(Circulation. 1995;91:2703-2711.)
© 1995 American Heart Association, Inc.
Articles |
From the Departments of Medicine (Cardiology) and Biomedical Research, St Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Mass.
Correspondence to Jeffrey M. Isner, MD, St Elizabeth's Medical Center, 736 Cambridge St, Boston, MA 02135. E-mail jisner@ opal.tufts.edu.
Background Apoptosis has been recognized in normal, including rapidly proliferating, cell populations and is inferred to be potentially responsible for the maintenance of stable cell numbers in tissues with various degrees of proliferative activity. Previous studies performed in rats indicated that despite the persistence of a relatively high level of injury-induced proliferative activity, total arterial smooth muscle content at 12 weeks remained unchanged from that measured at 2 weeks, suggesting that accrual of vascular smooth muscle cells is mitigated by cell death. The extent to which apoptosis may be observed in human atherosclerosis and/or restenosis, however, has not been previously established.
Methods and Results We performed immunohistochemical studies on 56 specimens retrieved from patients undergoing directional atherectomy for primary atherosclerotic lesions or recurrent arterial narrowing after percutaneous revascularization (restenosis). Immunohistochemical staining disclosed evidence of apoptosis in 35 (63%) of the 56 specimens studied. When present, immunohistochemical evidence of apoptosis was typically limited to <2% of cells in the specimen. The finding of apoptosis, however, was not distributed equally among four groups of specimens studied. Specimens retrieved from patients with restenosis were more frequently observed to contain foci of apoptosis than specimens retrieved from patients with primary atherosclerotic lesions. Among 14 peripheral arterial specimens from patients with restenosis, 13 (93%) contained foci of apoptosis; in contrast, apoptosis was observed in only 6 (43%) of 14 peripheral specimens from patients with primary lesions (P=.0046). Among coronary arterial specimens, apoptosis was observed in 12 (86%) of 14 specimens from patients with restenosis versus 6 (29%) of 14 specimens from patients with primary obstructions (P<.0075).
Conclusions Apoptosis is a feature of human vascular pathology, including restenotic lesions and, to a lesser extent, primary atherosclerotic lesions. The findings of the present study suggest that apoptosis may modulate the cellularity of lesions that produce human vascular obstruction, particularly those with evidence of more extensive proliferative activity.
Key Words: apoptosis programmed cell death proliferation BCL-2
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A. Orlandi, A. Francesconi, D. Cocchia, A. Corsini, and L. G. Spagnoli Phenotypic Heterogeneity Influences Apoptotic Susceptibility to Retinoic Acid and cis-Platinum of Rat Arterial Smooth Muscle Cells In Vitro : Implications for the Evolution of Experimental Intimal Thickening Arterioscler Thromb Vasc Biol, July 1, 2001; 21(7): 1118 - 1123. [Abstract] [Full Text] [PDF] |
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E. Sho, M. Sho, T. M. Singh, C. Xu, C. K. Zarins, and H. Masuda Blood Flow Decrease Induces Apoptosis of Endothelial Cells in Previously Dilated Arteries Resulting From Chronic High Blood Flow Arterioscler Thromb Vasc Biol, July 1, 2001; 21(7): 1139 - 1145. [Abstract] [Full Text] [PDF] |
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D. Ekhterae, O. Platoshyn, S. Krick, Y. Yu, S. S. McDaniel, and J. X.-J. Yuan Bcl-2 decreases voltage-gated K+ channel activity and enhances survival in vascular smooth muscle cells Am J Physiol Cell Physiol, July 1, 2001; 281(1): C157 - C165. [Abstract] [Full Text] [PDF] |
