Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2012

Open Access 01-12-2012 | Research article

Combination coating of chitosan and anti-CD34 antibody applied on sirolimus-eluting stents can promote endothelialization while reducing neointimal formation

Authors: Feng Yang, Shi-Chao Feng, Xiang-Jun Pang, Wei-Xiao Li, Yong-Hua Bi, Qian Zhao, Shi-Xuan Zhang, Yang Wang, Bo Feng

Published in: BMC Cardiovascular Disorders | Issue 1/2012

Login to get access

Abstract

Background

Circulating endothelial progenitor cells (EPCs) capture technology improves endothelialization rates of sirolimus-eluting stents (SES), but the problem of delayed re-endothelialization, as well as endothelial dysfunction, has still not been overcome. Therefore, we investigated whether the combination coating of hyaluronan-chitosan (HC) and anti-CD34 antibody applied on an SES (HCASES) can promote endothelialization, while reducing neointimal formation and inflammation.

Methods

Sirolimus-eluting stents(SES), anti-CD34 antibody stents (GS) and HC-anti-CD34 antibody combined with sirolimus-eluting stents (HCASES) were deployed in 54 normal porcine arteries and harvested for scanning electron microscopy (SEM) and histological analysis. The ratio of endothelial coverage above the stents was evaluated by SEM analysis at 7, 14 and 28 days. The percentage of in-stent stenosis was histologically analyzed at 14 and 28 days.

Results

SEM analysis at 7 days showed that endothelial strut coverage was increased in the HCASES group (68±7%) compared with that in the SES group (31±4%, p=0.02). At 14 days, stent surface endothelialization, evaluated by SEM, showed a significantly higher extent of endothelial coverage above struts in the GS (95 ± 2%) and the HCASES groups (87±4%) compared with that in the SES group (51±6%, p=0.02). Histological examination showed that the percentage of stenosis in the HCASES group was not significantly different to that of the SES and GS groups (both p> 0.05). At 28 days, there was no difference in the rates of endothelial coverage between the HCASES and GS groups. The HCASES group showed less stenosis than that in the GS group (P < 0.05), but it was not significantly different from the SES group (P=0.068).

