载固定化抗炎趋化素 15 肽的血管支架减轻血管内膜增生并加速血管愈合。
Vascular stent with immobilized anti-inflammatory chemerin 15 peptides mitigates neointimal hyperplasia and accelerates vascular healing.
机构信息
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610065, China.
Stomatologic Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui 230032, China.
出版信息
Acta Biomater. 2024 Apr 15;179:371-384. doi: 10.1016/j.actbio.2024.02.022. Epub 2024 Feb 20.
Endovascular stenting is a safer alternative to open surgery for use in treating cerebral arterial stenosis and significantly reduces the recurrence of ischemic stroke, but the widely used bare-metal stents (BMSs) often result in in-stent restenosis (ISR). Although evidence suggests that drug-eluting stents are superior to BMSs in the short term, their long-term performances remain unknown. Herein, we propose a potential vascular stent modified by immobilizing clickable chemerin 15 (C15) peptides on the stent surface to suppress coagulation and restenosis. Various characterization techniques and an animal model were used to evaluate the surface properties of the modified stents and their effects on endothelial injury, platelet adhesion, and inflammation. The C15-immobilized stent could prevent restenosis by minimizing endothelial injury, promoting physiological healing, restraining the platelet-leukocyte-related inflammatory response, and inhibiting vascular smooth muscle cell proliferation and migration. Furthermore, in vivo studies demonstrated that the C15-immobilized stent mitigated inflammation, suppressed neointimal hyperplasia, and accelerated endothelial restoration. The use of surface-modified, anti-inflammatory, endothelium-friendly stents may be of benefit to patients with arterial stenosis. STATEMENT OF SIGNIFICANCE: Endovascular stenting is increasingly used for cerebral arterial stenosis treatment, aiming to prevent and treat ischemic stroke. But an important accompanying complication is in-stent restenosis (ISR). Persistent inflammation has been established as a hallmark of ISR and anti-inflammation strategies in stent modification proved effective. Chemerin 15, an inflammatory resolution mediator with 15-aa peptide, was active at picomolar through cell surface receptor, no need to permeate cell membrane and involved in resolution of inflammation by inhibiting inflammatory cells adhesion, modulating macrophage polarization into protective phenotype, and reducing inflammatory factors release. The implications of this study are that C15 immobilized stent favors inflammation resolution and rapid re-endothelialization, and exhibits an inhibitory role of restenosis. As such, it helps the decreased incidence of ISR.
血管内支架置入术是治疗脑动脉狭窄的一种较开放手术更为安全的选择,可显著降低缺血性脑卒中的复发率,但广泛应用的裸金属支架(BMS)常导致支架内再狭窄(ISR)。尽管有证据表明,药物洗脱支架在短期内优于 BMS,但它们的长期性能仍不清楚。在这里,我们提出了一种通过在支架表面固定点击化学切梅林 15(C15)肽来抑制凝血和再狭窄的潜在血管支架改性方法。我们使用各种表征技术和动物模型来评估改性支架的表面性能及其对内皮损伤、血小板黏附、炎症的影响。C15 固定支架可以通过最小化内皮损伤、促进生理愈合、抑制血小板-白细胞相关炎症反应以及抑制血管平滑肌细胞增殖和迁移来预防再狭窄。此外,体内研究表明,C15 固定支架减轻了炎症、抑制了新生内膜增生,并加速了内皮修复。使用表面改性、抗炎、内皮友好的支架可能对动脉狭窄患者有益。
意义
血管内支架置入术越来越多地用于治疗脑动脉狭窄,旨在预防和治疗缺血性脑卒中。但一个重要的伴随并发症是支架内再狭窄(ISR)。持续的炎症已被确立为 ISR 的标志,支架修饰中的抗炎策略已被证明是有效的。切梅林 15 是一种含有 15 个氨基酸的炎症消退介质,通过细胞表面受体以皮摩尔级发挥作用,无需穿透细胞膜,并通过抑制炎症细胞黏附、调节巨噬细胞向保护性表型极化以及减少炎症因子释放来参与炎症消退。本研究的意义在于,C15 固定支架有利于炎症消退和快速再内皮化,并表现出抑制再狭窄的作用。因此,它有助于降低 ISR 的发生率。