Document Detail

Extracellular matrix changes in stented human coronary arteries.
MedLine Citation:
PMID:  15302784     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Restenosis after stenting occurs secondary to the accumulation of smooth muscle cells (SMCs) and extracellular matrix (ECM), with the ECM accounting for >50% of the neointimal volume. The composition of the in-stent ECM has not been well characterized in humans. METHODS AND RESULTS: Postmortem human coronary arteries (n=45) containing stents underwent histological assessment of neointimal proteoglycans, hyaluronan, collagen (types I and III), SMCs, and CD44 (a cell surface receptor for hyaluronan). The mean duration of stent implantation was 18.7 months; stents in place > or =3 to <9 months (n=17) were assigned to group 1, stents > or =9 to <18 months old (n=19) to group 2, and stents > or =18 months old (n=9) to group 3. In groups 1 and 2, neointimal versican and hyaluronan staining was strongly positive, colocalized with alpha-actin-positive SMCs, and was greater in intensity compared with group 3. Conversely, decorin staining was greatest in group 3. The neointima of both group 1 and 2 stents was rich in type III collagen, with reduced staining in group 3. Type I collagen staining was weakest in group 1 stents, with progressively stronger staining in groups 2 and 3. SMC density and stent stenosis were significantly reduced in group 3 stents compared with groups 1 and 2. CD44 staining colocalized with macrophages and was associated with increased neointimal thickness. CONCLUSIONS: The ECM within human coronary stents resembles a wound that is not fully healed until 18 months after deployment, followed by neointimal retraction. ECM contraction may be a target for therapies aimed at stent restenosis prevention.
Andrew Farb; Frank D Kolodgie; Jin-Yong Hwang; Allen P Burke; Kirubel Tefera; Deena K Weber; Thomas N Wight; Renu Virmani
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Publication Detail:
Type:  Journal Article     Date:  2004-08-09
Journal Detail:
Title:  Circulation     Volume:  110     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-24     Completed Date:  2005-02-28     Revised Date:  2007-07-25    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  940-7     Citation Subset:  AIM; IM    
Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
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MeSH Terms
Antigens, CD44 / analysis
Cell Count
Collagen / analysis
Coronary Restenosis / metabolism*
Extracellular Matrix / chemistry*
Extracellular Matrix Proteins
Hyaluronic Acid / analysis
Lectins, C-Type
Middle Aged
Myocytes, Smooth Muscle / pathology
Postmortem Changes
Protein Isoforms / analysis
Proteochondroitin Sulfates / analysis
Proteoglycans / analysis
Selection Bias
Time Factors
Tunica Intima / chemistry
Wound Healing
Reg. No./Substance:
0/Antigens, CD44; 0/Cspg2 protein, rat; 0/Extracellular Matrix Proteins; 0/Lectins, C-Type; 0/Protein Isoforms; 0/Proteochondroitin Sulfates; 0/Proteoglycans; 0/VCAN protein, human; 0/decorin; 123939-84-4/biglycan; 126968-45-4/Versicans; 9004-61-9/Hyaluronic Acid; 9007-34-5/Collagen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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