Effect of serum from patients with restenosis after PTCA on migration-stimulating activity of cultured smooth muscle cells.

背景：内侧平滑肌细胞向动脉内膜迁移，并伴随内膜细胞增殖，是经皮冠状动脉腔内成形术（PTCA）后再狭窄发生的主要特征之一。尽管已经研究了几种生长和/或迁移刺激因素作为PTCA后再狭窄发展的可能候选因素，但每种因素的相对重要性尚不清楚。本研究的目的是测定人血清对标准培养平滑肌细胞的促迁移活性和促有丝分裂活性，并探讨这些活性与PTCA后再狭窄发生率之间的关系。方法与结果采用冢本多孔趋化室法测定PTCA患者血清对平滑肌细胞的促迁移活性。用中性红比色法测定有丝分裂活性。再狭窄组随着冠状动脉评分、血清LP (a)、甘油三酯和磷酸盐离子浓度的升高，刺激迁移活性显著增加，而非有丝分裂活性。与非糖尿病患者相比，糖尿病患者PTCA后再狭窄的发生率更高。结论与胎牛血清一样，人血清中含有一种刺激培养的主动脉平滑肌细胞通过膜过滤器迁移的因子。在PTCA后发生再狭窄的患者血清中，这种刺激迁移的活性大大增强。

Background Migration of medial smooth muscle cells into the intima of the artery, with subsequent intimal cell proliferation, is one of main features of the development of restenosis after percutaneous transluminal coronary angioplasty (PTCA). Although several growth and/or migration-stimulating factors have been studied as possible candidates for a role in the development of restenosis after PTCA,the relative importance of each of these factors is unknown. The aim of this study was to measure migration-stimulating and mitogenic activities of human serum on standard cultured smooth muscle cells and to see if there was any relationship between thses activities and the incidence of restenosis after PTCA.Methods and Results The migration-stimulating activity of serum from patients who underwent PTCA on smooth muscle cells was assayd by the multi-well chemotaxis chamber method as described by Tsukamoto. The mitogenic activity was assayaed by colorimetric method by neutral red as described by Borenfreund. The migration-stimulating activity, but not the mitogenic activity, was significantly increased in the restenotic group along with elevation of coronary score, serum LP (a), triglyceride and phosphate ion concentration. A higher incidence of restenosis after PTCA was detected in patients with diabetes mellitus (DM) as compared to those without DM.Conclusion Human serum, like fetal calf serum, contains a factor (s) that stimulates migration of cultured aortic smooth muscle cells through a membran filter. This migration-stimulating activity was greatly enhanced in the serum of patients who developed restenosis after PTCA.