一种释放雷帕霉素的血管周围聚合物鞘能高效抑制内膜增生。
A rapamycin-releasing perivascular polymeric sheath produces highly effective inhibition of intimal hyperplasia.
作者信息
Yu Xiaohua, Takayama Toshio, Goel Shakti A, Shi Xudong, Zhou Yifan, Kent K Craig, Murphy William L, Guo Lian-Wang
机构信息
Department of Biomedical Engineering, University of Wisconsin, 5009 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA.
Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA.
出版信息
J Control Release. 2014 Oct 10;191:47-53. doi: 10.1016/j.jconrel.2014.05.017. Epub 2014 May 20.
Intimal hyperplasia produces restenosis (re-narrowing) of the vessel lumen following vascular intervention. Drugs that inhibit intimal hyperplasia have been developed, however there is currently no clinical method of perivascular drug-delivery to prevent restenosis following open surgical procedures. Here we report a poly(ε-caprolactone) (PCL) sheath that is highly effective in preventing intimal hyperplasia through perivascular delivery of rapamycin. We first screened a series of bioresorbable polymers, i.e., poly(lactide-co-glycolide) (PLGA), poly(lactic acid) (PLLA), PCL, and their blends, to identify desired release kinetics and sheath physical properties. Both PLGA and PLLA sheaths produced minimal (<30%) rapamycin release within 50days in PBS buffer. In contrast, PCL sheaths exhibited more rapid and near-linear release kinetics, as well as durable integrity (>90days) as evidenced in both scanning electron microscopy and subcutaneous embedding experiments. Moreover, a PCL sheath deployed around balloon-injured rat carotid arteries was associated with a minimum rate of thrombosis compared to PLGA and PLLA. Morphometric analysis and immunohistochemistry revealed that rapamycin-loaded perivascular PCL sheaths produced pronounced (85%) inhibition of intimal hyperplasia (0.15±0.05 vs 1.01±0.16), without impairment of the luminal endothelium, the vessel's anti-thrombotic layer. Our data collectively show that a rapamycin-loaded PCL delivery system produces substantial mitigation of neointima, likely due to its favorable physical properties leading to a stable yet flexible perivascular sheath and steady and prolonged release kinetics. Thus, a PCL sheath may provide useful scaffolding for devising effective perivascular drug delivery particularly suited for preventing restenosis following open vascular surgery.
内膜增生会导致血管介入后血管腔再狭窄(再次变窄)。虽然已经开发出了抑制内膜增生的药物,但目前尚无用于开放手术术后防止再狭窄的血管周围给药的临床方法。在此,我们报告一种聚(ε-己内酯)(PCL)鞘管,其通过血管周围递送雷帕霉素可有效预防内膜增生。我们首先筛选了一系列可生物降解的聚合物,即聚(丙交酯-共-乙交酯)(PLGA)、聚乳酸(PLLA)、PCL及其共混物,以确定所需的释放动力学和鞘管物理性质。在PBS缓冲液中,PLGA和PLLA鞘管在50天内的雷帕霉素释放量均极少(<30%)。相比之下,PCL鞘管表现出更快且接近线性的释放动力学,以及持久的完整性(>90天),这在扫描电子显微镜和皮下包埋实验中均得到证实。此外,与PLGA和PLLA相比,置于球囊损伤大鼠颈动脉周围的PCL鞘管的血栓形成率最低。形态计量分析和免疫组织化学显示,负载雷帕霉素的血管周围PCL鞘管可显著(85%)抑制内膜增生(0.15±0.05对1.01±0.16),且不会损害管腔内皮层(血管的抗血栓层)。我们的数据共同表明,负载雷帕霉素的PCL递送系统可显著减轻新生内膜,这可能是由于其良好的物理性质导致形成稳定而柔韧的血管周围鞘管以及稳定且持久的释放动力学。因此,PCL鞘管可为设计特别适用于防止开放血管手术后再狭窄的有效血管周围药物递送提供有用的支架。