Neointima Formation in Injured Hamster Carotid Artery Is Effectively Prevented by the Combination G4120 and Quinapril

Long-term effects of ACE inhibitor on vascular remodelling

The long-term pathomorphological changes of the injured vessels under angiotensin-converting-enzyme (ACE) inhibitor are still not known. Therefore, we assessed the alternations of vascular architecture after three-month therapy with ACE inhibitor and identified new target cells for this medication. Carotid arteries of spontaneously hypertensive rats underwent balloon angioplasty. 14 days prior intervention, half of the animals was treated with ACE inhibitor. After three months of vascular trauma, the injured vessels were explored by histomorphology and immunohistochemistry for angiotensin-II receptor (AT1R), dendritic and HSP47+ cells. The neointimal growth decreased significantly only up to 28 days under ACE inhibitor. In contrast, the reductive effect of ACE inhibitor on media area persisted up to three months after intervention. A significant fraction of early neointimal cells was of a dendritic cell type. The relevant portion of these cells showed an expression of AT1R and HSP47. AT1R was present in 70% and HSP47 in 18% of all early neointimal cells in both groups. ACE inhibitor may at least temporarily diminish remodelling processes in injured vessels. The detection of AT1R on dendritic cells identifies these cells as important targets for therapeutic strategies involving modulation of the renin-angiotensin system.

Cellular interactions with elastin

Elastin is a key structural component of the extracellular matrix. Tropoelastin is the soluble precursor of elastin. In addition to providing elastic recoil to various tissues such as the aorta and lung, elastin, tropoelastin and elastin degradation products are able to influence cell function and promote cellular responses. These responses include chemotaxis, proliferation and cell adhesion. The interaction of elastin products with cells has been attributed to the elastin receptor. However, additional cell-surface receptors have also been identified. These include G protein-coupled receptors and integrins. The potential roles of these receptors in cell-elastin interactions, with particular focus on elastin formation are discussed.

Effect of a Synthetic Matrix Metalloproteinase Inhibitor (ONO-4817) on Neointima Formation in Hypercholesterolemic Hamsters

Degradation of extracellular matrix (ECM) proteins plays an important role in the development of vascular remodeling. We investigated the alteration of matrix metalloproteinases (MMPs) on the development of neointima formation and the effect of a newly synthesized MMP inhibitor using hypercholesterolemic hamsters. Endothelial injury was achieved by a catheter in the hamster carotid artery. Two weeks after the injury, neointima was detected in all hamsters. Oral administration (twice a day) of ONO-4817 was started 2 hours before injury and continued for the next 2 weeks. The neointimal area, with appearance of maze-like structures, was markedly reduced by 52.4 +/- 8.4% by treatment with ONO-4817 at a dose of 20 mg/kg per day. The treatment by ONO-4817 (20 mg/kg per day) significantly reduced the indexes of histone H1 on day 1, 5, and 10 and the BrdU index of intimal smooth muscle cells on day 5 and 10, but not on day 1. Whereas DNA synthesis was not reduced by ONO-4817, in vitro SMC migration on the other hand was reduced dose dependently. According to the results of western-blotting analysis, the expressions of MMPs were increased 1 week after injury. Especially, MMP-12 was not detected in hamsters without cholesterol diet, but it was much increased after injury in hypercholesterolemic hamsters. Additionally, active form of MMP-12 increased in the injured artery of hypercholesterolemic hamsters. In conclusion, inhibition of MMPs results in the suppression of neointima following vascular injury via both prevention of SMC migration and SMC proliferation of late phase in hypercholesterolemic hamsters. MMP-12 plays an important role on vascular stenosis in hypercholesterolemia and ONO-4817 could be a useful compound for the therapy for this field.

alphaIIbbeta3 antagonism vs. antiadhesive treatment to prevent platelet interactions with vascular subendothelium

Platelets adhering to blood vessels promote coagulation and inflammation, and release growth factors that trigger smooth muscle cell activation. We have therefore studied the pharmacological modification of platelet deposition quantitatively by comparing adhesion of flowing platelets to various subendothelial ligands in the absence or presence of an antialpha(IIb)beta(3) antagonist with the effects of antiadhesive treatment consisting of von Willebrand factor (VWF) and fibronectin neutralization or of the combined inhibition of platelet adhesion and aggregation. In vitro, perfusion of anticoagulated human blood over calf skin collagen reiterated that alpha(IIb)beta(3) antagonism prevents platelet aggregation, but not adhesion per se: single platelets strongly bound to collagen at wall shear rates of both 1300 and 2700 s(-1), largely VWF-independent. When perfused over a human umbilical vein endothelial cell-derived extracellular matrix, single alpha(IIb)beta(3)-antagonized platelets primarily adhered to matrix-bound VWF when perfused at 2700 s(-1), but at 1300 s(-1) they also adhered significantly to fibronectin. During perfusion of anticoagulated rabbit blood over de-endothelialized rabbit aorta at a wall shear rate of 1100 s(-1), alpha(IIb)beta(3) antagonism even increased the absolute numbers of adhering platelets and VWF neutralization redirected alpha(IIb)beta(3)-antagonized platelets towards other vascular ligands. Finally, in vivo, following photochemically induced blood vessel injury in mice, alpha(IIb)beta(3) antagonism inhibited platelet-rich thrombus formation, but platelet adhesion was only significantly inhibited when associated with fibronectin neutralization. In conclusion, antiadhesive platelet treatment more potently interferes with platelet deposition on injured blood vessels than alpha(IIb)beta(3) antagonism, but abrogating platelet adhesion can only be achieved by carefully selected antiplatelet drug combinations.