Conclusions

SEM and histology demonstrated that HCASESs can promote re-endothelialization while enhancing antiproliferative effects.
Appendix
Available only for authorised users
Literature
1.
go back to reference Spaulding C, Daemen J, Boersma E, et al: A pooled analysis of data comparing sirolimus-eluting stents with baremetal stents. N Engl J Med. 2007, 356: 989-997. 10.1056/NEJMoa066633.CrossRefPubMed Spaulding C, Daemen J, Boersma E, et al: A pooled analysis of data comparing sirolimus-eluting stents with baremetal stents. N Engl J Med. 2007, 356: 989-997. 10.1056/NEJMoa066633.CrossRefPubMed
2.
go back to reference Lagerqvist B, James SK, Stenestrand U, et al: Long-term outcomes with drug-eluting stents versus bare-metal stents in Sweden. N Engl J Med. 2007, 356: 1009-1019. 10.1056/NEJMoa067722.CrossRefPubMed Lagerqvist B, James SK, Stenestrand U, et al: Long-term outcomes with drug-eluting stents versus bare-metal stents in Sweden. N Engl J Med. 2007, 356: 1009-1019. 10.1056/NEJMoa067722.CrossRefPubMed
3.
go back to reference Nakazawa G, Tanabe K, Aoki J, et al: Sirolimus-Eluting Stents Suppress Neointimal Formation Irrespective of Metallic Allergy. Circ J. 2008, 72: 893-896. 10.1253/circj.72.893.CrossRefPubMed Nakazawa G, Tanabe K, Aoki J, et al: Sirolimus-Eluting Stents Suppress Neointimal Formation Irrespective of Metallic Allergy. Circ J. 2008, 72: 893-896. 10.1253/circj.72.893.CrossRefPubMed
4.
go back to reference Lakshmana K, Pendyala , Xinhua Y, et al: The First-Generation Drug-Eluting Stents and Coronary Endothelial Dysfunction. J Am Coll Cardiol Intv. 2009, 2: 1169-1177.CrossRef Lakshmana K, Pendyala , Xinhua Y, et al: The First-Generation Drug-Eluting Stents and Coronary Endothelial Dysfunction. J Am Coll Cardiol Intv. 2009, 2: 1169-1177.CrossRef
5.
go back to reference van den Heuvel M, Sorop O, Batenburg WW, et al: Specific Coronary Drug-Eluting Stents Interfere With Distal Microvascular Function After Single Stent Implantation in Pigs. J Am Coll Cardiol Intv. 2010, 3: 723-730.CrossRef van den Heuvel M, Sorop O, Batenburg WW, et al: Specific Coronary Drug-Eluting Stents Interfere With Distal Microvascular Function After Single Stent Implantation in Pigs. J Am Coll Cardiol Intv. 2010, 3: 723-730.CrossRef
6.
go back to reference Joner M, Finn AV, Farb A, et al: Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol. 2006, 48: 193-202. 10.1016/j.jacc.2006.03.042.CrossRefPubMed Joner M, Finn AV, Farb A, et al: Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol. 2006, 48: 193-202. 10.1016/j.jacc.2006.03.042.CrossRefPubMed
7.
go back to reference Curcio A, Torella D, Indolfi C: Mechanisms of Smooth Muscle Cell Proliferation and Endothelial Regeneration After Vascular Injury and Stenting. Circ J. 2011, 75: 1287-1296. 10.1253/circj.CJ-11-0366.CrossRefPubMed Curcio A, Torella D, Indolfi C: Mechanisms of Smooth Muscle Cell Proliferation and Endothelial Regeneration After Vascular Injury and Stenting. Circ J. 2011, 75: 1287-1296. 10.1253/circj.CJ-11-0366.CrossRefPubMed
8.
go back to reference van Beusekom HM, Serruys PW: Drug-Eluting Stent Endothelium. J Am Coll Cardiol Intv. 2010, 1: 76-77.CrossRef van Beusekom HM, Serruys PW: Drug-Eluting Stent Endothelium. J Am Coll Cardiol Intv. 2010, 1: 76-77.CrossRef
9.
go back to reference Klomp M, Beijk MA, de Winter RJ: Genous endothelial progenitor cell-capturing stent system: a novel stent technology. Expert Rev Med Devices. 2009, 6: 365-375. 10.1586/erd.09.16.CrossRefPubMed Klomp M, Beijk MA, de Winter RJ: Genous endothelial progenitor cell-capturing stent system: a novel stent technology. Expert Rev Med Devices. 2009, 6: 365-375. 10.1586/erd.09.16.CrossRefPubMed
10.
go back to reference Gaku N, Granada JF, Alviar CL, et al: Anti-CD34 Antibodies Immobilized on the Surface of Sirolimus-Eluting Stents Enhance Stent Endothelialization. J Am Coll Cardiol Intv. 2010, 3: 68-75.CrossRef Gaku N, Granada JF, Alviar CL, et al: Anti-CD34 Antibodies Immobilized on the Surface of Sirolimus-Eluting Stents Enhance Stent Endothelialization. J Am Coll Cardiol Intv. 2010, 3: 68-75.CrossRef
11.
go back to reference Rossi ML, Zavalloni D, Gasparini GL, et al: The first report of late stent thrombosis leading to acute myocardial infarction in patient receiving the new endothelial progenitor cell capture stent. Int J Cardiol. 2010, 141: e20-e22. 10.1016/j.ijcard.2008.11.134.CrossRefPubMed Rossi ML, Zavalloni D, Gasparini GL, et al: The first report of late stent thrombosis leading to acute myocardial infarction in patient receiving the new endothelial progenitor cell capture stent. Int J Cardiol. 2010, 141: e20-e22. 10.1016/j.ijcard.2008.11.134.CrossRefPubMed
