Endothelial injury and its repair strategies after intravascular stents implantation_Journal of Biomedical Engineering

Authors：

XI Yadong , HUANG Yuhua , DU Ruolin , WANG Yazhou , WANG Guixue ,  YIN Tieying

Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory For Vascular Implants, Bioengineering College, Chongqing University, Chongqing 400044, P.R.China;

Corresponding author：

Keywords：

intravascular stents; vascular endothelial cells; restenosis; injury; repair

DOI：

10.7507/1001-5515.201612008

Video：

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Coronary atherosclerotic heart disease is a serious threat to human life and health. In recent years, the main treatment for it is to implant the intravascular stent into the lesion to support blood vessels and reconstruct blood supply. However, a large number of experimental results showed that mechanical injury and anti-proliferative drugs caused great damage after stent implantation, and increased in-stent restenosis and late thrombosis risk. Thus, maintaining the integrity and normal function of the endothelium can significantly reduce the rate of thrombosis and restenosis. Stem cell mobilization, homing, differentiation and proliferation are the main mechanisms of endothelial repair after vascular stent implantation. Vascular factor and mechanical microenvironmental changes in implanted sites have a certain effect on re-endothelialization. In this paper, the process of injury caused by stent implantation, the repair mechanism after injury and its influencing factors are expounded in detail. And repairing strategies are analyzed and summarized. This review provides a reference for overcoming the in-stent restenosis, endothelialization delay and late thrombosis during the interventional treatment, as well as for designing drug-eluting and biodegradation stents.

Citation： XI Yadong, HUANG Yuhua, DU Ruolin, WANG Yazhou, WANG Guixue, YIN Tieying. Endothelial injury and its repair strategies after intravascular stents implantation. Journal of Biomedical Engineering, 2018, 35(2): 307-313. doi: 10.7507/1001-5515.201612008 Copy