Expression and characterization of the ScFv fragment of antiplatelet GPIIIa monoclonal antibody SZ-21

Platelet thrombus formation is a major contributor to various cardiovascular diseases caused by vascular occlusion. Glycoprotein IIb/IIIa (GPIIb/IIIa) plays a key role in platelet aggregation and hence the formation of thrombi. In the present study, the genes encoding the light- and heavy-chain variable regions (V(H) and V(L)) of SZ-21, which is a monoclonal antibody (MoAb) against GPIIIa integrin have been cloned by RT-PCR from the SZ-21 hybridoma. The genes of V(H) and V(L) were attached to the oligonucleotide of the linker peptide and single-chain antibody fragment (ScFv) was constructed. The ScFv was ligated into phage display vector pHEN1, and the phagemid pHEN1-21ScFv was constructed. The high-affinity phage display technology was used to retain the SZ-21ScFv binding activity to platelets in great effort. After four rounds of enrichment, the screening clone of SZ-21ScFv gene with good reactivity to platelets was ligated into highly expressed vector pET20b and expressed in Escherichia coli BL21(DE3)PlysS for the fusion protein. Recombinant ScFv fragment was produced mostly in the form of inclusion bodies, with its yield up to 21% of the total amount of bacteria protein. The ScFv fragment with the similar binding activity to platelets as MoAb SZ-21 was confirmed by enzyme-linked immunosorbent assay (ELISA) and Western blot. ADP-induced platelet aggregation can be inhibited by ScFv fragment in a dose-dependent manner and the maximal inhibition rate was obtained at a concentration of 750 nM. In addition, the ScFv fragment has ability to inhibit the binding of fibrinogen to platelets and react with endothelial cells. In this study, we have successfully produced the SZ-21ScFv, which retained the binding affinity to platelets and antithrombotic ability of their murine counterparts.

Characterization of simple and reproducible vascular stenosis model in hypercholesterolemic hamsters

The importance of low-density lipoprotein (LDL) in the etiology of atherosclerosis is well recognized. We have established a reproducible stenosis model in hypercholesterolemic hamsters, and the process of arterial stenosis by thrombus or neointima was studied and compared with that in normal hamsters. The level of plasma LDL was 4.6 times higher in hamsters fed a high-cholesterol diet than in hamsters fed normal food. Endothelial injury in right common carotid arteries was induced using a modified catheter. Arterial blood flow was monitored continuously using a Doppler flow probe. Arterial patency after the initiation of injury in high-cholesterol hamsters was significantly changed as compared with that of normal hamsters. Neointima was observed 2 wk after the vascular injury. The neointimal area of high-cholesterol hamsters was significantly larger than that of normal hamsters. To characterize the stenosis in hypercholesterolemic hamsters, we measured platelet aggregation, thrombin time, activated partial thromboplastin time, and proliferating smooth muscle cells (SMC) in vitro and in vivo. The half-maximal inhibitory concentration value for platelet aggregation induced by thrombin or collagen, the DNA synthesis stimulated by platelet-derived growth factor (PDGF)-BB, and 5-bromo-2-deoxy-uridine labeling indices (proliferating index of SMC in vivo) in high-cholesterol hamsters were each significantly higher than the comparable value from normal hamsters. However, specific binding of PDGF-BB in SMC was not different between the two types of hamsters. Furthermore, we investigated the inhibitory effects of probucol or losartan on neointima formation using this model. Probucol, but not losartan, significantly reduced the neointimal area in hypercholesterolemic hamsters. These findings indicated that high levels of plasma LDL strongly contributed to the development of thrombus and neointima formation via both up-regulation of platelet aggregation and the enhancement of SMC proliferation. This stenosis model may be useful for the investigation of hypercholesterolemia-associated cardiovascular diseases.

