Effectiveness of Triptolide-Coated Stent on Decreasing Inflammation and Attenuation of Intimal Hyperplasia in a Pig After Coronary Angioplasty

Abstract

Objective: The study is to test the efficacy of triptolide-coated stent on anti-inflammatory and inhibiting intimal hyperplasia in preventing restenosis. Methods: A total of 15 triptolide-coated stents (TCSs), 12 drug-eluting stents (DESs), and 12 bare metal stents (BMSs) were deployed in porcine coronary arteries. Coronary angiography, histopathologic and inflammatory markers levels were analyzed at 4 week after stenting. Results: At 4-week follow-up, quantitative coronary angiography (QCA) showed that minimum lumen diameter was greater, and percentage stenosis and late lumen loss in TCS group and DES group were less than that of BMS group. Compared to BMS group, injury and inflammation score in TCS group and DES group were decreased, neointimal area significantly reduced and lumen area enlarged in TCS, DES group as well. Conclusion: Triptolide-coated stent showed the effect of preventing restenosis via inhibition of neointimal hyperplasia and anti-inflammation acts after coronary angioplasty.

Keywords

inflammation neointimal hyperplasia triptolide restenosis stent

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References

Patel HJ , Su SH , Patterson C. , Nguyen KT A combined strategy to reduce restenosis for vascular tissue engineering . Biotechnol Prog. 2006;22(1):38-44.

Sopko G. Preventing cardiac events and restenosis after percutaneous coronary intervention . JAMA. 2002;287(24):3259-3261.

Forrester JS , Fishbein M. , Helfant R. , Fagin J. A paradigm for restenosis based on cell biology: clues for the development of new preventive therapies. J Am Coll Cardiol. 1991;17(3):758-769.

Austin GE , Ratliff NB , Hollman J. , Tabei S. , Phillips DF Intimal proliferation of smooth muscle cells as an explanation for recurrent coronary artery stenosis after percutaneous transluminal coronary angioplasty . J Am Coll Cardiol. 1985;6(2):369-375.

Giraldo AA , Esposo OM , Meis JM Intimal hyperplasia as a cause of restenosis after percutaneous transluminal coronary angioplasty. Arch Pathol Lab Med. 1985;109(2):173-175.

Ahn YK , Jeong MH , Kim JW , et al. Preventive effects of the heparincoated stent on restenosis in the porcine model. Catheter Cardiovasc Interv. 1999;48(3):324-330.

Gallo R. , Padurean A. , Jayaraman T. , et al. Inhibition of intimal thickening after balloon angioplasty in porcine coronary arteries by targeting regulators of the cell cycle. Circulation. 1999; 99(16):2164-2170.

Versaci F. , Gaspardone A. Prevention of restenosis after stenting: the emerging role of inflammation . Coron Artery Dis. 2004;15(6): 307-311.

Morice MC , Serruys PW , Sousa JE , et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med . 2002;346(23):1773-1780.

10.

Gogo PB Jr , Schneider DJ , Watkins MW , Terrien EF , Sobel BE , Dauerman HL Systemic inflammation after drug-eluting stent placement. J Thromb Thrombolysis . 2005;19(2):87-92.

11.

Welt FGP , Rogers C. Inflammation and restenosis in the stent era. Arterioscler Thromb Vasc Biol. 2002;22(11):1769-1776.

12.

Toutouzas K. , Colombo A. , Stefanadis C. Inflammation and restenosis after percutaneous coronary interventions. Eur Heart J. 2004;25(19):1679-1687.

13.

Jun M. , Dey M. , Yang H. , et al. Anti-inflammatory and immunosuppressive compounds from Tripterygium wilfordii. Phytochemistry. 2007;68(8):1172-1178.

14.

Schwartz RS , Huber KC , Murphy JG , et al. Restenosis and the proportional neointimal response to coronary artery injury: results in a porcine model. J Am Coll Cardiol. 1992 ;19(2):267-274.

15.

Mintz GS , Popma JJ , Pichard AD , et al. Arterial remodeling after coronary angioplasty: a serial intravascular ultrasound study. Circulation. 1996;94(1):35-43.

16.

Nakatani M. , Takeyama Y. , Shibata M. , et al. Mechanisms of restenosis after coronary intervention; difference between plane old balloon angioplasty and stenting . Cardiovasc Pathol. 2003;12: 40-48.

17.

Carter AJ , Laird JR , Farb A. , Kufs W. , Wortham DC , Virmani R. Morphologic characteristics of lesion formation and time course of smooth muscle cell proliferation in a porcine proliferative restenosis model . J Am Coll Cardiol. 1994;24(5):1398-1405.

18.

Farb A. , Weber DK , Kolodgie FD , Burke AP , Virmani R. Morphological predictors of restenosis after coronary stenting in humans. Circulation. 2002;105(25):2974-2980.

19.

Schwartz RS , Chronos NA , Virmani R. Preclinical restenosis models and drug-eluting stents: still important, still much to learn. J Am Coll Cardiol . 2004;44(7):1373-1385.

20.

Ge H. , Zhou Y. , Hanying M. , et al. Influence of drug-eluting stent on inflammation during restenosis in a porcine coronary model. Acta Cardiol. 2010;65(1):31-35.

21.

Wu Y. , Cui J. , Bao X. , et al. Triptolide attenuate oxidative stress, NF-kappaB activation and multiple cytokine gene expression in murine peritoneal macrophage. Int J Mol Med. 2006;17(1): 141-150.

22.

Lu Y. , Fukuda K. , Nakamura Y. , Kimura K. , Kumagai N. , Nishida T. Inhibitory effect of triptolide on chemokine expression induced by proinflammatory cytokines in human corneal fibroblasts. Invest Ophthalmol Vis Sci. 2005;46(7):2346-2352.