Greisler H P, Klosak J J, Steinam S J, Lam T M, Burgess W H, Kim D U
Loyola University Medical Center Department of Surgery, Maywood, IL 60153.
J Vasc Surg. 1990 May;11(5):665-74. doi: 10.1067/mva.1990.19423.
Fibronectin and heparin binding growth factor-type 1 have been affixed to vascular graft surfaces to enhance the attachment and the proliferation of transplanted endothelial cells, respectively. The current study examines the effect of fibronectin and heparin binding growth factor-type 1 on platelet adhesion and activation in vivo and on platelet aggregation in vitro. Expanded polytetrafluoroethylene prostheses (5 cm x 4 mm internal diameter) were treated either with fibronectin (n = 9), fibronectin/heparin/heparin binding growth factor-type 1/heparin (n = 12), or neither (n = 13) and were interposed into canine aortoiliac systems bilaterally. Autogenous radiolabeled (Indium 111 oxine, 650 microCi) platelets were injected intravenously before reestablishment of circulation. Perfusion was maintained for 30 minutes, and prostheses were removed with segments of native aorta and distal iliac arteries bilaterally. Specimens were examined for thrombus-free surface area, by gamma well counting for adherent radiolabeled platelets, and by light microscopy and transmission and scanning electron microscopic techniques. Results showed that both the fibronectin and fibronectin/heparin/heparin binding growth factor-type 1/heparin pretreated prostheses contained significantly greater numbers of platelets and adherent radioactivity than did control graft segments when normalized to their ipsilateral iliac arteries. Fibronectin/heparin/heparin binding growth factor-type 1/heparin pretreated prostheses contained 27 +/- 16 times more radioactivity per square millimeter than ipsilateral iliac arteries, fibronectin pretreated prostheses had 13 +/- 8 times more radioactivity per square millimeter than ipsilateral iliac arteries, and untreated expanded polytetrafluoroethylene had 4 +/- 3 times more radioactivity per square millimeter than ipsilateral iliac arteries. Fibronectin/heparin/heparin binding growth factor-type 1/heparin was more radioactive than fibronectin alone (p = 0.056). Histologic evaluation and thrombus-free surface area determinations corroborated the gamma well counting data. Platelet aggregation in vitro was not activated by either fibronectin (1 to 100 micrograms/100 microliters) or heparin binding growth factor-type 1 (25 to 2500 ng/100 microliters). These data suggest that fibronectin and heparin binding growth factor-type 1 promote platelet adhesion not aggregation.
纤连蛋白和肝素结合生长因子-1已被附着于血管移植物表面,分别用于增强移植内皮细胞的黏附和增殖。本研究检测了纤连蛋白和肝素结合生长因子-1在体内对血小板黏附和活化以及在体外对血小板聚集的影响。将膨体聚四氟乙烯假体(内径5 cm×4 mm)分别用纤连蛋白处理(n = 9)、用纤连蛋白/肝素/肝素结合生长因子-1/肝素处理(n = 12)或不做处理(n = 13),然后双侧植入犬的主-髂动脉系统。在恢复循环前静脉注射自体放射性标记(铟111氧嗪,650微居里)的血小板。维持灌注30分钟,然后双侧连同一段自体主动脉和远端髂动脉一起取出假体。通过γ计数法检测无血栓表面积,通过γ计数法检测黏附的放射性标记血小板,以及通过光学显微镜、透射电子显微镜和扫描电子显微镜技术进行检查。结果显示,当与同侧髂动脉进行标准化比较时,纤连蛋白处理组和纤连蛋白/肝素/肝素结合生长因子-1/肝素处理组的假体所包含的血小板数量和黏附放射性均显著多于对照组移植物节段。纤连蛋白/肝素/肝素结合生长因子-1/肝素处理组的假体每平方毫米所含放射性比同侧髂动脉多27±16倍,纤连蛋白处理组的假体每平方毫米所含放射性比同侧髂动脉多13±8倍,未处理的膨体聚四氟乙烯每平方毫米所含放射性比同侧髂动脉多4±3倍。纤连蛋白/肝素/肝素结合生长因子-1/肝素组的放射性比单独使用纤连蛋白组更高(p = 0.056)。组织学评估和无血栓表面积测定结果证实了γ计数数据。体外血小板聚集未被纤连蛋白(1至100微克/100微升)或肝素结合生长因子-1(25至2500纳克/100微升)激活。这些数据表明,纤连蛋白和肝素结合生长因子-1促进血小板黏附而非聚集。