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H. Kataoka, N. Kume, S. Miyamoto, M. Minami, M. Morimoto, K. Hayashida, N. Hashimoto, and T. Kita Oxidized LDL Modulates Bax/Bcl-2 Through the Lectinlike Ox-LDL Receptor-1 in Vascular Smooth Muscle Cells Arterioscler Thromb Vasc Biol, June 1, 2001; 21(6): 955 - 960. [Abstract] [Full Text] [PDF] |
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A. M. Healy, J. J. Schwartz, X. Zhu, B. E. Herrick, B. Varnum, and H. W. Farber Gas 6 promotes Axl-mediated survival in pulmonary endothelial cells Am J Physiol Lung Cell Mol Physiol, June 1, 2001; 280(6): L1273 - L1281. [Abstract] [Full Text] [PDF] |
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M. Li, P. M. Absher, P. Liang, J. C. Russell, B. E. Sobel, and N. K. Fukagawa High Glucose Concentrations Induce Oxidative Damage to Mitochondrial DNA in Explanted Vascular Smooth Muscle Cells Experimental Biology and Medicine, May 1, 2001; 226(5): 450 - 457. [Abstract] [Full Text] |
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M. Leskinen, Y. Wang, D. Leszczynski, K. A. Lindstedt, and P. T. Kovanen Mast Cell Chymase Induces Apoptosis of Vascular Smooth Muscle Cells Arterioscler Thromb Vasc Biol, April 1, 2001; 21(4): 516 - 522. [Abstract] [Full Text] [PDF] |
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K. HEERMEIER, W. LEICHT, A. PALMETSHOFER, M. ULLRICH, C. WANNER, and J. GALLE Oxidized LDL Suppresses NF-{{kappa}}B and Overcomes Protection from Apoptosis in Activated Endothelial Cells J. Am. Soc. Nephrol., March 1, 2001; 12(3): 456 - 463. [Abstract] [Full Text] |
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T.-S. Lee and L.-Y. Chau Fas/Fas ligand-mediated death pathway is involved in oxLDL-induced apoptosis in vascular smooth muscle cells Am J Physiol Cell Physiol, March 1, 2001; 280(3): C709 - C718. [Abstract] [Full Text] [PDF] |
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D M Braganza and M R Bennett New insights into atherosclerotic plaque rupture Postgrad. Med. J., February 1, 2001; 77(904): 94 - 98. [Full Text] |
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C.-C. Hsieh, M.-H. Yen, C.-H. Yen, and Y.-T. Lau Oxidized low density lipoprotein induces apoptosis via generation of reactive oxygen species in vascular smooth muscle cells Cardiovasc Res, January 1, 2001; 49(1): 135 - 145. [Abstract] [Full Text] [PDF] |
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Y. Okura, M. Brink, H. Itabe, K. J. Scheidegger, A. Kalangos, and P. Delafontaine Oxidized Low-Density Lipoprotein Is Associated With Apoptosis of Vascular Smooth Muscle Cells in Human Atherosclerotic Plaques Circulation, November 28, 2000; 102(22): 2680 - 2686. [Abstract] [Full Text] [PDF] |
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V. Hampl and J. Herget Role of Nitric Oxide in the Pathogenesis of Chronic Pulmonary Hypertension Physiol Rev, October 1, 2000; 80(4): 1337 - 1372. [Abstract] [Full Text] [PDF] |
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H. Obara, A. Takayanagi, J. Hirahashi, K. Tanaka, G. Wakabayashi, K. Matsumoto, M. Shimazu, N. Shimizu, and M. Kitajima Overexpression of Truncated I{kappa}B{alpha} Induces TNF-{alpha}-Dependent Apoptosis in Human Vascular Smooth Muscle Cells Arterioscler Thromb Vasc Biol, October 1, 2000; 20(10): 2198 - 2204. [Abstract] [Full Text] [PDF] |
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F. D. Kolodgie, J. Narula, A. P. Burke, N. Haider, A. Farb, Y. Hui-Liang, J. Smialek, and R. Virmani Localization of Apoptotic Macrophages at the Site of Plaque Rupture in Sudden Coronary Death Am. J. Pathol., October 1, 2000; 157(4): 1259 - 1268. [Abstract] [Full Text] [PDF] |
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J. A. Hamilton, G. Whitty, and W. Jessup Oxidized LDL Can Promote Human Monocyte Survival Arterioscler Thromb Vasc Biol, October 1, 2000; 20 (10): 2329 - 2331. [Full Text] [PDF] |
