Nikol S, Huehns T Y, Weir L, Wight T N, Höfling B
Department of Medicine, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany.
Atherosclerosis. 1998 Jul;139(1):31-9. doi: 10.1016/s0021-9150(98)00050-1.
The restenosis rate in vein bypass grafts is higher than in native coronary arteries, and both the cascade of regulatory factors and the vessel reaction may be altered. In this study, vein bypass atherectomy specimens were classified as primary (n = 10) or restenotic (n = 12). Immunohistochemistry with 11 primary antibodies showed low levels of proliferation in both tissues and similar amounts of extracellular matrix components in both primary and restenotic specimens at the time points at which tissue was removed for clinical reasons. Inflammation appeared increased in restenotic specimens. Using in situ hybridization, transforming growth factor-beta1 messenger RNA was detected in both primary and restenotic tissue, with a trend to higher expression in restenosis (8.4 +/- 5.3 vs. 9.4 +/- 7.4 grains/nucleus) and further increased expression in multiple compared with single restenoses (15.1 +/- 6.1 vs. 5.6 +/- 5.1 grains/nucleus, P < 0.05). Hence, there were no great differences in cell proliferation or extracellular matrix formation between primary and restenosis vein graft tissue, in contrast to previously described findings in arterial tissue. This suggests that primary vein graft tissue is already in a chronic 'restenosis-like' state and subsequent injury creates minimal additional upregulation.
静脉搭桥移植物的再狭窄率高于天然冠状动脉，并且调节因子级联反应和血管反应可能都会发生改变。在本研究中，静脉搭桥斑块旋切术标本被分为原发性（n = 10）或再狭窄性（n = 12）。使用11种一抗进行免疫组织化学检测显示，在因临床原因取出组织的时间点，两种组织中的增殖水平均较低，原发性和再狭窄性标本中的细胞外基质成分含量相似。再狭窄性标本中的炎症似乎有所增加。使用原位杂交技术，在原发性和再狭窄性组织中均检测到转化生长因子-β1信使核糖核酸，再狭窄中的表达有升高趋势（8.4±5.3对9.4±7.4颗粒/细胞核），与单个再狭窄相比，多个再狭窄中的表达进一步增加（15.1±6.1对5.6±5.1颗粒/细胞核，P<0.05）。因此，与先前在动脉组织中描述的结果相反，原发性和再狭窄性静脉移植物组织在细胞增殖或细胞外基质形成方面没有很大差异。这表明原发性静脉移植物组织已经处于慢性“再狭窄样”状态，随后的损伤只会产生最小程度的额外上调。
