Hattori Keisuke, Yamanouchi Dai, Banno Hiroshi, Kobayashi Masayoshi, Yamamoto Kiyoto, Kajikuri Junko, Itoh Takeo, Komori Kimihiro
Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-chou, Showa-ku, Nagoya 466-8550, Japan.
J Vasc Surg. 2007 Jul;46(1):116-23. doi: 10.1016/j.jvs.2007.03.044.
Beta-adrenoceptor antagonist celiprolol has been widely used as an effective antihypertensive agent. Some studies reported that celiprolol enhances nitric oxide production. The purpose of the present study is to examine the effects of celiprolol on vein graft intimal hyperplasia and endothelium-dependent nitric oxide (NO)-mediated relaxation.
Japanese white rabbits were randomized to a control group that was fed regular rabbit chow or to a celiprolol group that was fed regular rabbit chow supplemented with 100 mg/body celiprolol sodium. The reversed jugular vein was implanted into the carotid artery. At 2 and 4 weeks after the operation, vein grafts in both groups were harvested, and intimal hyperplasia of the vein grafts was assessed. At 4 weeks after the operation, harvested vein grafts from both the groups were examined on the endothelium-dependent relaxation by application of Ach and were examined to detect for endothelial NO synthase (eNOS) expression and superoxide anion production.
Celiprolol inhibited intimal hyperplasia of carotid interposition-reversed jugular vein grafts 4 weeks after implantation (Intima/media index of celiprolol group, 0.48 +/- 0.01 vs control group, 1.07 +/- 0.08, P < .05) and suppressed cell proliferation in the neointima 2 weeks after implantation. In addition, celiprolol significantly enhanced endothelium-dependent NO-mediated relaxation in the vein graft with no change in eNOS expression and a reduction in superoxide production.
These novel findings clearly demonstrate that beta-adrenoceptor antagonist celiprolol can suppress intimal hyperplasia of the vein graft, which may be due to the enhancement of nitric oxide function through an inhibition of superoxide production. These results strongly support the clinical usefulness of celiprolol administration for preventing intimal hyperplasia of the vein graft after bypass grafting.
β-肾上腺素能受体拮抗剂塞利洛尔已被广泛用作一种有效的抗高血压药物。一些研究报道塞利洛尔可增强一氧化氮的生成。本研究的目的是探讨塞利洛尔对静脉移植物内膜增生以及内皮依赖性一氧化氮(NO)介导的舒张功能的影响。
将日本白兔随机分为对照组,给予常规兔饲料,以及塞利洛尔组,给予添加了100mg/只塞利洛尔钠的常规兔饲料。将颈静脉倒置后植入颈动脉。术后2周和4周,收集两组的静脉移植物,评估静脉移植物的内膜增生情况。术后4周,对两组收集的静脉移植物应用乙酰胆碱检测内皮依赖性舒张功能,并检测内皮型一氧化氮合酶(eNOS)的表达及超氧阴离子的产生。
塞利洛尔抑制了植入后4周的颈动脉间置-颈静脉倒置移植物的内膜增生(塞利洛尔组的内膜/中膜指数为0.48±0.01,对照组为1.07±0.08,P<0.05),并抑制了植入后2周内膜新生内膜中的细胞增殖。此外,塞利洛尔显著增强了静脉移植物中内皮依赖性NO介导的舒张功能,eNOS表达无变化,超氧阴离子生成减少。
这些新发现清楚地表明,β-肾上腺素能受体拮抗剂塞利洛尔可抑制静脉移植物的内膜增生,这可能是由于通过抑制超氧阴离子生成增强了一氧化氮功能。这些结果有力地支持了塞利洛尔给药在预防旁路移植术后静脉移植物内膜增生方面的临床实用性。