Cellular mechanisms in the response of the arterial wall to injury and repair

Spontaneous well-differentiated pancreatic islet cell carcinoma with vascular invasion in a male F344 rat

This case report describes a case of spontaneous pancreatic islet cell carcinoma with vascular invasion in a 110-week-old male F344 rat. Histologically, a pancreatic nodule consisting of tumor cells and many blood-rich vessels, and covered with a fibrous capsule showed local invasion in the capsule and adjacent acinar tissues, encircling a large duct-like structure (DS). The tumor was composed of well-differentiated tumor cells resembling normal pancreatic islet cells, which had small round nuclei and eosinophilic cytoplasm. Mitotic figures were rare. Immunohistochemistry revealed that the tumor cells were positive for insulin. Although endothelial cells were not detected, the DS wall showed cells positive for α-smooth muscle actin and elastic fibers, suggesting that the DS is the pancreatic artery. This is a rare case of islet cell carcinoma consisting of well-differentiated tumor cells with invasion of the pancreatic artery in a rat.

Hemodynamic Influences on Vascular Endothelial Biology*

The vascular endothelium resides in a unique biomechanical stress environment resulting from the hemodynamics of the system. In vivo studies indicate that there are regional differences in endothelial biology and that this may be due to the influence of the local hemodynamic environment. To investigate this further, cell culture studies have been conducted using well-defined mechanical stress environments. To study flow effects, we have employed a parallel plate chamber in which endothelial cell monolayers are exposed to laminar flow. In such experiments and concomitant with changes in morphology, there are a variety of other alterations in cell function, including a decrease in the rate of cell proliferation for subconfluent monolayers. Changes in cell behavior due to the direct effect of pressure and in cultured cells which are in a cyclical stress field also have been observed. In the recognition/transduction of such a mechanical signal, the pathway may possibly include a membrane event linked to the control of intracellular calcium. It may be that the same signaling mechanisms are involved both in cytoskeletal/shape changes and in the control of the cell's growth program and, in exercising such an influence, hemodynamics may have an important role in the response of the arterial wall to injury and the resulting repair and/or disease processes.

Endothelial cells, cholesterol, cytokines, and aging

It has been reported that high levels of cholesterol and triglycerides are associated with increased risk of developing atherosclerosis and shorter life. In fact, vascular endothelial dysfunction occurs during the human aging process. Accumulation of lipids in vascular endothelium activates leukocytes to produce cytokines and chemokines which recruit macrophages. On the other hand, macrophages augment inflammatory response and secrete vascular endothelial growth factor, a key cytokine that mediates angiogenesis and inflammatory response. In addition, hyperlipidaemia is one of the main risk factors for aging, hypertension and diabetes. Here, we review the interrelationship between endothelial cells, high level of cholesterol, and aging.

Self-expanding nitinol renal artery stents: comparison of safety and efficacy of bare versus Polyzene-F nanocoated stents in a porcine model

OBJECTIVE

To investigate the safety and efficacy of a Polyzene-F nanocoat on new low-profile self-expandable nitinol stents in minipig renal arteries.

MATERIALS AND METHODS

Ten bare nitinol stents (BNS) and 10 stents coated with a 50 nm-thin Polyzene-F coating were randomly implanted into renal arteries of 10 minipigs (4- and 12-week follow-up, 5 animals/group). Thrombogenicity, on-stent surface endothelialization, vessel wall injury, late in-stent stenosis, and peristrut vessel wall inflammation were determined by quantitative angiography and postmortem histomorphometry.

RESULTS

In 6 of 10 BNS, >50% stenosis was found, but no stenosis was found in stents with a nanothin Polyzene-F coating. Histomorphometry showed a statistically significant (p < 0.05) different average maximum luminal loss of 55.16% ± 8.43% at 12 weeks in BNS versus 39.77% ± 7.41% in stents with a nanothin Polyzene-F coating. Stents with a nanothin Polyzene-F coating had a significantly (p < 0.05) lower inflammation score after 12 weeks, 1.31 ± 1.17 versus 2.17 ± 0.85 in BNS. The results for vessel wall injury (0.6 ± 0.58 for Polyzene-F-coated stents; 0.72 ± 0.98 for BNS) and re-endothelialization, (1.16 ± 0.43 and 1.23 ± 0.54, respectively) were not statistically significant at 12-week follow-up. No thrombus deposition was observed on the stents at either follow-up time point.

