Reverse regulation of endothelial cells and myointimal hyperplasia on cell proliferation by a heatshock protein-coinducer after hypoxia

Effect of Peri-Interventional Blood Loss on In-Stent Thrombosis After Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

This paper evaluates the effect of blood loss on in-stent stenosis after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Nine hundred and ninety-seven patients who underwent PCI for AMI as well as follow-up coronary angiography at 6-12 months from two centers were categorized into three groups based on peri-interventional blood loss at the primary intervention (mild, <1 mmol/L moderate, 1-2 mmol/L; severe > 2 mmol/L). The endpoint was to evaluate the incidence and severity of in-stent stenosis at follow-up angiography and the revascularization rate. The incidence of in-stent stenosis and revascularization in mild, moderate, and severe groups was 19.3%, 33.1%, and 61.1%, respectively (p = 0.001), with HR: 1.35 (95% CI; 1.10-1.65), p < 0.001. Peri-interventional blood loss was associated with a higher incidence of in-stent stenosis and revascularization 6-12 months after successful PCI in patients with AMI.

Impact of exercise and metabolic disorders on heat shock proteins and vascular inflammation

Heat shock proteins (Hsp) play critical roles in the body's self-defense under a variety of stresses, including heat shock, oxidative stress, radiation, and wounds, through the regulation of folding and functions of relevant cellular proteins. Exercise increases the levels of Hsp through elevated temperature, hormones, calcium fluxes, reactive oxygen species (ROS), or mechanical deformation of tissues. Isotonic contractions and endurance- type activities tend to increase Hsp60 and Hsp70. Eccentric muscle contractions lead to phosphorylation and translocation of Hsp25/27. Exercise-induced transient increases of Hsp inhibit the generation of inflammatory mediators and vascular inflammation. Metabolic disorders (hyperglycemia and dyslipidemia) are associated with type 1 diabetes (an autoimmune disease), type 2 diabetes (the common type of diabetes usually associated with obesity), and atherosclerotic cardiovascular disease. Metabolic disorders activate HSF/Hsp pathway, which was associated with oxidative stress, increased generation of inflammatory mediators, vascular inflammation, and cell injury. Knock down of heat shock factor-1 (HSF1) reduced the activation of key inflammatory mediators in vascular cells. Accumulating lines of evidence suggest that the activation of HSF/Hsp induced by exercise or metabolic disorders may play a dual role in inflammation. The benefits of exercise on inflammation and metabolism depend on the type, intensity, and duration of physical activity.

Restenosis and therapy

The vascular disease involves imbalanced function of the blood vessels. Risk factors playing a role in development of impaired vessel functions will be briefly discussed. In ischemia/reperfusion (I/R), ischemic hypoxia is one of the cardinal risk factors of restenosis. Various insults are shown to initiate the phenotype switch of VSMCs. The pathological process, leading to activated inflammatory process, complement activation, and release of growth factors, initiate the proliferation of VSMCs in the media and cause luminal narrowing and impaired vascular function. The review summarizes the alteration process and demonstrates some of the clinical genetic background showing the role of complement and the genotypes of mannose-binding lectin (MBL2). Those could be useful markers of carotid restenosis after stent implantation. Gene therapy and therapeutic angiogenesis is proposed for therapy in restenosis. We suggest a drug candidate (iroxanadine), which ensures a noninvasive treatment by reverse regulation of the highly proliferating VSMCs and the disturbed function of ECs.