Haron Nur A'tiqah, Ishak Mohamad Fikeri, Yazid Muhammad Dain, Vijakumaran Ubashini, Ibrahim Roszita, Raja Sabudin Raja Zahratul Azma, Alauddin Hafiza, Md Ali Nur Ayub, Haron Hairulfaizi, Ismail Muhammad Ishamuddin, Abdul Rahman Mohd Ramzisham, Sulaiman Nadiah
Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia.
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia.
J Clin Med. 2024 Aug 14;13(16):4774. doi: 10.3390/jcm13164774.
Coronary artery bypass grafting (CABG) utilizing saphenous vein grafts (SVGs) stands as a fundamental approach to surgically treating coronary artery disease. However, the long-term success of CABG is often compromised by the development of intimal hyperplasia (IH) and subsequent graft failure. Understanding the mechanisms underlying this pathophysiology is crucial for improving graft patency and patient outcomes. : This study aims to explore the potential of an ex vivo model utilizing SVG to investigate IH and re-endothelialization. : A thorough histological examination of 15 surplus SVG procured from CABG procedures at Hospital Canselor Tuanku Muhriz, Malaysia, was conducted to establish their baseline characteristics. : SVGs exhibited a mean diameter of 2.65 ± 0.93 mm with pre-existing IH averaging 0.42 ± 0.13 mm in thickness, alongside an observable lack of luminal endothelial cell lining. Analysis of extracellular matrix components, including collagen, elastin, and glycosaminoglycans, at baseline and after 7 days of ex vivo culture revealed no significant changes in collagen but demonstrated increased percentages of elastin and glycosaminoglycans. Despite unsuccessful attempts at re-endothelialization with blood outgrowth endothelial cells, the established ex vivo SVG IH model underscores the multifaceted nature of graft functionality and patency, characterized by IH presence, endothelial impairment, and extracellular matrix alterations post-CABG. : The optimized ex vivo IH model provides a valuable platform for delving into the underlying mechanisms of IH formation and re-endothelialization of SVG. Further refinements are warranted, yet this model holds promise for future research aimed at enhancing graft durability and outcomes for CAD patients undergoing CABG.
利用大隐静脉移植物（SVG）进行冠状动脉旁路移植术（CABG）是外科治疗冠状动脉疾病的一种基本方法。然而，CABG的长期成功常常受到内膜增生（IH）的发展及随后移植物失败的影响。了解这种病理生理学的潜在机制对于提高移植物通畅率和患者预后至关重要。：本研究旨在探索利用SVG的体外模型来研究IH和再内皮化的潜力。：对从马来西亚敦库穆赫里兹医院的CABG手术中获取的15条多余SVG进行了全面的组织学检查，以确定其基线特征。：SVG的平均直径为2.65±0.93毫米，预先存在的IH平均厚度为0.42±0.13毫米，同时可观察到管腔内缺乏内皮细胞内衬。对包括胶原蛋白、弹性蛋白和糖胺聚糖在内的细胞外基质成分在基线和体外培养7天后的分析显示，胶原蛋白无显著变化，但弹性蛋白和糖胺聚糖的百分比增加。尽管用血液衍生内皮细胞进行再内皮化的尝试未成功，但所建立的体外SVG IH模型强调了移植物功能和通畅性的多方面性质，其特征为CABG后存在IH、内皮损伤和细胞外基质改变。：优化后的体外IH模型为深入研究SVG的IH形成和再内皮化的潜在机制提供了一个有价值的平台。尽管仍需进一步完善，但该模型为未来旨在提高接受CABG的CAD患者移植物耐久性和预后的研究带来了希望。
