Pathogen burden, inflammation, proliferation and apoptosis in human in-stent restenosis -: Tissue characteristics compared to primary atherosclerosis
Pathogen burden, inflammation, proliferation and apoptosis in human in-stent restenosis -: Tissue characteristics compared to primary atherosclerosis
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DOI：
10.1159/000081809
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发表时间：
2004-01-01
影响因子：
1.7
通讯作者：
Bauriedel, G
中科院分区：
文献类型：
--
作者：
Skowasch, D;Jabs, A;Bauriedel, G
导致支架内再狭窄(ISR)的致病事件仍不完全清楚。其中，炎症、免疫反应、不受控制的细胞死亡和生长已被提出。因此，对21例有症状的ISR患者的动脉粥样硬化切除探针进行了免疫组织化学分析，并与20例稳定型心绞痛患者的主要靶点病变进行了比较。ISR未发现巨细胞病毒、单纯疱疹病毒、EB病毒和幽门螺杆菌感染，其中6/21(29%)存在急性和/或持续性衣原体感染。人热休克蛋白60在8/21探针中表达(38%)。CD68、CD40和CRP信号不同，5/21例(24%)、3/21例(14%)和2/21例(10%)有炎症反应。ISR的细胞密度显著高于原发灶(977+/-315vs.431+/-148cell/mm(2)；p<；0.001)。Ki67和增殖细胞核抗原检测均未见复制细胞。2 1例ISR标本中有6/2 1例(2 9%)可见TUNEL+细胞。定量分析显示，与原发性动脉粥样硬化相比，ISR中各内膜决定因素的表达水平较低(均P<；0.05)。综上所述，临床表现时人类ISR的特点是病原体负担和炎症的频率较低，但明显的高细胞、低凋亡和无增殖。版权所有(C)2004 S.Karger AG，巴塞尔。
Pathogenic events leading to in-stent restenosis (ISR) are still incompletely understood. Among others, inflammation, immune reactions, deregulated cell death and growth have been suggested. Therefore, atherectomy probes from 21 patients with symptomatic ISR were analyzed by immunohistochemistry for pathogen burden and compared to primary target lesions from 20 stable angina patients. While cytomegalovirus, herpes simplex virus, Epstein-Barr virus and Helicobacter pylori were not found in ISR, acute and/or persistent chlamydial infection were present in 6/21 of these lesions (29%). Expression of human heat shock protein 60 was found in 8/21 of probes (38%). Indicated by distinct signals of CD68, CD40 and CRP, inflammation was present in 5/21 (24%), 3/21 (14%) and 2/21 (10%) of ISR cases. Cell density of ISR was significantly higher than that of primary lesions ( 977 +/- 315 vs. 431 +/- 148 cells/mm(2); p < 0.001). There was no replicating cell as shown by Ki67 or PCNA. TUNEL+ cells indicating apoptosis were seen in 6/21 of ISR specimens (29%). Quantitative analysis revealed lower expression levels for each intimal determinant in ISR compared to primary atheroma (all p < 0.05). In summary, human ISR at the time of clinical presentation is characterized by low frequency of pathogen burden and inflammation, but pronounced hypercellularity, low apoptosis and absence of proliferation. Copyright (C) 2004 S. Karger AG, Basel.