Stöhr S, Meyer T, Smolenski A, Kreuzer H, Buchwald A B
Abteilung Kardiologie, Universitätsklinikum Göttingen, Germany.
J Cardiovasc Pharmacol. 1995 May;25(5):782-8. doi: 10.1097/00005344-199505000-00014.
The mechanisms resulting in the high incidence of stenoses of coronary venous bypass grafts are still unclear. Heparin, a potential inhibitor of cellular proliferation, neither inhibits intimal hyperplasia in animal models of vein-to-artery grafting nor prevents graft stenosis when administered to patients. We studied the effects of heparin on cultured pairs of human aortic and venous smooth muscle cells (SMC) obtained during coronary bypass surgery from patients with no history of previous restenosis or graft failure. DNA synthesis was measured as [3H]thymidine incorporation after stimulation with 10% fetal calf serum (FCS). Heparin (100 micrograms/ml) inhibited DNA synthesis of aortic SMC to 64 +/- 14% (mean +/- SEM), whereas it stimulated DNA synthesis of venous SMC to 136 +/- 23% (10% FCS alone = 100%; p = 0.01, Wilcoxon signed-rank test, n = 7). Binding studies with [3H]heparin showed no significant differences of Kd values and number of binding sites per cell between SMC derived from aorta or vein that could account for the lack of heparin inhibition of venous SMC DNA synthesis. These data suggest an inherent difference in the heparin susceptibility that may explain the failure of heparin to inhibit intimal proliferation in vein grafts.
导致冠状动脉静脉搭桥移植物狭窄发生率高的机制仍不清楚。肝素是一种潜在的细胞增殖抑制剂,在动静脉移植动物模型中既不能抑制内膜增生,在用于患者时也不能预防移植物狭窄。我们研究了肝素对在冠状动脉搭桥手术期间从无既往再狭窄或移植物失败病史的患者获取的人主动脉和静脉平滑肌细胞(SMC)培养对的影响。用10%胎牛血清(FCS)刺激后,通过[3H]胸苷掺入法测量DNA合成。肝素(100微克/毫升)将主动脉SMC的DNA合成抑制至64±14%(平均值±标准误),而它将静脉SMC的DNA合成刺激至136±23%(单独使用10%FCS时=100%;p = 0.01,Wilcoxon符号秩检验,n = 7)。用[3H]肝素进行的结合研究表明,源自主动脉或静脉的SMC之间的Kd值和每个细胞的结合位点数没有显著差异,这可以解释肝素对静脉SMC DNA合成缺乏抑制作用的原因。这些数据表明肝素敏感性存在内在差异,这可能解释了肝素无法抑制静脉移植物内膜增殖的原因。