Kistrin inhibits human smooth muscle cell interaction with fibrin

Because of the lack of function-blocking anti-integrin antibodies that react with nonprimate species, the study of the role of integrins in in vivo animal models of atherosclerosis has been limited. In contrast, peptides or small molecules have shown less species specificity and thus may be better tools to use. In an attempt to identify integrin antagonists of potential use against smooth muscle response to injury, we investigated the role of human smooth muscle cell interactions with fibrin by using a panel of integrin antagonists consisting of the snake venom disintegrin, Kistrin, as well as cyclic peptides with well-defined integrin antagonists activities. We demonstrate that Kistrin, a disintegrin that inhibits beta1, beta2, beta3, and beta5 integrin interactions, had the most potent inhibitory effect. Based on our results, Kistrin or peptides with similar pan-integrin selectivity patterns are prime candidates for use as anti-integrin antagonists in further studies of atherosclerosis and restenosis.

Effect of GR144053, a fibrinogen-receptor antagonist, on thrombus formation and vascular patency after thrombolysis by tPA in the injured carotid artery of the hamster

The antithrombotic effect of GR144053, which inhibits platelet aggregation by binding to the fibrinogen receptor (glycoprotein IIb/IIIa), was investigated in vitro and in vivo by using hamsters. This compound inhibited the platelet aggregation induced by adenosine diphosphate (ADP; 2.5 microM) with a mean inhibitory concentration (IC50) value of 2.2 +/- 0.4 x 10(-5) M. Vascular injury was inflicted in one carotid artery by using a modified catheter to produce endothelial denudation. In the control group, arterial blood flow was interrupted 4.4 +/- 2.3 min (n = 12) after the injury. When GR144053 continuously infused intravenously at doses of 0 (saline) 0.1, 0.3, and 1.0 mg/kg/h (n = 8, each), the time that elapsed before the vessel became completely obstructed was prolonged in a dose-dependent manner. In separate experiments, reperfusion could be obtained by continuous infusion of tissue-type plasminogen activator (tPA; 0.52 mg/kg) starting 30 min after the initiation of thrombus formation. When GR144053 (0.3 and 1.0 mg/kg/h) was infused in addition to tPA, the incidence of reperfusion and the later patency of the reperfused artery were much improved as compared with tPA alone. The bleeding time at the end of tPA infusion was significantly prolonged in the presence of the highest dose of GR144053. Next, neointima formation was evaluated 2 weeks after the vascular injury. When GR144053 (0.3 mg/kg/h) was continuously infused i.v. by an implanted osmotic pump for 14 days, the neointimal area was significantly reduced. In separate hamsters, the proliferating index of smooth muscle cells (SMCs) by using bromodeoxyuridine (BrdU) was investigated, and treatment with both tPA and GR144053 significantly decreased the SMC proliferation index in vivo. However, in the in vitro experiments using a hamster SMC line, GR144053 did not have an inhibitory effect on SMC proliferation. These findings suggest that GR144053 inhibits platelet activation on the injured artery and improves vascular patency after thrombolysis with tPA, which furthermore results in suppression of neointima formation.

Inhibition of von Willebrand factor binding to platelet GP Ib by a fractionated aurintricarboxylic acid prevents restenosis after vascular injury in hamster carotid artery

BACKGROUND

Aurintricarboxylic acid (ATA) prevents von Willebrand factor binding to platelet glycoprotein (GP) Ib, with higher-molecular-weight ATA more effective than the lower-molecular-weight compound. We investigated the effects of high-molecular-weight ATA (Mr=7500), obtained by fractionating commercial ATA, in the injured hamster carotid artery.

METHODS AND RESULTS

Platelet aggregation was induced in vitro with ADP (2.5 micromol/L) or botrocetin (5 microg/mL) in hamster platelet-rich plasma. IC50 values were 348.6+/-22.4 and 8.2+/-3.2 microg/mL, respectively. The endothelium of hamster carotid artery was denuded with a modified catheter. Continuous administration of high-molecular-weight ATA (10, 30, and 100 microg x kg(-1) x h(-1)) with an infusion pump produced antithrombotic effects in a dose-dependent manner, as evaluated by prolongation of time to occlusion. Neointima formation was observed 2 weeks after catheterization, and proliferating smooth muscle cells (SMCs) were identified by the thymidine analogue 5-bromo-2-deoxyuridine (BrdU). Continuous treatment with the compound (100 microg x kg(-1) x h(-1)) with a 2ML1 Alzet infusion pump resulted in a reduction of neointimal area by 38.0+/-8.8% and decreased the BrdU index on days 1 and 7 significantly. DNA synthesis in DDT1MF2 hamster SMCs was also decreased by the compound in a dose-dependent manner. In histological observation, the process of endothelial healing was improved by this treatment with the compound.

CONCLUSIONS

Inhibition of platelet adhesion by von Willebrand factor binding to platelet GP Ib by high-molecular-weight ATA results in the prevention of thrombus formation and the suppression of neointima lesion. In addition, high-molecular-weight ATA has an inhibitory effect on SMC proliferation. This inhibition of both platelet adhesion and SMC proliferation markedly reduced vascular stenosis.