Conrad Jobst Vascular Research Laboratory, Section of Vascular Surgery, Department of Surgery, University of Michigan Medical School, Boston MA, United States.
Thromb Res. 2013 Sep;132(3):360-6. doi: 10.1016/j.thromres.2013.06.027. Epub 2013 Aug 24.
Post thrombotic syndrome therapy is primarily palliative, and the associated vein wall inflammatory mechanisms are unclear. Vein wall fibrotic injury following deep venous thrombosis (VT) is associated with elevated matrix metalloproteinases (MMPs). Whether and by what mechanism MMP9 directly contributes to vein wall remodeling after VT is unknown.
WT and MMP9 -/- mice underwent stasis VT by ligation of the inferior vena cava (IVC) and tissue was harvested at 2, 8, and 21days. Assessment of thrombus size, and gene, protein and structural vein wall determinations were done.
VT resolution was increased in MMP9-/- mice as compared with controls at 21d only. The primary phenotypic fibrotic vein wall differences occurred at 8d post VT, with significantly less vein wall collagen content as assessed by Picosirius red staining in MMP9 -/- mice as compared with WT. Increased monocytic vein wall influx with less IL-1b and TGFb was found in MMP9 -/- vein walls as compared with WT. Corresponding levels of PAI-1 were increased in MMP9 -/- compared with WT, and no difference in FSP-1+cells as compared with controls.
In stasis VT, MMP9 modulates midterm vein wall collagen content, with an altered local inflammatory and profibrotic environment, likely directed by monocytes. Thus, MMP9 plays a role in both vein wall responses as well as late thrombus resolution.
血栓后综合征的治疗主要是姑息性的,其相关的静脉壁炎症机制尚不清楚。深静脉血栓形成(VT)后静脉壁纤维化损伤与基质金属蛋白酶(MMPs)升高有关。MMP9 是否以及通过什么机制直接导致 VT 后静脉壁重塑尚不清楚。
WT 和 MMP9-/- 小鼠通过结扎下腔静脉(IVC)发生淤滞性 VT,并在 2、8 和 21 天采集组织。评估血栓大小以及基因、蛋白和静脉壁结构的测定。
与对照组相比,仅在 21 天时 MMP9-/- 小鼠的 VT 消退增加。主要的表型纤维化静脉壁差异发生在 VT 后 8 天,与 WT 相比,MMP9-/- 小鼠的静脉壁胶原含量明显减少,通过天狼星红染色评估。与 WT 相比,MMP9-/- 静脉壁中单核细胞静脉壁内流增加,IL-1b 和 TGFb 减少。与 WT 相比,MMP9-/- 中的 PAI-1 水平增加,与对照组相比,FSP-1+细胞无差异。
在淤滞性 VT 中,MMP9 调节中期静脉壁胶原含量,同时改变局部炎症和促纤维化环境,可能由单核细胞介导。因此,MMP9 既参与静脉壁反应,也参与晚期血栓溶解。