Foegh M L, Khirabadi B S, Chambers E, Amamoo S, Ramwell P W
Department of Surgery, Georgetown University Medical Center, Washington, DC 20007.
Atherosclerosis. 1989 Aug;78(2-3):229-36. doi: 10.1016/0021-9150(89)90228-1.
Accelerated coronary atherosclerosis of cardiac allograft occurs in 30-40% of cardiac transplant patients and remains an unsolved clinical problem. The etiology is unknown and anti-platelet drugs are used without conspicuous success. The inhibitory effect of the octapeptide, angiopeptin on coronary atherosclerosis was studied in a previously described rabbit heterotopic cardiac transplant model where allograft rejection is prevented by daily administration of cyclosporin A (CsA, 10 mg/kg per day s.c.). Twenty male New Zealand white rabbits (2.6-2.8 kg) received a heterotopic cardiac transplant from rabbits of the same strain. Donors and recipients were fed a 0.5% cholesterol diet 1 week prior to transplantation which was continued for the recipient until death 6 weeks later. The control group (n = 16) received CsA and saline injections twice daily and the treatment group (n = 4) received CsA and angiopeptin (60 micrograms/rabbit daily s.c.) in 2 divided doses. The treatment began after completion of the transplantation. Coronary artery transplant atherosclerosis was uniformly distributed (tubular) in the entire length of the coronary arteries. Angiopeptin inhibited the intimal hyperplasia in the transplanted heart from 47.5 +/- 2.4% (mean +/- SE) to 25.0 +/- 6.9% and in the native heart from 24.2 +/- 1.4% to 15.7 +/- 1.5%. The intimal hyperplasia is expressed as area of intimal hyperplasia/total vessel area x 100%. A similar inhibition by angiopeptin was seen in lipid deposition in the donor ascending aorta which is transplanted with the heart. Angiopeptin attenuated significantly the hyperplasia and the lipid deposition of the native coronary arteries and aorta but to a lesser extent.(ABSTRACT TRUNCATED AT 250 WORDS)
心脏移植患者中,30%-40%会出现心脏移植冠状动脉粥样硬化加速的情况,这仍是一个尚未解决的临床问题。其病因不明,使用抗血小板药物也未取得显著成效。在先前描述的兔异位心脏移植模型中,研究了八肽血管肽素对冠状动脉粥样硬化的抑制作用,该模型通过每日皮下注射环孢素A(CsA,10mg/kg/天)预防同种异体移植排斥反应。20只雄性新西兰白兔(2.6-2.8kg)接受了同品系兔的异位心脏移植。供体和受体在移植前1周喂食0.5%胆固醇饮食,并持续至受体6周后死亡。对照组(n = 16)每日接受两次CsA和生理盐水注射,治疗组(n = 4)每日分两次接受CsA和血管肽素(60μg/兔/天皮下注射)。治疗在移植完成后开始。冠状动脉移植粥样硬化在冠状动脉全长呈均匀分布(管状)。血管肽素将移植心脏的内膜增生从47.5±2.4%(平均值±标准误)抑制至25.0±6.9%,将天然心脏的内膜增生从24.2±1.4%抑制至15.7±1.5%。内膜增生以内膜增生面积/血管总面积×100%表示。在与心脏一起移植的供体升主动脉脂质沉积中也观察到血管肽素的类似抑制作用。血管肽素显著减轻了天然冠状动脉和主动脉的增生及脂质沉积,但程度较轻。(摘要截断于250字)