Vein graft harvesting induces inflammation and impairs vessel reactivity
Vein graft harvesting induces inflammation and impairs vessel reactivity
复制标题
DOI：
10.1016/j.athoracsur.2006.05.038
复制
发表时间：
2006-10-01
影响因子：
4.6
通讯作者：
Vaage, Jarle
中科院分区：
文献类型：
--
作者：
Hinokiyama, Kazuhiro;Valen, Guro;Vaage, Jarle
背景隐静脉常用于冠状动脉旁路移植术（CABG），但通畅性丧失是一个问题。外科手术可能导致移植物损伤。我们的目的是研究隐静脉的手术处理对移植物炎症和血管功能的影响。在静脉采集（开放技术）开始时和最后一次近端吻合缝合后，从9例接受择期CABG的患者中采集隐静脉活检样本。用半定量逆转录聚合酶链反应（RT-PCR）扩增mRNA。研究了促炎细胞因子（肿瘤坏死因子-α、白细胞介素-1 β）、白细胞粘附分子（E-选择素、细胞间粘附分子-1）和血管活性物质（内皮素-1、诱导型和内皮型一氧化氮合酶）的基因表达。采用电泳迁移率改变试验检测核因子-κ B（NF-κ B）的易位。应用免疫组化法检测血管性血友病因子（vonWillebrand factor，vWF）的表达，观察血管内皮细胞的损伤情况，并研究体外静脉对苯肾上腺素和内皮素-1的反应性。细胞因子和白细胞粘附分子的基因表达增加移植收获和存储后，而血管活性物质没有改变。手术处理后发生NF κ B B核转位，同时伴有部分内皮细胞丢失和收缩功能受损。静脉移植物的标准手术处理诱导血管壁中NF κ B驱动的炎症并损害血管功能。这可能会导致早期和晚期移植物闭塞。
Background. Saphenous veins are often used for coronary artery bypass grafting (CABG), but loss of patency is a problem. The surgical procedure may contribute to graft injury. Our aim was to study the impact of surgical handling of saphenous veins on graft inflammation and vascular function.Methods. Biopsy samples of saphenous veins were taken from 9 patients undergoing elective CABG at the start of vein harvesting (open technique) and after the last proximal anastomosis was sutured. Messenger RNA was extracted and amplified with semiquantitative reverse transcription polymerase chain reaction. Gene expression of proinflammatory cytokines (tumor necrosis factor-alpha, interleukin-1 beta), leukocyte adhesion molecules (E-selectin, intercellular adhesion molecule-1), and vasoactive substances (endothelin-1, inducible and endothelial nitric oxide synthase) was investigated. Translocation of nuclear factor-kappa B (NF kappa B) was evaluated with electrophoretic mobility shift assay. Immunostaining for von Willebrand factor was performed to evaluate loss of endothelium, and in vitro vein reactivity to phenylephrine and endothelin-1 was studied.Results. Gene expression of cytokines and leukocyte adhesion molecules increased after graft harvesting and storage, whereas vasoactive substances did not change. Nuclear translocation of NF kappa B occurred after surgical handling, concurrent with partial loss of endothelium and impaired contractile function.Conclusions. Standard surgical handling of vein grafts induces NF kappa B-driven inflammation in the vessel wall and impairs vascular function. This may potentially contribute to both early and late graft occlusion.