新型组合涂层抗CD34抗体应用于西罗莫司洗脱支架的长期影响

Long-Term Effects of Novel Combination Coating Anti-CD34 Antibody Applied on Sirolimus-Eluting Stents.

作者信息

Chen Feng, Yang Feng, Zhao Qian, Feng Shichao, Li Weixiao, Bi Yonghua, Zhang Shixuan, Wang Yang, Feng B O

机构信息

Interventional Radiology Department, The First Affiliated Hospital of China Medical University, Shenyang, China.

Key Laboratory of Medical Imaging and Interventional Radiology, Shenyang, China.

出版信息

J Interv Cardiol. 2015 Jun;28(3):257-63. doi: 10.1111/joic.12208. Epub 2015 May 20.

DOI:10.1111/joic.12208

PMID:25989965

Abstract

OBJECTIVES

We investigated whether the combination coating of a novel "prohealing coating" hyaluronan-chitosan (HC) and anti-CD34 antibody applied on an SES (HCASES) can reduce neointimal formation while promoting endothelialization compared to either agent alone.

BACKGROUND

Drug-eluting stents have considerably reduced the incidence of in-stent restenosis compared with bare metal stents. However, the beneficial effect of drug elution is overshadowed by delayed re-endothelialization as well as later "catch-up" proliferation related to the drug.

METHODS

Three different stents: Sirolimus-eluting stents (SES), Genous anti-CD34 antibody stents (GS), and the combination of HC-anti-CD34 antibody with sirolimus-eluting stents (HCASES) were deployed in 54 normal porcine coronary arteries and harvested for scanning electron microscopy (SEM) and histological analysis at 60, 90, and 120 days.

RESULTS

At 60 and 90 days, SEM analysis showed stent surface endothelial coverage was nearly completed in the HCASES (87 ± 3%, 95 ± 3%) compared with that in the SES (68 ± 6%, 77 ± 8%, P = 0.03). Histological examination at 90 days showed that the HCASES group had less percentage of stenosis than the GS group (P < 0.05). At 120 days, SEM showed a significantly higher extent of endothelial coverage above struts in the HCASES (96 ± 2%) and the GS (95 ± 3%) as compared with the SES group (66 ± 3%; P = 0.02). The HCASES group showed less stenosis than that in the GS group (P < 0.05), but it was not significantly different from the SES group (P = 0.063).

CONCLUSIONS

Histological and SEM analyses demonstrate that the HCASES can reduce neointimal formation and inflammation while promoting endothelialization in the long term.

摘要

目的

我们研究了与单独使用这两种药物相比，将新型“促愈合涂层”透明质酸-壳聚糖（HC）和抗CD34抗体联合应用于药物洗脱支架（SES）（HCASES）上是否能减少新生内膜形成，同时促进内皮化。

背景

与裸金属支架相比，药物洗脱支架已显著降低了支架内再狭窄的发生率。然而，药物洗脱的有益效果被延迟的再内皮化以及与药物相关的后期“追赶性”增殖所掩盖。

方法

将三种不同的支架：西罗莫司洗脱支架（SES）、Genous抗CD34抗体支架（GS）以及HC-抗CD34抗体与西罗莫司洗脱支架的组合（HCASES）植入54条正常猪冠状动脉中，并在60、90和120天时取出进行扫描电子显微镜（SEM）和组织学分析。

结果

在60天和90天时，SEM分析显示，与SES组（68±6%，77±8%，P = 0.03）相比，HCASES组（87±3%，95±3%）的支架表面内皮覆盖几乎完成。90天时的组织学检查显示，HCASES组的狭窄百分比低于GS组（P < 0.05）。在120天时，SEM显示，与SES组（66±3%；P = 0.02）相比，HCASES组（96±2%）和GS组（95±3%）的支架小梁上方内皮覆盖程度显著更高。HCASES组的狭窄程度低于GS组（P < 0.05），但与SES组无显著差异（P = 0.063）。