Malinska Agnieszka, Podemska Zuzanna, Sujka-Kordowska Patrycja, Witkiewicz Wojciech, Nowicki Michal, Perek Bartlomiej, Witt Martin
Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland.
Regional Specialized Hospital in Wroclaw, Wroclaw, Poland.
Interact Cardiovasc Thorac Surg. 2017 May 1;24(5):714-720. doi: 10.1093/icvts/ivw411.
Intimal hyperplasia leading to graft failure in patients undergoing coronary artery bypass grafting (CABG) is related to vascular smooth muscle cells (SMCs) proliferation. SMCs respond to a variety of mediators, the most important of which is platelet-derived growth factor (PDGF). The platelet-derived growth factor-induced cellular response has been shown to be mediated by caveolins. The aim of this study was to analyze CAV1-3 expression in internal thoracic artery (ITA) grafts used in CABG and correlate their expression with graft occlusion.
Six hundred patients undergoing CABG with the use of ITA grafts between 2008 and 2014 were enrolled into this prospective study. CAV1-3 expression in the ITA grafts was analyzed prior to graft transplantation into the coronary circulation via immunohistochemistry. Estimated caveolins expression pattern was then correlated with the occurrence of ITA graft failure observed within 24-months of surgery.
Thirty-four patients developed ITA graft failure (subgroup A) and 566 study participants presented no adverse events (subgroup B). CAV1 and CAV3 expression levels in SMCs of the tunica media of the ITA grafts did not differ between the study subgroups and were not associated with the risk of graft failure. CAV2 was expressed within SMCs of the ITA grafts in 94.1% of the patients from subgroup A and 2.5% from subgroup B, and its expression was associated with ITA graft occlusion observed within 24-months after CABG.
CAV2 expression in SMCs of the tunica media in autologous ITA transplants might indicate the risk of graft failure.
冠状动脉旁路移植术（CABG）患者中导致移植物失败的内膜增生与血管平滑肌细胞（SMC）增殖有关。SMC对多种介质有反应，其中最重要的是血小板衍生生长因子（PDGF）。血小板衍生生长因子诱导的细胞反应已被证明是由小窝蛋白介导的。本研究的目的是分析CABG中使用的胸廓内动脉（ITA）移植物中CAV1 - 3的表达，并将它们的表达与移植物闭塞相关联。
纳入2008年至2014年间600例使用ITA移植物进行CABG的患者进行这项前瞻性研究。在将ITA移植物移植到冠状动脉循环之前，通过免疫组织化学分析ITA移植物中CAV1 - 3的表达。然后将估计的小窝蛋白表达模式与手术24个月内观察到的ITA移植物失败的发生情况相关联。
34例患者出现ITA移植物失败（A组），566名研究参与者未出现不良事件（B组）。ITA移植物中膜层SMC中CAV1和CAV3的表达水平在研究亚组之间没有差异，并且与移植物失败的风险无关。在A组94.1%的患者和B组2.5%的患者的ITA移植物的SMC中表达CAV2，其表达与CABG后24个月内观察到 的ITA移植物闭塞相关。
自体ITA移植物中膜层SMC中CAV2的表达可能表明移植物失败的风险。
