the fasudil group compared with the control group at 2 and 4 weeks after the operation. In the fasudil group, VSMC proliferation was suppressed at 1 and 2 weeks after the operation, whereas VSMC apoptosis was enhanced at 2 weeks after the procedure.
These results indicate that Rho kinase is substantially involved in the pathogenesis of intimal thickening of vein grafts and that it is an important therapeutic target for the prevention of graft failure.
Rho激酶在血管平滑肌细胞(VSMC)收缩及其他细胞功能(如增殖、迁移和凋亡)中发挥重要作用。最近的研究表明,长期抑制Rho激酶可抑制冠状动脉痉挛和动脉损伤后的血管病变形成。在心血管外科领域,静脉移植物内膜增厚是晚期移植物失败的主要原因,目前尚未开发出有效的治疗方法。在本研究中,我们检测了长期抑制Rho激酶是否能抑制兔自体静脉移植物的内膜增厚。
将雄性兔随机分为两组,分别给予普通饲料(对照组)或含0.09%法舒地尔的特殊饲料(法舒地尔组)。口服后,法舒地尔代谢为特异性Rho激酶抑制剂羟基法舒地尔。每组均行颈内静脉至左颈总动脉的自体静脉逆向移植手术。在术后1、2和4周,我们检测了移植物内膜增厚程度以及VSMC增殖和凋亡情况。
与对照组相比,法舒地尔组在术后2周和4周时内膜增厚明显受到抑制。在法舒地尔组,术后1周和2周时VSMC增殖受到抑制,而术后2周时VSMC凋亡增强。
这些结果表明,Rho激酶在静脉移植物内膜增厚的发病机制中起重要作用,是预防移植物失败的重要治疗靶点。