支架对切应力的影响:与内皮损伤和修复的相关性。

The effects of stenting on shear stress: relevance to endothelial injury and repair.

机构信息

Biomedical Engineering, Department Cardiology, ErasmusMC, Rotterdam, The Netherlands.

出版信息

Cardiovasc Res. 2013 Jul 15;99(2):269-75. doi: 10.1093/cvr/cvt090. Epub 2013 Apr 15.

Abstract

Stent deployment following balloon angioplasty is used routinely to treat coronary artery disease. These interventions cause damage and loss of endothelial cells (EC), and thus promote in-stent thrombosis and restenosis. Injured arteries are repaired (intrinsically) by locally derived EC and by circulating endothelial progenitor cells which migrate and proliferate to re-populate denuded regions. However, re-endothelialization is not always complete and often dysfunctional. Moreover, the molecular and biomechanical mechanisms that control EC repair and function in stented segments are poorly understood. Here, we propose that stents modify endothelial repair processes, in part, by altering fluid shear stress, a mechanical force that influences EC migration and proliferation. A more detailed understanding of the biomechanical processes that control endothelial healing would provide a platform for the development of novel therapeutic approaches to minimize damage and promote vascular repair in stented arteries.

摘要

球囊血管成形术后的支架置入术通常用于治疗冠状动脉疾病。这些介入会导致内皮细胞(EC)的损伤和丢失,从而促进支架内血栓形成和再狭窄。受损的动脉通过局部来源的 EC 和循环内皮祖细胞进行修复(内在修复),这些细胞迁移和增殖以重新填充裸露区域。然而,再内皮化并不总是完全的,而且往往功能失调。此外,控制支架段 EC 修复和功能的分子和生物力学机制还知之甚少。在这里,我们提出支架通过改变影响 EC 迁移和增殖的流体切应力来改变内皮修复过程,这是一种机械力。更详细地了解控制内皮愈合的生物力学过程将为开发新的治疗方法提供一个平台,以最大限度地减少损伤并促进支架血管的血管修复。

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