Everolimus-eluting stents improve vascular response in a diabetic animal model.
Everolimus-eluting stents improve vascular response in a diabetic animal model.
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DOI：
10.1161/circinterventions.113.001023
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发表时间：
2014-08
期刊：
影响因子：
--
通讯作者：
Finn AV
中科院分区：
文献类型：
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作者：
Habib A;Karmali V;John MC;Polavarapu R;Nakazawa G;Pachura K;Davis T;Kolodgie FD;Virmani R;Finn AV
药物洗脱支架(DES)的血管反应的临床前评估是有限的，特别是在糖尿病(DM)的情况下，直到临床使用后才能评估DES设计和洗脱药物的变化。用培养的人主动脉内皮细胞(HAEC)比较西罗莫司(SRL)及其类似物伊维洛莫斯(EVL)在高血糖环境下对内皮细胞恢复所需的各种细胞功能的影响。采用糖尿病兔髂动脉支架模型，比较伊波利莫司洗脱(EES)、西罗莫司洗脱(SES)和裸金属支架(BMS)置入后血管反应的组织学和形态计量学特征。在高血糖条件下，SRL对HAEC的内皮屏障功能、迁移和增殖的损害程度比EVL更大。在我们的体内糖尿病模型中，与EES和BMS相比，SES的28天内皮化显著降低，内皮完整性受损。与EES和BMS相比，SES的新生内膜面积、裸露的支架和纤维蛋白沉积显著增加。在我们的糖尿病临床前模型中，使用EES可以改善血管反应。
Pre-clinical evaluation of the vascular response of drug eluting stents (DES) is limited especially in the setting of diabetes mellitus (DM) preventing the evaluation of changes in DES design and eluted drugs until after clinical use. Cultured human aortic endothelial cells (HAEC) were used to assess the differences between sirolimus (SRL) and its analog, everolimus (EVL), in the setting of hyperglycemia on various cellular functions necessary for endothelial recovery. A diabetic rabbit model of iliac artery stenting was used to compare histologic and morphometric characteristics of the vascular response to everolimus-eluting (EES), sirolimus-eluting (SES) and bare metal stent (BMS) placement. Under hyperglycemic conditions, SRL impaired HAEC endothelial barrier function, migration and proliferation to a greater degree compared with EVL. In our in vivo model of diabetes, endothelialization at 28 days was significantly lower and endothelial integrity was impaired in SES when compared to both EES and BMS. Neointimal area, uncovered struts and fibrin deposition was significantly higher in SES when compared to EES and BMS. Use of EES results in improved vascular response in our pre-clinical models of diabetes.