School of Medical Sciences, Faculty of Health and Medicine, Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW, 2006, Australia.
Adv Sci (Weinh). 2023 Jul;10(20):e2300521. doi: 10.1002/advs.202300521. Epub 2023 May 7.
Minimally invasive interventions using drug-eluting stents or balloons are a first-line treatment for certain occlusive cardiovascular diseases, but the major long-term cause of failure is neointimal hyperplasia (NIH). The drugs eluted from these devices are non-specific anti-proliferative drugs, such as paclitaxel (PTX) or sirolimus (SMS), which do not address the underlying inflammation. MCC950 is a selective inhibitor of the NLRP3-inflammasome, which drives sterile inflammation commonly observed in NIH. Additionally, in contrast to broad-spectrum anti-inflammatory drugs, MCC950 does not compromise global immune function due this selective activity. In this study, MCC950 is found to not impact the viability, integrity, or function of human coronary endothelial cells, in contrast to the non-specific anti-proliferative effects of PTX and SMS. Using an in vitro model of NLRP3-mediated inflammation in murine macrophages, MCC950 reduced IL-1β expression, which is a key driver of NIH. In an in vivo mouse model of NIH in vascular grafts, MCC950 significantly enhanced re-endothelialization and reduced NIH compared to PTX or SMS. These findings show the effectiveness of a targeted anti-inflammatory drug-elution strategy with significant implications for cardiovascular device intervention.
使用载药支架或球囊的微创介入治疗是某些闭塞性心血管疾病的一线治疗方法,但主要的长期失败原因是新生内膜增生(NIH)。这些设备洗脱的药物是非特异性抗增殖药物,如紫杉醇(PTX)或西罗莫司(SMS),它们不能解决潜在的炎症问题。MCC950 是 NLRP3 炎性小体的选择性抑制剂,可驱动 NIH 中常见的无菌性炎症。此外,与广谱抗炎药不同,由于这种选择性活性,MCC950 不会损害全身免疫功能。在这项研究中,与 PTX 和 SMS 的非特异性抗增殖作用相反,MCC950 对人冠状动脉内皮细胞的活力、完整性或功能没有影响。在体外 NLRP3 介导的炎症的小鼠巨噬细胞模型中,MCC950 降低了 IL-1β 的表达,这是 NIH 的关键驱动因素。在血管移植物中 NIH 的体内小鼠模型中,与 PTX 或 SMS 相比,MCC950 显著增强了再内皮化并减少了 NIH。这些发现表明靶向抗炎药物洗脱策略的有效性,对心血管器械干预具有重要意义。