Jeremy J Y, Dashwood M R, Timm M, Izzat M B, Mehta D, Bryan A J, Angelini G D
Bristol Heart Institute, University of Bristol, United Kingdom.
Ann Thorac Surg. 1997 Feb;63(2):470-6. doi: 10.1016/s0003-4975(96)01144-7.
A high proportion of autologous saphenous vein grafts occlude as the result of intimal thickening. Blood vessels synthesize substances that may inhibit such intimal thickening. These include cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), which are stimulated by prostacyclin and nitric oxide, respectively. The prostacyclin-cAMP and nitric oxide-cGMP axes were therefore investigated in porcine vein grafts.
Saphenous vein-carotid artery interposition graft procedures were carried out in pigs. One month after the operation, ungrafted saphenous veins, vein grafts, and carotid arteries were excised, the formation of cAMP and cGMP was assessed by radioimmunoassay, and the nitric oxide synthase content was determined by autoradiography.
The formation of cAMP and nitroprusside-stimulated cGMP was significantly diminished in vein grafts compared with ungrafted saphenous veins and carotid arteries. Calimycin-stimulated cGMP synthesis (nitric oxide release dependent) and the endothelial nitric oxide synthase content (autoradiography) were significantly elevated in vein grafts compared with ungrafted saphenous veins but were significantly less than those in carotid arteries.
Adenylyl and guanylyl cyclase activity are down-regulated in vein grafts, which may contribute to the development of intimal and medial thickening. Nitric oxide release and endothelial nitric oxide synthase content are up-regulated in vein grafts, which is indicative of an adaptation to the arterial conditions of shear stress and pulsatile pressure.
由于内膜增厚,很大一部分自体隐静脉移植物会发生闭塞。血管会合成一些可能抑制这种内膜增厚的物质。这些物质包括环磷酸腺苷(cAMP)和环磷酸鸟苷(cGMP),它们分别由前列环素和一氧化氮刺激产生。因此,对猪静脉移植物中的前列环素 - cAMP轴和一氧化氮 - cGMP轴进行了研究。
在猪身上进行隐静脉 - 颈动脉间置移植手术。术后1个月,切除未移植的隐静脉、静脉移植物和颈动脉,通过放射免疫测定法评估cAMP和cGMP的生成,并通过放射自显影法测定一氧化氮合酶含量。
与未移植的隐静脉和颈动脉相比,静脉移植物中cAMP的生成以及硝普钠刺激的cGMP生成显著减少。与未移植的隐静脉相比,静脉移植物中钙霉素刺激的cGMP合成(依赖一氧化氮释放)和内皮型一氧化氮合酶含量(放射自显影)显著升高,但显著低于颈动脉中的水平。
静脉移植物中的腺苷酸环化酶和鸟苷酸环化酶活性下调,这可能导致内膜和中膜增厚。静脉移植物中一氧化氮释放和内皮型一氧化氮合酶含量上调,这表明对剪切应力和搏动压力的动脉条件有适应性变化。