CONCLUSION

Nitinol stents with a nanothin Polyzene-F coating successfully decreased in-stent stenosis and vessel wall inflammation compared with BNS. Endothelialization and vessel wall injury were found to be equal. These studies warrant long-term pig studies (≥120 days) because 12 weeks may not be sufficient time for complete healing; thereafter, human studies may be warranted.

Biomarkers and mechanisms of drug-induced vascular injury in non-rodents

In preclinical safety studies, drug-induced vascular injury can negatively impact candidate-drug selection because there are no obvious diagnostic markers for monitoring this pathology preclinically or clinically. Furthermore, our current understanding of the pathogenesis of this lesion is limited. While vasodilatation and increased shear stress appear to play a role, the exact mechanism(s) of injury to the primary target cells, smooth muscle (SMC) and endothelial cell (EC), are unknown. Evaluation of potential novel markers for clinical monitoring with a mechanistic underpinning would add value in risk assessment and risk management. This mini review focuses on the efforts and progress to identify diagnostic markers as well as understanding the mechanism of action in nonrodent drug-induced vascular injury.

Rapid leukocyte activation following intraarticular bleeding

The study aims at elucidating the leukocyte activation in the joint fluid of patients with acute traumatic hemarthrosis. Paired samples of peripheral blood and articular effusions after an acute hemorrhage were obtained from 22 patients. Leukocytes were separated and stained with fluorescein isothiocyanate (FITC)-conjugated mouse anti-human CD11a, CD18, and CD97 monoclonal antibodies for flow cytometry. The reactive oxygen species (ROS) production of leukocytes in corresponding samples of peripheral blood and joint effusion was measured via luminol dependent whole blood chemiluminometry. Significant decrease of CD11a density on monocytes, but markedly enhanced expression of CD97 and CD18 on polymorphonuclear neutrophil granulocytes (PMN), and significantly increased proportion of CD97 positive lymphocytes were found in the joint fluids as compared to the corresponding peripheral blood samples. Moreover, significantly decreased lag time and elevated rate of ROS production were revealed by chemiluminometry in case of joint derived leukocytes. Our results provide good evidence for intraarticular leukocyte activation during acute hemarthrosis. Since the activation precedes synovial inflammation, it is suggested that the leukocytes play an important role as an initiator in the pathogenesis of acute hemarthrosis.

Activated PMNs lead to oxidative stress on chondrocytes: a study of swine knees

Using an in vitro model, based on primary cultured chondrocytes, we examined possible oxidative injury caused by activated polymorphonuclear neutrophil granulocytes (PMNs), which are thought to be part of the pathomechanism of hemarthrosis. Chondrocytes were isolated from swine knee joints and divided into three groups. Pure chondrocytes acted as the control population (group I). PMNs from the systemic circulation, and hydrogen peroxide (as an artificial source of reactive oxygen species (ROS)) were added to groups II and III, respectively. All cultures were incubated for 6 hours. After the experiment, lipid membrane degradation by ROS was assessed by monitoring changes in the levels of malondialdehyde (MDA) and 4-hydroxyalkenal contents of the chondrocyte specimens. Changes in the endogenous scavenger status of the chondrocytes were characterized by measuring of reductions in glutathione (GSH) concentration and superoxide dismutase (SOD) activity. Significant increases in MDA/4-hydroxyalkenal levels and SOD activity as well as an expressive reduction in intracellular GSH content were highlighted by comparing the control to the PMN- or H2O2-treated cell populations. These findings confirm previous suggestions that PMN-derived ROS contribute to degradation of cartilage in hemarthrosis.

A novel insight into the mechanism of the antithrombotic action of defibrotide

Defibrotide is a polydeoxyribonucleotide sodium salt with antithrombotic properties. These properties have been attributed to its profibrinolytic activity [increase of tissue plasminogen activator (t-PA) activity, concomitant decrease of that of plasminogen activator inhibitor (PAI)], but there could conceivably be other factor(s). To look for these, we studied Defibrotide in a thrombosis model (pulmonary thromboembolism in mice) in which free radicals play a pivotal role. Defibrotide was found to be active after both intravenous and oral administration. Defibrotide behaved in vitro like a scavenger of H2O2 but not of O2.- in cell-free systems. Defibrotide added in vitro to cellular systems decreased the stimulated release of beta-glucuronidase from polymorphonuclear cells (PMNs), the luminol chemiluminescence induced by oxygen species generated by stimulated PMNs and the generation of O2.- from stimulated macrophages. We think that the antithrombotic activity of Defibrotide is based on other factor(s) in addition to profibrinolytic activity, i.e., some scavenger activity and desensitization of cells involved in thrombus formation must also be taken into account.