12.
go back to reference Meng S, Liu Z, Shen L, et al: The effect of a layer-by-layer chitosan-heparin coating on the endothelialization and coagulation properties of a coronary stent system. Biomaterials. 2009, 30 (12): 2276-2283. 10.1016/j.biomaterials.2008.12.075.CrossRefPubMed Meng S, Liu Z, Shen L, et al: The effect of a layer-by-layer chitosan-heparin coating on the endothelialization and coagulation properties of a coronary stent system. Biomaterials. 2009, 30 (12): 2276-2283. 10.1016/j.biomaterials.2008.12.075.CrossRefPubMed
13.
go back to reference Van Der Giessen WJ, Regar E, Harteveld MS, et al: “Edge Effect”of (32)p radioactive stents is causes by the combination of chronic stent injury and radioactive dose falloff. Circulation. 2001, 104: 2236-2241. 10.1161/hc4301.097873.CrossRefPubMed Van Der Giessen WJ, Regar E, Harteveld MS, et al: “Edge Effect”of (32)p radioactive stents is causes by the combination of chronic stent injury and radioactive dose falloff. Circulation. 2001, 104: 2236-2241. 10.1161/hc4301.097873.CrossRefPubMed
14.
go back to reference Derkx P, Nigg AL, Bosman FT, et al: Immunolocalization and quantification of noncollagenous bone matrix proteins in methylmethacry-late-embedded adult human bone in combination with histomorphometry. Bone. 1998, 22: 367-373. 10.1016/S8756-3282(97)00299-8.CrossRefPubMed Derkx P, Nigg AL, Bosman FT, et al: Immunolocalization and quantification of noncollagenous bone matrix proteins in methylmethacry-late-embedded adult human bone in combination with histomorphometry. Bone. 1998, 22: 367-373. 10.1016/S8756-3282(97)00299-8.CrossRefPubMed
15.
go back to reference Co M, Tay E, Lee CH, et al: Use of endothelial progenitor cell capture stent (Genous Bio-Engineered R Stent) during primary percutaneous coronary intervention in acute myocardial infarction: intermediate- to long-term clinical follow-up. Am Heart J. 2008, 155: 128-132. 10.1016/j.ahj.2007.08.031.CrossRefPubMed Co M, Tay E, Lee CH, et al: Use of endothelial progenitor cell capture stent (Genous Bio-Engineered R Stent) during primary percutaneous coronary intervention in acute myocardial infarction: intermediate- to long-term clinical follow-up. Am Heart J. 2008, 155: 128-132. 10.1016/j.ahj.2007.08.031.CrossRefPubMed
16.
go back to reference Aoki J, Serruys PW, van Beusekom H, et al: Endothelial progenitor cell capture by stents coated with antibody against CD34: The HEALING-FIM (Healthy Endothelial Accelerated Lining Inhibits Neointimal Growth-First In Man) Registry. J Am Coll Cardiol. 2005, 45: 1574-1579. 10.1016/j.jacc.2005.01.048.CrossRefPubMed Aoki J, Serruys PW, van Beusekom H, et al: Endothelial progenitor cell capture by stents coated with antibody against CD34: The HEALING-FIM (Healthy Endothelial Accelerated Lining Inhibits Neointimal Growth-First In Man) Registry. J Am Coll Cardiol. 2005, 45: 1574-1579. 10.1016/j.jacc.2005.01.048.CrossRefPubMed
17.
go back to reference Miglionico M, Patti G, D’Ambrosio A, et al: Percutaneous coronary intervention utilizing a new endothelial progenitor cells antibody-coated stent: A prospective single-center registry in high-risk patients. Catheter Cardiovasc Interv. 2008, 71: 600-604. 10.1002/ccd.21437.CrossRefPubMed Miglionico M, Patti G, D’Ambrosio A, et al: Percutaneous coronary intervention utilizing a new endothelial progenitor cells antibody-coated stent: A prospective single-center registry in high-risk patients. Catheter Cardiovasc Interv. 2008, 71: 600-604. 10.1002/ccd.21437.CrossRefPubMed
18.
go back to reference Meng S, Liu Z, Zhong W, et al: Phosphorylcholine Modified Chitosan:Appetent and Safe material for Cell. Carbohydr Polym. 2007, 70: 82-88. 10.1016/j.carbpol.2007.03.006.CrossRef Meng S, Liu Z, Zhong W, et al: Phosphorylcholine Modified Chitosan:Appetent and Safe material for Cell. Carbohydr Polym. 2007, 70: 82-88. 10.1016/j.carbpol.2007.03.006.CrossRef
19.
go back to reference Yin M, Yuan Y, Liu C, et al: Combinatorial coating of adhesive polypeptide and anti-CD34tibody for improved endothelial cell adhesion and proliferation. J Mater Sci: Mater Med. 2009, 20: 1513-1523. 10.1007/s10856-009-3715-3. Yin M, Yuan Y, Liu C, et al: Combinatorial coating of adhesive polypeptide and anti-CD34tibody for improved endothelial cell adhesion and proliferation. J Mater Sci: Mater Med. 2009, 20: 1513-1523. 10.1007/s10856-009-3715-3.
