Yamada T, Shiraishi R, Taki K, Nakano S, Tokunaga O, Itoh T
Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Japan.
Angiology. 1997 May;48(5):381-90. doi: 10.1177/000331979704800502.
In this study, phenotypic modulation and remodulation of smooth muscle cells and associated intermediate filament expression were demonstrated by means of immunohistochemistry and ultrastructure to understand the development of intimal hyperplasia in aortocoronary saphenous vein grafts. In nongrafted saphenous veins, all smooth muscle cells expressed vimentin and desmin and were of a contractile form. In saphenous vein grafts showing stenotic intimal hyperplasia (luminal stenosis < 75%), expression of desmin was notably lower, whereas that of vimentin was higher. The cells were shown to be of a synthetic phenotype, suggesting modulation from the original contractile form. In saphenous vein grafts showing occlusive intimal hyperplasia (luminal stenosis > 76%), desmin expression in smooth muscle cells was increased again, and such cells were of a contractile form, suggesting remodulation from the synthetic phenotype. Some of the smooth muscle cells of the synthetic phenotype were positive for an antibody against proliferation cell nuclear antigen. Smooth muscle cells of the contractile form were negative for this antibody. The study suggests that smooth muscle cells of synthetic phenotype are highly responsible for "growing" intimal hyperplasia of aortocoronary saphenous vein grafts.
在本研究中，通过免疫组织化学和超微结构方法证实了平滑肌细胞的表型调节和再调节以及相关中间丝的表达，以了解主动脉 - 冠状动脉大隐静脉移植血管内膜增生的发展情况。在未移植的大隐静脉中，所有平滑肌细胞均表达波形蛋白和结蛋白，且呈收缩型。在显示狭窄性内膜增生（管腔狭窄<75%）的大隐静脉移植血管中，结蛋白的表达明显降低，而波形蛋白的表达则升高。这些细胞表现为合成表型，提示从原始收缩型发生了调节。在显示闭塞性内膜增生（管腔狭窄>76%）的大隐静脉移植血管中，平滑肌细胞中结蛋白的表达再次增加，且这些细胞呈收缩型，提示从合成表型发生了再调节。一些合成表型的平滑肌细胞对增殖细胞核抗原抗体呈阳性反应。收缩型平滑肌细胞对该抗体呈阴性反应。该研究表明，合成表型的平滑肌细胞对主动脉 - 冠状动脉大隐静脉移植血管内膜增生的“生长”负有高度责任。
