COMBINATION OF VITAMIN-C AND VITAMIN-E ALTERS THE RESPONSE TO CORONARY BALLOON INJURY IN THE PIG
COMBINATION OF VITAMIN-C AND VITAMIN-E ALTERS THE RESPONSE TO CORONARY BALLOON INJURY IN THE PIG
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DOI：
10.1161/01.atv.15.1.156
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发表时间：
1995-01-01
影响因子：
8.7
通讯作者：
BERK, BC
中科院分区：
文献类型：
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作者：
NUNES, GL;SGOUTAS, DS;BERK, BC
再狭窄是经皮腔内冠状动脉成形术长期成功的主要限制。再狭窄的过程涉及血管损伤的修复和血管结构的重塑。因此，改善血管功能的治疗干预可能有益于再狭窄的治疗。普罗布考、维生素 C 和 E 等抗氧化剂已被证明可有效改善高胆固醇血症的内皮功能、抑制动脉粥样硬化动物模型中的脂质积累以及降低人类心血管死亡率。将 42 只雌性家猪分为四个研究组：对照组（n=12）；维生素 C（500 毫克/天，C 组，n=9）；维生素 E（1000 U/天，E 组，n=10）；以及维生素 C 和 E（500 mg/d + 1000 U/d，C + E 组，n=11），在左冠状动脉前降支和回旋支动脉发生过大球囊损伤之前。在球囊损伤前 7 天给予维生素，并持续到损伤后 14 天将猪杀死。仅在 C + E 组中存在形态参数的显着差异，损伤最大的节段中血管和管腔面积增加。虽然内膜面积或最大内膜厚度没有减少，但内膜面积与血管面积的比率显着减少，与 C + E 组的积极效果一致。对所有节段的初始血管损伤（使用内弹力板骨折长度/管腔周长）和血管对损伤的反应（使用内膜面积/血管面积）之间关系的图形分析显示，C + E 组的指数有所改善（P 组 E > C 组。维生素 C 和 E 的组合改善了血管对所有节段的反应）由于维生素 C + E 的组合对血管重塑具有明显的有益作用，这一事实与维生素 C 改善维生素 E 的抗氧化作用的能力一致，表明血管反应的改善是由于氧化还原状态的变化所致。这项研究表明氧自由基在血管对损伤的反应中发挥着重要作用，并表明血管重塑和内膜增殖对再狭窄过程很重要。
Restenosis is the major limitation of the long-term success of percutaneous transluminal coronary angioplasty. The process of restenosis involves repair of vascular injury and remodeling of vessel architecture. Therapeutic interventions that improve vascular function may therefore be beneficial in the treatment of restenosis. Antioxidants such as probucol and vitamins C and E have proved effective in improving endothelial function in hypercholesterolemia, inhibiting lipid accumulation in animal models of atherosclerosis, and decreasing cardiovascular mortality in humans. Forty-two female domestic swine were divided into four study groups: control (n=12); vitamin C (500 mg/d, group C, n=9); vitamin E (1000 U/d, group E, n=10); and vitamins C and E (500 mg/d + 1000 U/d, group C + E, n=11) before oversized balloon injury of the left anterior descending and circumflex coronary arteries. Vitamins were administered 7 days before balloon injury and continued until the swine were killed 14 days after injury. Significant differences in morphometric parameters were present only in group C + E, with increases in vessel and lumen area in the segment with maximal injury. Although there was no decrease in intima area or in maximal intima thickness, the ratio of intima area to vessel area was significantly reduced, consistent with a positive effect in group C + E. Graphic analysis of the relationship between initial vessel injury (using internal elastic lamina fracture length/lumen perimeter) and vessel response to injury (using intima area/vessel area) for all segments showed improved indices for group C + E (Pgroup E>group C. The combination of vitamins C and E improved vascular response to injury because of an apparent beneficial effect on vascular remodeling. The fact that the combination of vitamins C + E was better than vitamin E or vitamin C alone is consistent with the ability of vitamin C to improve the antioxidant effect of vitamin E, suggesting that the improved vessel response was due to a change in redox state. This study suggests an important role for oxygen radicals in the vascular response to injury and suggests that vascular remodeling and intimal proliferation are important to the restenotic process.