20.
go back to reference Celik T, Iyisoy A, Kursaklioglu H, et al: The forgotten layer of in-stent restenosis: Endothelial dysfunction. Int J Cardiol. 2008, 126: 443-444. 10.1016/j.ijcard.2007.02.050.CrossRefPubMed Celik T, Iyisoy A, Kursaklioglu H, et al: The forgotten layer of in-stent restenosis: Endothelial dysfunction. Int J Cardiol. 2008, 126: 443-444. 10.1016/j.ijcard.2007.02.050.CrossRefPubMed
21.
go back to reference Joner M, Nakazawa G, Finn AV, et al: Endothelial cell recovery between comparator polymer-based drug-eluting stents. J Am Coll Cardiol. 2008, 52: 333-342. 10.1016/j.jacc.2008.04.030.CrossRefPubMed Joner M, Nakazawa G, Finn AV, et al: Endothelial cell recovery between comparator polymer-based drug-eluting stents. J Am Coll Cardiol. 2008, 52: 333-342. 10.1016/j.jacc.2008.04.030.CrossRefPubMed
22.
go back to reference Chen TG, Chen JZ, Wang XX: Effects of rapamycin on number activity and eNOS of endothelial progenitor cells from peripheral blood. Cell Prolif. 2006, 39: 117-125. 10.1111/j.1365-2184.2006.00375.x.CrossRefPubMed Chen TG, Chen JZ, Wang XX: Effects of rapamycin on number activity and eNOS of endothelial progenitor cells from peripheral blood. Cell Prolif. 2006, 39: 117-125. 10.1111/j.1365-2184.2006.00375.x.CrossRefPubMed
23.
go back to reference Heleen MM, Oana Sorop M, et al: Endothelial function rather than endothelial restoration is altered in paclitaxel- as compared to bare metal-, sirolimus-and tacrolimus-eluting stents. Eurointervention. 2010, 6: 117-125. 10.4244/EIJV6I1A18.CrossRef Heleen MM, Oana Sorop M, et al: Endothelial function rather than endothelial restoration is altered in paclitaxel- as compared to bare metal-, sirolimus-and tacrolimus-eluting stents. Eurointervention. 2010, 6: 117-125. 10.4244/EIJV6I1A18.CrossRef
24.
go back to reference Butzal M, Loges S, Schweizer M, et al: Rapamycin inhibits proliferation and differentiation of human endothelial progenitor cells in vitro. Exp Cell Res. 2004, 300: 65-71. 10.1016/j.yexcr.2004.07.002.CrossRefPubMed Butzal M, Loges S, Schweizer M, et al: Rapamycin inhibits proliferation and differentiation of human endothelial progenitor cells in vitro. Exp Cell Res. 2004, 300: 65-71. 10.1016/j.yexcr.2004.07.002.CrossRefPubMed
25.
go back to reference Li JJ, Li J, Nan JL, et al: Coronary restenotic reduction of Drug-eluting stenting may be due to its anti-inflammatory effect. Med Hypotheses. 2007, 69 (5): 1004-1009. 10.1016/j.mehy.2007.01.090.CrossRefPubMed Li JJ, Li J, Nan JL, et al: Coronary restenotic reduction of Drug-eluting stenting may be due to its anti-inflammatory effect. Med Hypotheses. 2007, 69 (5): 1004-1009. 10.1016/j.mehy.2007.01.090.CrossRefPubMed
26.
go back to reference Adkins JR, Castresana MR, Wang Z, et al: Rapamycin inhibits release of tumor necrosis factor-alpha from human vascular smooth muscle cells. Am Surg. 2004, 70 (5): 384-387.PubMed Adkins JR, Castresana MR, Wang Z, et al: Rapamycin inhibits release of tumor necrosis factor-alpha from human vascular smooth muscle cells. Am Surg. 2004, 70 (5): 384-387.PubMed
27.
go back to reference Higo T, Ueda Y, Oyabu J, et al: Atherosclerotic and thrombogenic neointima formed over sirolimus drug-eluting stent: an angioscopic study. J Am Coll Cardiol Img. 2009, 2: 616-624.CrossRef Higo T, Ueda Y, Oyabu J, et al: Atherosclerotic and thrombogenic neointima formed over sirolimus drug-eluting stent: an angioscopic study. J Am Coll Cardiol Img. 2009, 2: 616-624.CrossRef
28.
go back to reference Nakazawa G, Vorpahl M, Finn AV, et al: One step forward and two steps back with drug-eluting-stents from preventing restenosis to causing late thrombosis and nouveau atherosclerosis. J Am Coll Cardiol Img. 2009, 2: 625-628.CrossRef Nakazawa G, Vorpahl M, Finn AV, et al: One step forward and two steps back with drug-eluting-stents from preventing restenosis to causing late thrombosis and nouveau atherosclerosis. J Am Coll Cardiol Img. 2009, 2: 625-628.CrossRef
Metadata
Title
Combination coating of chitosan and anti-CD34 antibody applied on sirolimus-eluting stents can promote endothelialization while reducing neointimal formation
Authors
Feng Yang
Shi-Chao Feng
Xiang-Jun Pang
Wei-Xiao Li
Yong-Hua Bi
Qian Zhao
Shi-Xuan Zhang
Yang Wang
Bo Feng
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2012
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-12-96

Other articles of this Issue 1/2012

BMC Cardiovascular Disorders 1/2012 Go to the issue