目的探讨支架涂层复合物紫杉醇水蛭素对脂多糖(LPS)诱导人冠状动脉平滑肌细胞(HCASMC)炎性活化过程中核转录因子NF-κ B p65及其下游炎症因子表达的影响。方法选用4~6代的HCASMC,将细胞分为空白对照组(正常HCASMC,未做任何处理)、LPS模...目的探讨支架涂层复合物紫杉醇水蛭素对脂多糖(LPS)诱导人冠状动脉平滑肌细胞(HCASMC)炎性活化过程中核转录因子NF-κ B p65及其下游炎症因子表达的影响。方法选用4~6代的HCASMC,将细胞分为空白对照组(正常HCASMC,未做任何处理)、LPS模型组(LPS干预)、紫杉醇水蛭素高浓度组(1μmol/L紫杉醇+0.2 mg/ml水蛭素+LPS干预)、紫杉醇水蛭素低浓度组(1μmol/L紫杉醇+0.0125 mg/ml水蛭素+LPS干预)。每组设置3个复孔。ELISA法检测细胞上清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和白介素-1β(IL-1β)的表达水平,用Q-PCR法对各组细胞NF-κ B p65、TNF-α、IL-6和IL-1βm RNA进行检测,用Western Blotting检测NF-κ B p65蛋白表达水平。结果与空白对照组比较,LPS模型组NF-κ B p65、TNF-α、IL-6和IL-1β的m RNA表达水平明显升高,差异有统计学意义(P均<0.05);HCASMC经高、低浓度紫杉醇水蛭素复合物预处理,LPS刺激后,上述指标低于LPS模型组,差异有统计学意义(P均<0.05)。LPS模型组NF-κ B p65蛋白表达水平明显高于空白对照组,而紫杉醇水蛭素预处理组NF-κ B p65蛋白表达水平较LPS模型组明显降低,其中高浓度处理组降低更为显著。与空白对照组比较,LPS模型组TNF-α、IL-1β和IL-6表达水平升高,差异有统计学意义(P均<0.05)。与LPS模型组比较,紫杉醇水蛭素低浓度与高浓度组TNF-α、IL-1β和IL-6水平明显降低,差异有统计学意义(P均<0.05)。其中高浓度紫杉醇水蛭素干预后IL-1β表达下降较低浓度更为显著,差异有统计学意义(P<0.05)。结论紫杉醇水蛭素支架涂层复合物对LPS诱导的HCASMC炎性活化过程中NF-κ B p65的激活具有明显的抑制作用,有效下调核转录因子NF-κ B p65的转录活性,显著抑制下游炎症因子TNF-α、IL-6和IL-1β的表达。展开更多
Background -Although drug-eluting stents(DESs) constitute a major achievement in preventing restenosis, concerns remain regarding the increased inflammatory and thrombogenic responses associated with the polymers used...Background -Although drug-eluting stents(DESs) constitute a major achievement in preventing restenosis, concerns remain regarding the increased inflammatory and thrombogenic responses associated with the polymers used. Recently, we showed that a nonpolymer on-site coating with rapamycin not only is feasible and safe but also leads to a dose-dependent reduction in restenosis. Methods and Results -To assess whether polymer-free stents coated on-site with 2%rapamycin solution are inferior to polymer-based paclitaxel-eluting stents for the prevention of restenosis, we randomly assigned a total of 450 patients with de novo lesions in native coronary vessels, excluding the left main trunk, to either the polymer-free, rapamycin-coated Yukon DES(rapamycin stent) or the polymer-based, paclitaxel-eluting Taxus stent(paclitaxel stent). The primary end point was in-stent late lumen loss. Secondary end points were angiographic restenosis and target lesion revascularization. The study was designed to test the noninferiority of the rapamycin stent compared with the paclitaxel stent with respect to late lumen loss according to a noninferiority margin of 0.13 mm. Follow-up angiography was completed in 81%of the patients. The mean difference in in-stent late lumen loss between the rapamycin-stent group and the paclitaxel-stent group was 0.002 mm, and the upper limit of the 1-sided 95%confidence interval was 0.10 mm(P=0.02 from test for noninferiority). No significant differences were observed regarding angiographic restenosis rates(14.2%with the rapamycin stent and 15.5%with the paclitaxel stent) and target lesion revascularization rates due to restenosis(9.3%in both groups). Conclusions -The polymer-free, rapamycin-coated stent has an antirestenotic effect that is not inferior to that observed with the polymer-based paclitaxel-eluting stent.展开更多