1.	陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告 2016》概要. 中国循环杂志, 2017, 32(6): 521-530.
2.	Kazemian M R, Solouk A, Tan A, et al. Preventing in-stent restenosis using lipoprotein (a), lipid and cholesterol adsorbent materials. Med Hypotheses, 2015, 85(6): 986-988.
3.	Papafaklis M I, Chatzizisis Y S, Naka K K, et al. Drug-eluting stent restenosis: effect of drug type, release kinetics, hemodynamics and coating strategy. Pharmacol Ther, 2012, 134(1): 43-53.
4.	Lan Hualin, Wang Yi, Yin Tieyin, et al. Progress and prospects of endothelial progenitor cell therapy in coronary stent implantation. J Biomed Mater Res B Appl Biomater, 2015, 104(6): 1237-1247.
5.	Foin N, Torii R, Mattesini A, et al. Biodegradable vascular scaffold:is optimal expansion the key to minimising flow disturbances and risk of adverse events?. EuroIntervention, 2015, 10(10): 1139-1142.
6.	Hu Tingzhang, Yang Jiali, Cui Kun, et al. Controlled Slow-Release Drug-Eluting stents for the prevention of coronary restenosis: recent progress and future prospects. ACS Appl Mater Interfaces, 2015, 7(22): 11695-11712.
7.	Mcginty S, Mckee S, Mccormick C, et al. Release mechanism and parameter estimation in drug-eluting stent systems: analytical solutions of drug release and tissue transport. Math Med Biol, 2015, 32(2): 163-186.
8.	Wilson H K, Canfield S G, Hjortness M K, et al. Exploring the effects of cell seeding density on the differentiation of human pluripotent stem cells to brain microvascular endothelial cells. Fluids Barriers CNS, 2015, 12: 13.
9.	李志海, 梁亚洲, 艾帅兵, 等. 他汀类药物对药物涂层支架置入后再内皮化化的影响. 中外女性健康研究. 2015(14): 29-30.
10.	Dan P, Velot E, Decot V, et al. The role of mechanical stimuli in the vascular differentiation of mesenchymal stem cells. J Cell Sci, 2015, 128(14): 2415-2422.
11.	Yu Baoqi, Wong M M, Potter C M, et al. Vascular stem/progenitor cell migration induced by smooth muscle Cell-Derived chemokine (C-C motif) ligand 2 and chemokine (C-X-C motif) ligand 1 contributes to neointima formation. Stem Cells, 2016, 34(9): 2368-2380.
12.	Campagnolo P, Hong Xuechong, Di Bernardini E A, et al. Resveratrol-Induced vascular progenitor differentiation towards endothelial lineage via MiR-21/Akt/beta-Catenin is protective in vessel graft models. PLoS One, 2015, 10(5): UNSP e0125122.
13.	Liu Junfeng, Chen Zhi, Du Zhongdong, et al. Granulocyte colony-stimulating factor ameliorates coronary artery elastin breakdown in a mouse model of Kawasaki disease. Chin Med J: Engl, 2014, 127(21): 3712-3717.
14.	安劲松. 雌激素通过内皮祖细胞对冠心病保护作用的研究进展. 内蒙古医学杂志, 2015(3): 318-320.
15.	Poh C K, Shi Zhilong, Lim T Y, et al. The effect of VEGF functionalization of Titanium on endothelial cells in vitro. Biomaterials, 2010, 31(7): 1578-1585.
16.	Song Chunli, Li Qian, Yu Yunpeng, et al. Study of novel coating strategy for coronary stents: simutaneous coating of VEGF and anti-CD34 antibody. Rev Bras Cir Cardiovasc, 2015, 30(2): 159-163.
17.	沈根, 张顺, 叶红华. 他汀类药物对内皮祖细胞作用的研究进展. 新医学, 2015, 46(12): 789-793.
18.	Saito N, Mori Y, Uchiyama S. Drug diffusion and biological responses of arteries using a drug-eluting stent with nonuniform coating. Med Devices: Evidence and Research, 2016, 9: 33-43.
19.	Zhu Jinzhou, Liu Huizhu, Cui Haipo, et al. Safety and efficacy of a novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent. J Mater Sci Mater Med, 2017, 28(3): 54.
20.	张旭军. 药物洗脱支架在冠状动脉介入治疗中的新进展. 中国临床研究, 2014, 27(9): 1144-1146.
21.	潘兴纳, 李亚雄, 蒋立虹. 组织工程血管支架材料的研究与进展. 中国组织工程研究, 2016, 20(34): 5149-5154.
22.	陈亮, 丁健, 王永利, 等. 镁合金支架植入兔腹主动脉后降解时间观察. 介入放射学杂志, 2015, 24(11): 984-987.
23.	Kubasek J, Vojtech D, Jablonska E, et al. Structure, mechanical characteristics and in vitro degradation, cytotoxicity, genotoxicity and mutagenicity of novel biodegradable Zn-Mg alloys. Mater Sci Eng C Mater Biol Appl, 2016, 58: 24-35.
24.	Bowen P K, Guillory I R, Shearier E R, et al. Metallic Zinc exhibits optimal biocompatibility for bioabsorbable endovascular stents. Mater Sci Eng C Mater Biol Appl, 2015, 56: 467-472.
25.	Wu X, Zhao Y, Tang C, et al. Re-endothelialization study on endovascular stents seeded by endothelial cells through up-or downregulation of VEGF. ACS Appl Mater Interfaces, 2016, 8(11): 7578-7589.
26.	Shirota T, Yasui H, Shimokawa H, et al. Fabrication of endothelial progenitor cell(EPC)-seeded intravascular stent devices and in vitro endothelialization on hybrid vascular tissue. Biomaterials, 2003, 24(13): 2295-2302.
27.	Hwang C W, Johnston P V, Gerstenblith G, et al. Stem cell impregnated nanofiber stent sleeve for on-stent production and intravascular delivery of paracrine factors. Biomaterials, 2015, 52: 318-326.
28.	Wu Xue, Yin Tieying, Tian Jie, et al. Distinctive effects of CD34- and CD133-specific antibody-coated stents on re-endothelialization and in-stent restenosis at the early phase of vascular injury. Regenerative Biomaterials, 2015, 2(2): 87-96.
29.	杨峰, 赵骞, 张世轩, 等. 雷帕霉素联合 CD34 抗体复合支架快速捕获外周血中内皮祖细胞. 中国组织工程研究, 2015, 19(41): 6694-6698.

