Monocyte adhesion to human vein grafts: A marker for occult intraoperative injury?
Monocyte adhesion to human vein grafts: A marker for occult intraoperative injury?
复制标题
DOI：
10.1067/mva.2001.118590
复制
发表时间：
2001-11-01
影响因子：
4.3
通讯作者：
Conte, MS
中科院分区：
文献类型：
--
作者：
Eslami, MH;Gangadharan, SP;Conte, MS
目的：单核细胞粘附在血管壁被认为是动脉粥样硬化和内膜增生的重要起始事件。我们假设，隐匿性术中静脉损伤诱导单核细胞粘附的立即增加，可能是至关重要的静脉移植diseases.Methods的发展：静脉段从患者（n = 23）接受下肢搭桥术。在导管收获时立即切除初始段（V1，n = 17）。第二节段（V2，n = 23）在即将进行远端吻合术之前从远端管道获得。将片段与放射性标记的THP-1细胞（单核细胞样细胞系）在37 ℃下孵育1小时，然后冲洗并溶解以测定结合的放射性。在移植物亚组（n = 4）中，将THP-1细胞与单克隆抗体（mAB）7 E3（其在其纤维蛋白原[Fg]结合位点结合单核细胞整联蛋白Mac-1）或对照（mAB 14 E11）预孵育。纤维蛋白沉积和内皮覆盖。免疫组化检测（n = 10）。采用配对t检验和方差分析进行统计学分析。获得随访移植物通畅性数据，并使用精确检验（StatXact，Cytel软件，剑桥，马萨诸塞州）将其与粘附值相关联。手术操作后单核细胞粘附显著增加（V1，2400 +/- 770 vs. V2，7343 +/- 1555 cells/cm（2）; P <0.02）。Fg沉积在V2切片中丰富，而在Vl中未见。7 E3处理显著降低了单核细胞对V2节段的粘附（对照的58%，P <0.01）。移植物随访完成，平均间隔11个月。较高的V2粘附值与闭塞的移植物相关（P = 0.07）。6例闭塞移植物的中位值为6234个细胞/cm 2，而17例通畅移植物的中位值为3892个细胞/cm 2。单核细胞粘附到静脉壁后立即增加手术操作，并抑制单克隆抗体7 E3。早期单核细胞粘附到静脉移植物可能涉及Mac-1和PG之间的相互作用。在植入时单核细胞粘附水平升高可能是随后静脉移植失败的标志。
dObjective: Monocyte adhesion to the vessel wall is believed to be an important initiating event in atherosclerosis and intimal hyperplasia. We hypothesized that occult intraoperative vein injury induces an immediate increase in monocyte adhesion that may be critical to the development of vein graft disease.Methods: Vein segments were obtained from patients (n = 23) undergoing lower extremity bypass. The initial segment (V1, n = 17) was excised immediately at the time of conduit harvest. A second segment (V2, n = 23) was obtained from the distal conduit just before performing the distal anastomosis. Segments were incubated with radiolabeled THP-1 cells (monocytoid cell line) for 1 hour at 37 degreesC, then rinsed and solubilized for determination of bound radioactivity. In a subset of grafts (n = 4), THP-1 cells were preincubated with monoclonal antibody (mAB) 7E3 (which binds to the monocyte integrin Mac-1 at its fibrinogen [Fg]-binding site) or control (mAB 14E11). Fg deposition and endothelial coverage were. evaluated by immunohistochemistry (n = 10). Statistical analysis was performed using the paired t test and analysis of variance. Follow-up graft patency data were obtained and correlated with adhesion values using an exact test (StatXact, Cytel Software, Cambridge, Mass).Results. Monocyte adhesion was significantly increased after surgical manipulation (V1, 2400 +/- 770 versus V2, 7343 +/- 1555 cells/cm(2); P < .02). Fg deposition was abundant in V2 sections and not seen in Vl. Monocyte adhesion to V2 segments was significantly reduced (58% of control, P < .01) by 7E3 treatment. Graft follow-up was complete with a mean interval of 11 months. Higher V2 adhesion values were associated with occluded grafts (P = .07). The median value for the six occluded grafts was 6234 cells/cm(2) versus 3892 cells/cm(2) for the 17 patent grafts.Conclusions. Monocyte adhesion to the vein wall is immediately increased after surgical manipulation and is inhibited by mAB 7E3. Early monocyte adhesion to vein grafts is likely to involve interactions between Mac-1 and Pg. Heightened levels of monocyte adhesion at implantation may be a marker for subsequent vein graft failure.