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F. Jung, J. Haendeler, C. Goebel, A. M. Zeiher, and S. Dimmeler Growth factor-induced phosphoinositide 3-OH kinase/Akt phosphorylation in smooth muscle cells: induction of cell proliferation and inhibition of cell death Cardiovasc Res, October 1, 2000; 48(1): 148 - 157. [Abstract] [Full Text] [PDF] |
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D. Hou, P. I. Rogers, P. M. Toleikis, W. Hunter, and K. L. March Intrapericardial Paclitaxel Delivery Inhibits Neointimal Proliferation and Promotes Arterial Enlargement After Porcine Coronary Overstretch Circulation, September 26, 2000; 102(13): 1575 - 1581. [Abstract] [Full Text] [PDF] |
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Jianhua Zhu and Danchen Gao Losartan reduces collagen content and intimal thickening of iliac arteries after balloon injury in rabbits Journal of Renin-Angiotensin-Aldosterone System, September 1, 2000; 1(3): 278 - 282. [Abstract] [PDF] |
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K. Walsh, R. C. Smith, and H.-S. Kim Vascular Cell Apoptosis in Remodeling, Restenosis, and Plaque Rupture Circ. Res., August 4, 2000; 87(3): 184 - 188. [Full Text] [PDF] |
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N. Latif, M. A. Khan, E. Birks, A. O'Farrell, J. Westbrook, M. J. Dunn, and M. H. Yacoub Upregulation of the Bcl-2 family of proteins in end stage heart failure J. Am. Coll. Cardiol., June 1, 2000; 35(7): 1769 - 1777. [Abstract] [Full Text] [PDF] |
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B. Metzler, Y. Hu, H. Dietrich, and Q. Xu Increased Expression and Activation of Stress-Activated Protein Kinases/c-Jun NH2-Terminal Protein Kinases in Atherosclerotic Lesions Coincide with p53 Am. J. Pathol., June 1, 2000; 156(6): 1875 - 1886. [Abstract] [Full Text] [PDF] |
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S. Yasuda, T. Noguchi, M. Gohda, T. Arai, N. Tsutsui, T. Matsuda, and H. Nonogi Single Low-Dose Administration of Human Recombinant Hepatocyte Growth Factor Attenuates Intimal Hyperplasia in a Balloon-Injured Rabbit Iliac Artery Model Circulation, May 30, 2000; 101(21): 2546 - 2549. [Abstract] [Full Text] [PDF] |
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M. Klouche, S. Rose-John, W. Schmiedt, and S. Bhakdi Enzymatically Degraded, Nonoxidized LDL Induces Human Vascular Smooth Muscle Cell Activation, Foam Cell Transformation, and Proliferation Circulation, April 18, 2000; 101(15): 1799 - 1805. [Abstract] [Full Text] [PDF] |
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H.-S. Kim, K.-K. Hwang, J.-W. Seo, S.-Y. Kim, B.-H. Oh, M.-M. Lee, and Y.-B. Park Apoptosis and Regulation of Bax and Bcl-X Proteins During Human Neonatal Vascular Remodeling Arterioscler Thromb Vasc Biol, April 1, 2000; 20(4): 957 - 963. [Abstract] [Full Text] [PDF] |
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J.-K. Hsieh, D. Kletsas, G. Clunn, A. D. Hughes, M. Schachter, and C. Demoliou-Mason p53, p21WAF1/CIP1, and MDM2 Involvement in the Proliferation and Apoptosis in an In Vitro Model of Conditionally Immortalized Human Vascular Smooth Muscle Cells Arterioscler Thromb Vasc Biol, April 1, 2000; 20(4): 973 - 981. [Abstract] [Full Text] [PDF] |
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J.-K. Hsieh, D. Kletsas, G. Clunn, A. D. Hughes, M. Schachter, and C. Demoliou-Mason p53, p21WAF1/CIP1, and MDM2 Involvement in Proliferation and Apoptosis in an In Vitro Model of Conditionally Immortalized Human Vascular Smooth Muscle Cells Arterioscler Thromb Vasc Biol, March 1, 2000; 20(3): 636 - 644. [Abstract] [Full Text] [PDF] |
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M. MAYR, C. LI, Y. ZOU, U. HUEMER, Y. HU, and Q. XU Biomechanical stress-induced apoptosis in vein grafts involves p38 mitogen-activated protein kinases FASEB J, February 1, 2000; 14(2): 261 - 270. [Abstract] [Full Text] |
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