(Circulation. 1997;96:82-90.)
© 1997 American Heart Association, Inc.
Articles |
Redifferentiation of Smooth Muscle Cells After Coronary Angioplasty Determined via Myosin Heavy Chain Expression
From the Third (M.A., Y.S., I.M., Y.Y., R.N.) and Second (K.K.) Departments of Internal Medicine, University of Tokyo, Faculty of Medicine; Department of Cardiology, Juntendo University School of Medicine (M.A., H.Y.); Department of Cardiology, Tokyo Women's Medical College (Y.S.); Department of Cardiology, Toranomon Hospital (S.I., N.K.), Tokyo; Second Department of Internal Medicine, Gunma University School of Medicine (R.N.), Gunma; and Department of Pathology, Osaka City University Medical School (M.U.), Osaka, Japan.
Correspondence to Ryozo Nagai, MD, Second Department of Internal Medicine, Gunma University School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371, Japan. E-mail nagai{at}news.sb.gunma-u.ac.jp
Background The pathophysiology of phenotypic modulation of smooth muscle cells (SMCs) involved in restenosis after angioplasty is not well understood. Smooth muscle myosin heavy chain (SM MHC) isoforms (SM1 and SM2) are specific markers for SMC differentiation. In particular, SM2 is useful as a marker of mature SMCs. SMemb is a nonmuscle myosin heavy chain (NM MHC) whose expression is upregulated in immature or activated SMC.
Methods and Results To determine SMC phenotypes in
neointimal tissues after percutaneous
transluminal coronary angioplasty (PTCA), we performed
immunohistochemistry on human coronary arteries with antibodies
against 
-SM actin, SM1, SM2, and SMemb. Tissues were obtained from
six autopsied patients and from atherectomy specimens from 16 patients
who had undergone PTCA. Medial SMCs were positive for -actin, SM1,
and SM2. Expression of SM1 and SM2 in the neointima varied
with the time after intervention, whereas -actin was constitutively
expressed in all cases studied. Neointimal cells at 16 and
20 days after PTCA contained -actin but little or no SM1 or SM2,
indicating that these cells modulated their phenotype to the
immature state. Neointimal SMCs recovered SM MHC
expression, first SM1 and then SM2, by 6 months after PTCA. Increased
expression of SMemb was found in the neointima but without
apparent relationship to the time after PTCA.
Conclusions Neointimal SMCs show features of an undifferentiated state, indicated by altered expression of SM MHC, and undergo redifferentiation in a time-dependent manner. The expression of SM MHC isoforms provides insight into the biology of healing after angioplasty and furnishes useful tools for the understanding of the roles of differentiation and phenotypic modulation of SMCs in human vascular lesions.
Key Words: angioplasty • coronary disease • muscle, smooth • myosin • restenosis
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