Multi-photon microscopic evaluation of saphenous vein endothelium and its preservation with a new solution, GALA
Multi-photon microscopic evaluation of saphenous vein endothelium and its preservation with a new solution, GALA
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DOI：
10.1016/s0003-4975(02)04705-7
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发表时间：
2003-04-01
影响因子：
4.6
通讯作者：
Khuri, SF
中科院分区：
文献类型：
--
作者：
Thatte, HS;Biswas, KS;Khuri, SF
背景在冠状动脉旁路移植术（CABC）期间，内皮损伤可损害旁路移植物的通畅性。维持移植物中内皮的结构和功能活力可能导致改善的长期通畅性。从应用多光子显微镜在透射和落射荧光模式获得的信息被用来评估存储在多种保存溶液中的人隐静脉段的结构和功能的完整性，并设计一个上级存储solution. Methods。采用多光子显微镜对从接受CABG的患者中采集的隐静脉组织进行深层成像，以分析内皮结构和功能。内皮细胞的结构活力，钙动员，和一氧化氮的产生测定使用特定的荧光标记。在标准保存溶液中收获和储存的60分钟内，钙动员和一氧化氮生成显著减少，超过90%的内皮细胞在静脉中不再存活。相比之下，静脉可以在新配制的含有谷胱甘肽、抗坏血酸和L-精氨酸（GALA）的肝素化生理缓冲盐溶液中储存24小时而细胞活力没有实质性损失。目前临床使用的标准溶液导致隐静脉内皮细胞活力显著下降，而新设计的生理盐溶液（GALA）可维持内皮功能和结构活力长达24小时。从使用GALA作为血管储存介质中看到的改善可能导致CABG手术后更大的长期静脉移植物通畅性。(C)2003年由胸外科医师协会发布。
Background. Injury to endothelium can compromise the patency of bypass grafts harvested during coronary artery bypass graft (CABC) surgery. Maintaining structural and functional viability of endothelium in grafts may lead to improved long-term patency. The information gained from the application of multi-photon microscopy in transmission and epifluorescence mode was used to assess the structural and functional integrity of human saphenous vein segments stored in multiple preservation solutions, and to design a superior storage solution.Methods. Multi-photon microscopy was used to image deep within saphenous vein tissue harvested from patients undergoing CABG for analysis of endothelial structure and function. Endothelial cell structural viability, calcium mobilization, and nitric oxide generation were determined using specific fluorescence markers.Results. Within 60 minutes of harvest and storage in standard preservation solutions, calcium mobilization and nitric oxide generation were markedly diminished with more than 90% of endothelial cells no longer viable in the vein. In contrast, veins could be stored for 24 hours without substantial loss in cell viability in a newly formulated heparinized physiologic buffered salt solution containing glutathione, ascorbic acid, and L-arginine (GALA).Conclusions. Standard solutions in clinical use today led to a profound decline in saphenous vein endothelial cell viability, whereas the newly designed physiologic salt solution (GALA) maintained endothelial function and structural viability for up to 24 hours. The improvements seen from using GALA as a vessel storage medium may lead to greater long-term vein graft patency following CABG surgery. (C) 2003 by The Society of Thoracic Surgeons.