文摘目的探讨支架涂层复合物紫杉醇水蛭素对脂多糖(LPS)诱导人冠状动脉平滑肌细胞(HCASMC)炎性活化过程中核转录因子NF-κ B p65及其下游炎症因子表达的影响。方法选用4~6代的HCASMC,将细胞分为空白对照组(正常HCASMC,未做任何处理)、LPS模型组(LPS干预)、紫杉醇水蛭素高浓度组(1μmol/L紫杉醇+0.2 mg/ml水蛭素+LPS干预)、紫杉醇水蛭素低浓度组(1μmol/L紫杉醇+0.0125 mg/ml水蛭素+LPS干预)。每组设置3个复孔。ELISA法检测细胞上清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和白介素-1β(IL-1β)的表达水平,用Q-PCR法对各组细胞NF-κ B p65、TNF-α、IL-6和IL-1βm RNA进行检测,用Western Blotting检测NF-κ B p65蛋白表达水平。结果与空白对照组比较,LPS模型组NF-κ B p65、TNF-α、IL-6和IL-1β的m RNA表达水平明显升高,差异有统计学意义(P均<0.05);HCASMC经高、低浓度紫杉醇水蛭素复合物预处理,LPS刺激后,上述指标低于LPS模型组,差异有统计学意义(P均<0.05)。LPS模型组NF-κ B p65蛋白表达水平明显高于空白对照组,而紫杉醇水蛭素预处理组NF-κ B p65蛋白表达水平较LPS模型组明显降低,其中高浓度处理组降低更为显著。与空白对照组比较,LPS模型组TNF-α、IL-1β和IL-6表达水平升高,差异有统计学意义(P均<0.05)。与LPS模型组比较,紫杉醇水蛭素低浓度与高浓度组TNF-α、IL-1β和IL-6水平明显降低,差异有统计学意义(P均<0.05)。其中高浓度紫杉醇水蛭素干预后IL-1β表达下降较低浓度更为显著,差异有统计学意义(P<0.05)。结论紫杉醇水蛭素支架涂层复合物对LPS诱导的HCASMC炎性活化过程中NF-κ B p65的激活具有明显的抑制作用,有效下调核转录因子NF-κ B p65的转录活性,显著抑制下游炎症因子TNF-α、IL-6和IL-1β的表达。
文摘Background -Although drug-eluting stents(DESs) constitute a major achievement in preventing restenosis, concerns remain regarding the increased inflammatory and thrombogenic responses associated with the polymers used. Recently, we showed that a nonpolymer on-site coating with rapamycin not only is feasible and safe but also leads to a dose-dependent reduction in restenosis. Methods and Results -To assess whether polymer-free stents coated on-site with 2%rapamycin solution are inferior to polymer-based paclitaxel-eluting stents for the prevention of restenosis, we randomly assigned a total of 450 patients with de novo lesions in native coronary vessels, excluding the left main trunk, to either the polymer-free, rapamycin-coated Yukon DES(rapamycin stent) or the polymer-based, paclitaxel-eluting Taxus stent(paclitaxel stent). The primary end point was in-stent late lumen loss. Secondary end points were angiographic restenosis and target lesion revascularization. The study was designed to test the noninferiority of the rapamycin stent compared with the paclitaxel stent with respect to late lumen loss according to a noninferiority margin of 0.13 mm. Follow-up angiography was completed in 81%of the patients. The mean difference in in-stent late lumen loss between the rapamycin-stent group and the paclitaxel-stent group was 0.002 mm, and the upper limit of the 1-sided 95%confidence interval was 0.10 mm(P=0.02 from test for noninferiority). No significant differences were observed regarding angiographic restenosis rates(14.2%with the rapamycin stent and 15.5%with the paclitaxel stent) and target lesion revascularization rates due to restenosis(9.3%in both groups). Conclusions -The polymer-free, rapamycin-coated stent has an antirestenotic effect that is not inferior to that observed with the polymer-based paclitaxel-eluting stent.
