冠状动脉支架术后再狭窄中血管平滑肌细胞表型转换的研究  

Phenotypic change of smooth muscle cells in restenosis after percutaneous coronary intervention

作　　者：张旭敏[1] 马晓烨[1] 王小东[1] 姚义安[1] 刘学波[1] 

机构地区：[1]上海市同济大学附属东方医院心内科,200120

出　　处：《国际心血管病杂志》2014年第3期186-188,201,共4页International Journal of Cardiovascular Disease

基　　金：上海市浦东新区科委课题(PKJ2011-Y21)

摘　　要：目的:通过制作猪冠状动脉支架术后再狭窄模型,研究冠状动脉支架内再狭窄时平滑肌细胞表型的变化。方法:将12只家猪随机分为正常对照组和支架组,每组各6只。正常对照组进行假手术,不做其他处理。支架组家猪于冠状动脉前降支和回旋支各置入裸支架1枚(微创Firebird)。取30 d后经冠状动脉造影确定发生再狭窄的血管段,HE染色观察组织形态;取中层平滑肌细胞培养,电镜观察细胞形态与结构;Western blot测定缝隙连接蛋白(connexin,Cx)43、Cx40、α-平滑肌肌动蛋白(α-SMA)、S100钙结合蛋白A4(S100A4)的表达。结果:支架组血管内膜显著增厚,中层平滑肌细胞以长菱形平滑肌细胞(R-SMC)为主,而对照组以纺锤形平滑肌细胞(S-SMC)为主;支架组Cx43、S100A4表达较对照组增强,Cx40、α-SMA表达较对照组降低(P<0.01)。结论:经皮冠状动脉介入术后S-SMC向R-SMC的转换可能参与了再狭窄过程。Objective：To investigate phenotypic transition of smooth muscle cells （SMCs） in a porcine coronary restenosis model.Methods：A total of 12 experimental domestic pigs were randomly divided into two groups：control group （n =6） and restenosis group （n =6）.Pigs in control group received sham operation,and the other 6 pigs were implanted 1 stent in the left anterior descending coronary artery and circumflex coronary artery respectively.Histomorphology was observed by HE staining.Cell morphology and structure was examined by electron microscopy.The expression of connexin （Cx）43,Cx40,α-smooth muscle actin（a-SMA）,S100 calcium binding protein A4（S100A4） in SMCs of coronary artery were examined by western blot.Results：Spindle-SMCs （S-SMCs） were predominant in control group,whereas rhomboid-SMCs （R-SMCs） were in higher proportion in restenosis group.Cx40 and a SMA were highly expressed in control group（P＜0.01）.In contrast,Cx43 and S100A4 were markedly upregulated in restenosis group（P＜0.01）.Conclusion：The switch from S-SMC to R SMC phenotype may be involved in restenosis after percutaneous coronary intervention.

关 键 词：支架内再狭窄 缝隙连接蛋白 平滑肌细胞 细胞表型 

分 类 号：R541.4[医药卫生—心血管疾病]