CVPath Institute, Inc, Gaithersburg, Maryland.
JACC Cardiovasc Interv. 2010 Jan;3(1):68-75. doi: 10.1016/j.jcin.2009.09.015.
In this study, we hypothesized that an antihuman-CD34 antibody immobilized on the surface of commercially available sirolimus-eluting stents (SES) could enhance re-endothelialization compared with SES alone.
Previous experience with antihuman-CD34 antibody surface modified Genous stents (GS) (OrbusNeich Medical, Fort Lauderdale, Florida) has shown enhanced stent endothelialization in vivo.
In the phase 1 study, stents were deployed in 21 pig coronary arteries for single stenting (9 vessels: 3 GS, 3 SES, and 3 bare-metal stents) and overlapping stenting with various combinations (12 vessels: 4 GS+GS, 4 SES+SES, and 4 GS+SES) and harvested at 14 days for scanning electron and confocal microscopy. In phase 2, immobilized anti-CD34 antibody coating was applied on commercially available SES (SES-anti-CD34, n = 7) and compared with GS (n = 8) and SES (n = 7) and examined at 3 and 14 days by scanning electron/confocal microscopy analysis.
In phase 1, single stent implantation showed greatest endothelialization in GS (99%) and in bare-metal stent (99%) compared with SES (55%, p = 0.048). In overlapping stents, endothelialization at the overlapping zone was significantly greater in GS+GS (95 +/- 6%) and GS+SES (79 +/- 5%) compared with the SES+SES (36 +/- 14%) group (p = 0.007). In phase 2, SES-anti-CD34 resulted in increased endothelialization compared with SES alone at 3 days (SES-anti-CD34 36 +/- 26%; SES 7 +/- 3%; and GS 76 +/- 8%; p = 0.01), and 14 days (SES-anti-CD34 82 +/- 8%; SES 53 +/- 20%; and GS 98 +/- 2%; p = 0.009).
Immobilization of anti-CD34 antibody on SES enhances endothelialization and may potentially be an effective therapeutic alternative to improve currently available drug-eluting stents.
本研究假设，与单纯使用载有西罗莫司的雷帕霉素洗脱支架（SES）相比，固定于商业 SES 表面的抗人 CD34 抗体可增强再内皮化。
先前对表面修饰的抗人 CD34 抗体的 Genous 支架（GS）（OrbusNeich Medical，佛罗里达州劳德代尔堡）的经验表明，体内支架内皮化得到增强。
在 1 期研究中，将支架部署于 21 头猪冠状动脉中单支架植入（9 支血管：3 支 GS、3 支 SES 和 3 支裸金属支架）和重叠支架植入（12 支血管：4 支 GS+GS、4 支 SES+SES 和 4 支 GS+SES），14 天进行扫描电镜和共聚焦显微镜检查。在 2 期，将固定化的抗 CD34 抗体涂层应用于市售 SES（SES-anti-CD34，n=7），并与 GS（n=8）和 SES（n=7）进行比较，在 3 天和 14 天通过扫描电镜/共聚焦显微镜分析进行检查。
在 1 期，单支架植入显示 GS（99%）和裸金属支架（99%）的内皮化程度最高，而 SES（55%）（p=0.048）。在重叠支架中，GS+GS（95±6%）和 GS+SES（79±5%）的重叠区内皮化明显高于 SES+SES（36±14%）组（p=0.007）。在 2 期，SES-anti-CD34 与单纯 SES 相比，在 3 天（SES-anti-CD34 36±26%；SES 7±3%；GS 76±8%；p=0.01）和 14 天（SES-anti-CD34 82±8%；SES 53±20%；GS 98±2%；p=0.009）时内皮化增加。
SES 上固定化的抗 CD34 抗体可增强内皮化，可能是改善现有药物洗脱支架的有效治疗替代方法。
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