Tesfamariam Belay
Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research, FDA, 10903 New Hampshire Ave, Bldg 22, Rm 4176, Silver Spring, MD, 20993, USA.
J Cardiovasc Transl Res. 2016 Apr;9(2):91-101. doi: 10.1007/s12265-016-9677-1. Epub 2016 Jan 21.
Coronary artery intervention using device implants significantly reduce the risk of restenosis and the need for revascularization but are associated with endothelial denudation and impaired function. This may be due to incomplete endothelial recovery as a result of intimal injury, presence of polymer and/or high antiproliferative drug accumulation in the intima. The permanent presence of a metal prosthesis or polymer may impair the proliferation of resident endothelial cells to cover empty areas. Attention has focused on the robust replenishment of endothelial monolayer by recruitment of circulating endothelial progenitor cells derived from the bone marrow to areas of endothelial injury. The balance between endothelial damage and repair is critical for the maintenance of intimal integrity, function, and prevention of thrombotic complications. This review will discuss on the aftereffects of intravascular device implants on endothelial injury and the pathways involved in endothelial repair and regeneration with an emphasis on endothelial progenitor cells.
使用器械植入物进行冠状动脉介入治疗可显著降低再狭窄风险和血管重建需求,但会导致内皮剥脱和功能受损。这可能是由于内膜损伤导致内皮恢复不完全、聚合物的存在和/或内膜中抗增殖药物的高积累。金属假体或聚合物的长期存在可能会损害驻留内皮细胞的增殖,从而无法覆盖空白区域。人们的注意力集中在通过募集源自骨髓的循环内皮祖细胞到内皮损伤区域,来强力补充内皮单层。内皮损伤与修复之间的平衡对于维持内膜完整性、功能以及预防血栓并发症至关重要。本综述将讨论血管内器械植入对内皮损伤的后遗症,以及内皮修复和再生所涉及的途径,重点是内皮祖细胞。