Research of "Autologous fibrin coated small caliber vascular prostheses improve the antithrombogenicity by less immunological response"

引言：小口径人造血管的开发仍然具有挑战性。最近，我们开发了一种新的血管移植物纤维蛋白涂层技术。我们假设自体纤维蛋白涂层可以通过减少免疫反应来提高移植物的抗血栓形成性。方法：采用改良乙醇法从血浆中提取自体（兔，A型移植物）或异种（人，X型移植物）纤维蛋白，对内径为2 mm的涤纶针织人造血管进行涂层处理。将50只日本白色家兔双侧颈动脉植入人工血管，根据移植物的选择分为A& X组（I组，n = 40），A& A组（II组，n=5），X& X组（III组，n=5）。观察移植物通畅率、抗移植物血清抗体、<111>铟血小板荧光造影和组织学变化。 关于我们 1、3、7、10、14、30、60、180（每种n=5）。结果：术后第10天，除1例X型移植物外，其余移植物均通畅，无狭窄和血栓形成。在POD 60，单层内皮样细胞覆盖在A移植物的整个表面上。在I组中，最大抗移植物血清抗体（在490 nm [O.D.]处的0.17±0.02光密度）在490 nm [O.D.] A型移植物血小板最大沉积量（10.3± 1.6 × 10 ~ 6/mm ~ 2）明显低于X型移植物（0.46±0.06 O.D.）。和17.4±1.4x10^6/mm^2;两者p&lt;0.0001）。术后第7 ~ 14天移植物纤维蛋白降解时血清IgG、IgM、tPA和派-1水平升高，但Ⅱ组明显低于Ⅲ组（p&lt;0.01，ANOVA）。派-1/tPA比值在两组中均随着移植物血小板沉积的增加而降低。结论：这些结果表明，自体纤维蛋白涂层通过减少免疫反应来提高抗血栓性，并具有用于混合小口径人造血管的潜在用途。少

Introduction : Development of small caliber vascular prostheses is still challenging. Recently we have developed a new technique of fibrin coatings for vascular grafts. We hypothesized that autologous fibrin coatings could improve the antithrombogenicity of grafts by less immunological response. We also examine the graft healing characteristics after implantation.Methods : Knitted polyester fabric vascular prostheses, 2mm in internal diameter, were coated with autologous (rabbit, A-graft) or xenologous (human, X-graft) fibrin by modified ethanol method from plasma. Fifty Japanese white rabbits were implanted with the grafts in bilateral carotid arteries and divided into three groups by the selection of grafts in the individual rabbit : A&X-grafts (group I, n40), A&A-grafts (group II, n=5), X&X-grafts (group III, n=5). To evaluate graft patency, anti-graft serum antibody, ^<111>Indium platelet scintigraphy and histology, the grafts in group I were explanted on postoperative days (PODs) … More 1, 3, 7, 10, 14, 30, 60, 180 (n=5 for each). Serum levels of immunoglobulin G (IgG) and M (IgM), tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) in group II and III were measured serially to compare immunological, coagulative and fibrinolytic reactions.Rsults : All of grafts except one X-graft on POD 10 were patent without stenosis and thrombus. Monolayer endothelial-like cells were covered on the entire surface of the A-grafts on POD 60. In group I, the maximal anti-graft serum antibodies (0.17±0.02 optical density at 490 nm [O.D.]) and the maximal platelet deposition (10.3±1.6x10^6/mm^2) in A-grafts were significantly less than those in X-grafts (0.46±0.06 O.D. and 17.4±1.4x10^6/mm^2, respectively ; p<0.0001 in both). Although serum levels of IgG, IgM, tPA and PAI-1 were increased at the time of fibrin degradation of grafts during POD 7 to 14, those in group II were significantly less than those in group III (p<0.O1, ANOVA). The PAI-1/tPA ratio in both groups was decreased as platelet deposition of the grafts was increased.Conclusion : These findings suggest that autologous fibrin coatings improve the antithrombogenicity by less immunological response and have a potential use for hybrid small caliber vascular prostheses. Less