Departments of Clinical & Translational Science and Trauma Surgery, Creighton University Medical Center, Omaha, Nebraska.
Department of Clinical & Translational Science, Creighton University Medical Center, Omaha, Nebraska.
J Surg Res. 2019 Nov;243:460-468. doi: 10.1016/j.jss.2019.06.102. Epub 2019 Aug 1.
Neointimal hyperplasia (NIH) and restenosis after percutaneous transluminal coronary angioplasty (PTCA) and intravascular stenting remain a problem on a long-term basis by causing endothelial denudation and damage to the intima and media. Vascular sterile inflammation has been attributed to the formation of NIH. Cathepsin L (CTSL), a lysosome protease, is associated with diet-induced atherogenesis. Vitamin D regulates the actions and regulatory effects of proteases and protease inhibitors in different cell types. Objectives of this study are to evaluate the modulatory effect of vitamin D on CTSL activity in post-PTCA coronary arteries of atherosclerotic swine.
Yucatan microswine were fed with high-cholesterol atherosclerotic diets. The swine were stratified to receive three diets: (1) vitamin D-deficient diet, (2) vitamin D-sufficient diet, and (3) vitamin D-supplement diet. After 6 mo, PTCA was performed in the left circumflex coronary artery (LCx). After 1 y, angiography and optical coherence tomography imaging were performed, and swine was euthanized. Coronary arteries were embedded in paraffin. Tissue sections were stained with hematoxylin and eosin. Expression of Ki67 and CTSL were evaluated by immunofluorescence.
Increased number of Ki67 + cells were observed in the postangioplasty LCx in vitamin D-deficient compared with vitamin D-sufficient or vitamin D-supplemented swine. Notably, the expression of CTSL was significantly increased in postangioplasty LCx of vitamin D-deficient swine compared with the vitamin D-sufficient or vitamin D-supplemented animal groups.
Increased expression of CTSL correlates with the formation of NIH in the PTCA-injured coronary arteries. However, in the presence of sufficient or supplemented levels of vitamin D in the blood, CTSL expression was significantly reduced.
经皮腔内冠状动脉血管成形术(PTCA)和血管内支架置入后,新生内膜增生(NIH)和再狭窄仍是一个长期存在的问题,会导致内皮细胞剥脱和内膜及中膜损伤。血管无菌性炎症与 NIH 的形成有关。组织蛋白酶 L(CTSL)是一种溶酶体蛋白酶,与饮食诱导的动脉粥样硬化形成有关。维生素 D 调节不同细胞类型中蛋白酶和蛋白酶抑制剂的作用和调节效应。本研究旨在评估维生素 D 对动脉粥样硬化猪 PTCA 后冠状动脉 CTSL 活性的调节作用。
用高胆固醇动脉粥样硬化饮食喂养尤卡坦微型猪。将猪分为三组:(1)维生素 D 缺乏饮食组,(2)维生素 D 充足饮食组,(3)维生素 D 补充饮食组。6 个月后,在左回旋支冠状动脉(LCx)进行 PTCA。1 年后,进行血管造影和光学相干断层扫描成像,并对猪进行安乐死。冠状动脉嵌入石蜡中。组织切片用苏木精和伊红染色。通过免疫荧光评估 Ki67 和 CTSL 的表达。
与维生素 D 充足或补充组相比,维生素 D 缺乏组 PTCA 后 LCx 中 Ki67+细胞数量增加。值得注意的是,与维生素 D 充足或补充组相比,维生素 D 缺乏组 PTCA 后 LCx 中 CTSL 的表达显著增加。
CTSL 的表达增加与 PTCA 损伤冠状动脉中 NIH 的形成相关。然而,在血液中存在足够或补充水平的维生素 D 时,CTSL 的表达显著降低。