A longitudinal immunohistochemical study of the healing of experimental aneurysms after embolization with platinum coils.
A longitudinal immunohistochemical study of the healing of experimental aneurysms after embolization with platinum coils.
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发表时间：
2006-04
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通讯作者：
D. Dai;Y. Ding;R. Kadirvel;M. A. Danielson;D. Lewis;H. Cloft;D. Kallmes
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作者：
D. Dai;Y. Ding;R. Kadirvel;M. A. Danielson;D. Lewis;H. Cloft;D. Kallmes
背景与目的本研究旨在通过多种特殊染色和免疫标记方法，探讨动脉瘤铂弹簧圈栓塞后愈合的细胞机制。方法采用弹性蛋白酶诱导法制备兔动脉瘤模型并栓塞。栓塞后2 - 24周切除动脉瘤。将标本包埋在石蜡中，切片，并用苏木精-伊红、Masson三色和多种免疫染色剂染色。结果：2周时，外周稀疏的梭形核细胞α-平滑肌肌动蛋白（SMA）、肌球蛋白和波形蛋白阳性，表明肌成纤维细胞分化。4周时，动脉瘤中所有梭形核细胞SMA、肌球蛋白、结蛋白和波形蛋白均呈阳性。栓塞后10周，动脉瘤细胞的免疫组化染色阳性显著减少。在第2、4、10、16和24周，每个高倍视野的平均阳性SMA细胞分别为5 +/- 3、45 +/- 9、10 +/- 5、0 +/- 0和0 +/- 0。Kruskal-Wallis检验结果显示这些数据存在显著差异（P =.0001）。事后检验显示，与2、10、16和24周相比，4周时细胞中SMA阳性染色的量显著更大（P <0.05）。此外，10周组的阳性细胞显著多于16周和24周组（P <0.05）。在植入后4周（37 +/- 11）至10周（8 +/- 4）之间，凋亡细胞减少了78%。10周后凋亡细胞完全消失。结论：动脉瘤愈合，对铂弹簧圈栓塞的反应，似乎经历了血栓形成、颗粒组织机化和疏松结缔组织形成的阶段。肌成纤维细胞，愈合中的关键细胞成分，出现在动脉瘤早期。随着时间的推移，它们的数量逐渐减少，最后通过凋亡机制消失。
BACKGROUND AND PURPOSE The purpose of this study was to probe the cellular mechanism of healing in aneurysms after platinum coil embolization, by using multiple special stains and immunolabels. METHODS Elastase-induced aneurysms were created and embolized in 28 rabbits. Aneurysms were excised between 2 and 24 weeks after embolization. Specimens were embedded in paraffin, sectioned, and stained with hematoxylin-eosin, Masson trichrome, and multiple immunostains. RESULTS At 2 weeks, peripheral sparse spindle-nucleated cells were positive for alpha-smooth muscle actin (SMA), myosin, and vimentin, indicating myofibroblastic differentiation. At 4 weeks, all spindle-nucleated cells in the aneurysm were positive for SMA, myosin, desmin, and vimentin. Ten weeks after embolization, positive immunohistochemical staining in the cells populating the aneurysm significantly decreased. Mean positive SMA cells, per high-powered field were 5 +/- 3, 45 +/- 9, 10 +/- 5, 0 +/- 0, and 0 +/- 0 at 2, 4, 10, 16, and 24 weeks, respectively. Findings of a Kruskal-Wallis test showed these data to be significantly different (P =.0001). Post hoc tests revealed significantly greater amounts of SMA-positive staining in the cells at 4 weeks compared with those at 2, 10, 16, and 24 weeks (P < .05). In addition, the 10-week group had significantly more positive cells than the 16- and 24-week groups (P < .05). There was a 78% decrease in apoptotic cells between 4 (37 +/- 11) and 10 weeks (8 +/- 4) after implantation. Apoptotic cells were completely absent beyond 10 weeks. CONCLUSION Aneurysm healing, in response to platinum coil embolization, appeared to progress through the stages of thrombus formation, granulated tissue organization, and loose connective tissue formation. Myofibroblasts, the key cellular component involved in healing, appeared within the aneurysm early. They progressively reduced in number with time and finally disappeared through the mechanism of apoptosis.