Botney M D, Kaiser L R, Cooper J D, Mecham R P, Parghi D, Roby J, Parks W C
Department of Medicine, Jewish Hospital, Washington University Medical Center, St. Louis, Missouri.
Am J Pathol. 1992 Feb;140(2):357-64.
Lobar pulmonary arteries from patients with unexplained pulmonary hypertension were obtained at the time of single-lung transplantation to determine the response of large elastic vessels to increased intraluminal pressure. Specifically, human pulmonary arteries were examined to determine if remodeling remained active at the time of surgery and whether remodeling was similar to previously reported remodeling observed in several animal models. Grossly, the hypertensive vessels appeared atherosclerotic. Histochemical stains revealed a thick, diffuse neointima in hypertensive vessels compared with normal vessels. Immunohistochemistry demonstrated elastin protein in the neointima and in situ hybridization studies demonstrated tropoelastin mRNA largely in the neointima. Similarly, immunohistochemistry and in situ hybridization detected cellular fibronectin, thrombospondin and type I collagen protein and mRNA within the thickened intima from hypertensive vessels. These studies provide evidence that hypertensive vessels in patients with severe chronic pulmonary hypertension are actively remodeling but that the pattern of remodeling is different from previously described animal models.
在单肺移植时获取了患有不明原因肺动脉高压患者的叶肺动脉，以确定大弹性血管对管腔内压力升高的反应。具体而言，对人类肺动脉进行检查，以确定手术时重塑是否仍在进行，以及重塑是否与先前在几种动物模型中观察到的重塑相似。大体上，高血压血管呈现出动脉粥样硬化。组织化学染色显示，与正常血管相比，高血压血管中有厚的、弥漫性的新内膜。免疫组织化学显示新内膜中有弹性蛋白，原位杂交研究表明原弹性蛋白mRNA主要存在于新内膜中。同样，免疫组织化学和原位杂交在高血压血管增厚的内膜中检测到细胞纤连蛋白、血小板反应蛋白和I型胶原蛋白及其mRNA。这些研究提供了证据，表明严重慢性肺动脉高压患者的高血压血管正在积极重塑，但重塑模式与先前描述的动物模型不同。
