Tyagi S C, Kumar S, Cassatt S, Parker J L
Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson 39216-4504, USA.
Can J Physiol Pharmacol. 1996 Aug;74(8):983-95.
Although heart attack is caused by occlusion of a major coronary artery, some patients have occlusion without heart attack because these patients have sufficient collateral circulation to provide an alternate pathway for blood supply to the myocardium at ischemic risk. The growth of new capillary vessels (angiogenesis) and enlargement of preexisting vessels play an important role in the collateral development. We evaluated the hypothesis that extracellular matrix metalloproteinase (MMP) expression is altered in coronary collateral arteries (0.5-1 mm o.d.) isolated from canine hearts 2-4 months after surgical placement of an ameroid occluder around the proximal left circumflex artery (n = 4), during the development of collateral vessels and restructuring new vessels. Histologic studies (hematoxylin and eosin, trichrome, and van Gieson stains) indicated cellular proliferation and increased collagen and elastin content in collateral vessels compared with comparable-sized unoccluded arterial segments of the left anterior descending (LAD) artery. In situ MMP activity of collateral vessels, measured using denatured collagen in the gel matrix, indicated an increase in total MMP activity in the intima of collateral vessels compared with normal LAD vessels. To further identify the type of MMP, tissue homogenates were prepared from collateral and LAD vessels and analyzed by SDS-PAGE zymography. The results suggest induction of gelatinase A and gelatinase B expression in collateral vessels compared with normal LAD tissue, when identical amounts of total protein were loaded onto each lane in the gel. Based on plasminogen-casein zymography, we observed the tissue plasminogen activator level to be increased in collateral vessels. On the basis of immunoblot and mRNA (Northern blot) analyses, we determined that the MMP-1 level was induced in collateral vessels 2 and 4 months after ameroid occlusion. In contrast with MMP-1, the level of TIMP-1 (tissue inhibitor of metelloproteinases) was decreased significantly (p < 0.001) in collateral compared with LAD vessels, suggesting a role for arterial TIMP in anti-angiogenic activity. Collectively, these results suggest that chronic occlusion of a major coronary artery induces upregulation of vascular remodeling mechanisms subserving collateral development. Increased MMP-2 activity in collaterals may be associated with decreased levels of tissue inhibitor of metalloproteinases and fibrous tissue remodeling following angiogenic and (or) adaptive responses of the myocardium to chronic ischemia.
虽然心脏病发作是由主要冠状动脉阻塞引起的,但一些患者虽有血管阻塞却未发生心脏病发作,因为这些患者有足够的侧支循环,可为有缺血风险的心肌提供替代的血液供应途径。新毛细血管(血管生成)的生长和现有血管的扩张在侧支循环发育中起重要作用。我们评估了这样一个假设:在左回旋支动脉近端周围手术植入阿梅里德阻塞器2 - 4个月后(n = 4),从犬心脏分离出的冠状动脉侧支(外径0.5 - 1毫米)在侧支血管发育和新血管重构过程中,细胞外基质金属蛋白酶(MMP)表达会发生改变。组织学研究(苏木精和伊红染色、三色染色及范吉森染色)表明,与左前降支(LAD)动脉同等大小的未阻塞动脉段相比,侧支血管中有细胞增殖,且胶原蛋白和弹性蛋白含量增加。使用凝胶基质中的变性胶原蛋白测量侧支血管的原位MMP活性,结果表明与正常LAD血管相比,侧支血管内膜中的总MMP活性增加。为了进一步确定MMP的类型,从侧支血管和LAD血管制备组织匀浆,并通过SDS - PAGE酶谱法进行分析。结果表明,当在凝胶的每个泳道上加载等量的总蛋白时,与正常LAD组织相比,侧支血管中明胶酶A和明胶酶B的表达有所诱导。基于纤溶酶原 - 酪蛋白酶谱法,我们观察到侧支血管中的组织纤溶酶原激活剂水平升高。基于免疫印迹和mRNA(Northern印迹)分析,我们确定在阿梅里德阻塞后2个月和4个月,侧支血管中MMP - 1水平被诱导。与MMP - 1相反,与LAD血管相比,侧支血管中TIMP - 1(金属蛋白酶组织抑制剂)水平显著降低(p < 0.001),这表明动脉TIMP在抗血管生成活性中起作用。总体而言,这些结果表明,主要冠状动脉的慢性阻塞会诱导有助于侧支循环发育的血管重塑机制上调。侧支血管中MMP - 2活性增加可能与金属蛋白酶组织抑制剂水平降低以及心肌对慢性缺血的血管生成和(或)适应性反应后的纤维组织重塑有关。