1. 陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告 2016》概要. 中国循环杂志, 2017, 32(6): 521-530.
2. Kazemian M R, Solouk A, Tan A, et al. Preventing in-stent restenosis using lipoprotein (a), lipid and cholesterol adsorbent materials. Med Hypotheses, 2015, 85(6): 986-988.
3. Papafaklis M I, Chatzizisis Y S, Naka K K, et al. Drug-eluting stent restenosis: effect of drug type, release kinetics, hemodynamics and coating strategy. Pharmacol Ther, 2012, 134(1): 43-53.
4. Lan Hualin, Wang Yi, Yin Tieyin, et al. Progress and prospects of endothelial progenitor cell therapy in coronary stent implantation. J Biomed Mater Res B Appl Biomater, 2015, 104(6): 1237-1247.
5. Foin N, Torii R, Mattesini A, et al. Biodegradable vascular scaffold:is optimal expansion the key to minimising flow disturbances and risk of adverse events?. EuroIntervention, 2015, 10(10): 1139-1142.
6. Hu Tingzhang, Yang Jiali, Cui Kun, et al. Controlled Slow-Release Drug-Eluting stents for the prevention of coronary restenosis: recent progress and future prospects. ACS Appl Mater Interfaces, 2015, 7(22): 11695-11712.
7. Mcginty S, Mckee S, Mccormick C, et al. Release mechanism and parameter estimation in drug-eluting stent systems: analytical solutions of drug release and tissue transport. Math Med Biol, 2015, 32(2): 163-186.
8. Wilson H K, Canfield S G, Hjortness M K, et al. Exploring the effects of cell seeding density on the differentiation of human pluripotent stem cells to brain microvascular endothelial cells. Fluids Barriers CNS, 2015, 12: 13.
9. 李志海, 梁亚洲, 艾帅兵, 等. 他汀类药物对药物涂层支架置入后再内皮化化的影响. 中外女性健康研究. 2015(14): 29-30.
10. Dan P, Velot E, Decot V, et al. The role of mechanical stimuli in the vascular differentiation of mesenchymal stem cells. J Cell Sci, 2015, 128(14): 2415-2422.
11. Yu Baoqi, Wong M M, Potter C M, et al. Vascular stem/progenitor cell migration induced by smooth muscle Cell-Derived chemokine (C-C motif) ligand 2 and chemokine (C-X-C motif) ligand 1 contributes to neointima formation. Stem Cells, 2016, 34(9): 2368-2380.
12. Campagnolo P, Hong Xuechong, Di Bernardini E A, et al. Resveratrol-Induced vascular progenitor differentiation towards endothelial lineage via MiR-21/Akt/beta-Catenin is protective in vessel graft models. PLoS One, 2015, 10(5): UNSP e0125122.
13. Liu Junfeng, Chen Zhi, Du Zhongdong, et al. Granulocyte colony-stimulating factor ameliorates coronary artery elastin breakdown in a mouse model of Kawasaki disease. Chin Med J: Engl, 2014, 127(21): 3712-3717.
14. 安劲松. 雌激素通过内皮祖细胞对冠心病保护作用的研究进展. 内蒙古医学杂志, 2015(3): 318-320.
15. Poh C K, Shi Zhilong, Lim T Y, et al. The effect of VEGF functionalization of Titanium on endothelial cells in vitro. Biomaterials, 2010, 31(7): 1578-1585.
16. Song Chunli, Li Qian, Yu Yunpeng, et al. Study of novel coating strategy for coronary stents: simutaneous coating of VEGF and anti-CD34 antibody. Rev Bras Cir Cardiovasc, 2015, 30(2): 159-163.
17. 沈根, 张顺, 叶红华. 他汀类药物对内皮祖细胞作用的研究进展. 新医学, 2015, 46(12): 789-793.
18. Saito N, Mori Y, Uchiyama S. Drug diffusion and biological responses of arteries using a drug-eluting stent with nonuniform coating. Med Devices: Evidence and Research, 2016, 9: 33-43.
19. Zhu Jinzhou, Liu Huizhu, Cui Haipo, et al. Safety and efficacy of a novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent. J Mater Sci Mater Med, 2017, 28(3): 54.
20. 张旭军. 药物洗脱支架在冠状动脉介入治疗中的新进展. 中国临床研究, 2014, 27(9): 1144-1146.
21. 潘兴纳, 李亚雄, 蒋立虹. 组织工程血管支架材料的研究与进展. 中国组织工程研究, 2016, 20(34): 5149-5154.
22. 陈亮, 丁健, 王永利, 等. 镁合金支架植入兔腹主动脉后降解时间观察. 介入放射学杂志, 2015, 24(11): 984-987.
23. Kubasek J, Vojtech D, Jablonska E, et al. Structure, mechanical characteristics and in vitro degradation, cytotoxicity, genotoxicity and mutagenicity of novel biodegradable Zn-Mg alloys. Mater Sci Eng C Mater Biol Appl, 2016, 58: 24-35.
24. Bowen P K, Guillory I R, Shearier E R, et al. Metallic Zinc exhibits optimal biocompatibility for bioabsorbable endovascular stents. Mater Sci Eng C Mater Biol Appl, 2015, 56: 467-472.
25. Wu X, Zhao Y, Tang C, et al. Re-endothelialization study on endovascular stents seeded by endothelial cells through up-or downregulation of VEGF. ACS Appl Mater Interfaces, 2016, 8(11): 7578-7589.
26. Shirota T, Yasui H, Shimokawa H, et al. Fabrication of endothelial progenitor cell(EPC)-seeded intravascular stent devices and in vitro endothelialization on hybrid vascular tissue. Biomaterials, 2003, 24(13): 2295-2302.
27. Hwang C W, Johnston P V, Gerstenblith G, et al. Stem cell impregnated nanofiber stent sleeve for on-stent production and intravascular delivery of paracrine factors. Biomaterials, 2015, 52: 318-326.
28. Wu Xue, Yin Tieying, Tian Jie, et al. Distinctive effects of CD34- and CD133-specific antibody-coated stents on re-endothelialization and in-stent restenosis at the early phase of vascular injury. Regenerative Biomaterials, 2015, 2(2): 87-96.
29. 杨峰, 赵骞, 张世轩, 等. 雷帕霉素联合 CD34 抗体复合支架快速捕获外周血中内皮祖细胞. 中国组织工程研究, 2015, 19(41): 6694-6698.

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