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

背景：经皮冠状动脉腔内成形术(PTCA)后，中膜平滑肌细胞迁移至动脉内膜，继而内膜细胞增殖是再狭窄的主要特征之一。尽管已经研究了几种生长和/或迁移刺激因子在PTCA术后再狭窄发生中的可能作用，但这些因子的相对重要性尚不清楚。本研究的目的是检测人血清对标准培养的血管平滑肌细胞的迁移刺激和有丝分裂活性，并探讨其与PTCA术后再狭窄发生率之间的关系。方法和结果采用Tsukamoto所描述的多孔趋化小室方法检测PTCA术后患者血清对平滑肌细胞的迁移刺激活性。按Borenfreund的方法用中性红比色法测定细胞的促分裂活性。随着冠脉积分、血清Lp(A)、甘油三酯和磷酸根离子浓度的升高，再狭窄组的迁移刺激活性显著增加，但丝裂原活性无明显变化。糖尿病患者PTCA术后再狭窄发生率明显高于非糖尿病患者。结论人血清与胎牛血清一样，含有一种能刺激培养的主动脉平滑肌细胞通过膜过滤器迁移的因子(S)。PTCA术后发生再狭窄的患者血清中这种迁移刺激活性显著增强。

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.