(Circulation. 2000;101:2546.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
From the National Cardiovascular Center, Osaka (S.Y., T.N., M.G., T.M., H.N.), and Tokai Medical Products Inc, Aichi (T.A., N.T.), Japan.
Correspondence to Satoshi Yasuda, MD, Division of Cardiology, Department of Medicine, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan. E-mail syasuda{at}hsp.ncvc.go.jp
BackgroundPrevious studies have
shown that repeated systemic administration of human recombinant
hepatocyte growth factor (hrHGF) in mg/kg levels modulates
the wound-healing process in various diseases. Recently, HGF has been
characterized as one of the most potent
endothelial-cellspecific growth factors. We tested
our hypothesis that local delivery of hrHGF, even at low µg/kg levels
(
2 orders of magnitude lower than systemically administered doses),
might attenuate neointimal hyperplasia in response to
vascular injury via accelerated
reendothelialization.
Methods and ResultsThe iliac artery was denuded in 16 New
Zealand White rabbits (3 kg), followed by administration, via a drug
delivery catheter, of either hrHGF (10 µg; n=11) or control vehicle
(n=5) over 20 minutes. In pilot studies using this device, the drug
permeated into the medial tissues, where it persisted for
24 hours.
Four weeks after the local delivery of hrHGF, computer-assisted
morphometric analysis revealed significant reduction in the
intimal area (hrHGF, 0.37±0.21 versus control, 0.68±0.16
mm2, mean±SD; P<0.05) but no change in the
medial area (hrHGF, 1.03±0.21 versus control, 1.10±0.52
mm2). Scanning electron microscopy revealed extensive
endothelialization with regular and confluent
endothelial cell layer regeneration in the
hrHGF-treated vessels.
ConclusionsAccelerated endothelialization after local delivery of hrHGF, a novel and potent endothelial cell mitogen, effectively attenuates neointimal proliferation even after single low-dose administration. This observation could have potential therapeutic implications in the prevention of restenosis after angioplasty.
Key Words: angioplasty catheters endothelium growth substances restenosis
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