血管外膜在血管成形术后再狭窄中的作用

The role of adventitia in the formation of restenosis after angioplasty

血管成形术是治疗血管狭窄、改善患者生活质量的重要手段。然而血管成形术可能会导致内膜过度增生,血管成形术再狭窄已成为临床严重问题。血管外膜由多种类型细胞组成,与血管成形术后再狭窄密切相关。血管损伤后激活的外膜成纤维细胞(AF)可转化为肌成纤维细胞(MF)并向内膜迁移,同时促进产生各种细胞因子和炎性分子,而AF衍生的活性氧(ROS)引起的氧化应激也会参与血管炎症,这一炎性反应加剧了血管再狭窄。炎性微环境下,祖细胞分化加剧,脂肪细胞功能失调,引起细胞增殖。本文首次综述了几种外膜细胞如AF、炎性细胞、祖细胞和脂肪细胞在血管成形术后血管重构和内膜增殖中的关键作用。

Angioplasty is an important means for treating vascular stenosis and improving the quality of life of patients.However,angioplasty may induce excessive intimal hyperplasia and post-angioplasty restenosis has become a serious clinical issue.The vascular adventitia is composed of multiple types of cells,which is closely related to the vascular restenosis after angioplasty.The adventitial fibroblasts(AF)activated by vascular injury can transform into myofibroblasts(MF)and migrate to the intima,promoting the production of various cytokines and inflammatory molecules,besides,oxidative stress that is induced by AF-derived reactive oxygen species(ROS)is also involved in the vascular inflammation response,which exacerbates the vascular restenosis.In the inflammatory microenvironment,the differentiation of progenitor cells becomes intensified and the adipocytes are malfunctioned,resulting in the proliferation of cells.This paper aims,for the first time,to make a detailed review about the critical roles of several adventitial cells,including AF,inflammatory cells,progenitors and adipocytes,in the vascular remodeling and intimal proliferation after angioplasty.