(Circulation. 1996;93:18-22.)
© 1996 American Heart Association, Inc.
Articles |
From the Departments of Pharmacology (T.M., F.V.), Cardiology (C.B., J.-L.A., M.H., E.v.B., J.-M.L., M.E.B.), and Anesthesiology (B.V.), University of Lille (France).
Correspondence to Christophe Bauters, MD, Service de Cardiologie B et Hémodynamique, Blvd du Prof J. Leclercq, 59037 Lille Cedex, France.
| Abstract |
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Methods and Results Thirty-nine New Zealand White rabbits underwent balloon denudation of the right iliac artery. Twenty rabbits received intravenous administration of bFGF (2.5 µg twice a week for 2 weeks). Nineteen rabbits receiving saline injections served as controls. Animals were killed on day 28 for assessment of reendothelialization and neointimal thickening and for analysis of in vitro vasoreactivity. Animals in the bFGF group had a significantly (P<.005) greater degree of reendothelialization than controls (115±13 versus 55±6 mm2). Neointimal thickening was similar in the two groups. Four weeks after denudation, endothelium-independent responses did not differ significantly between the two groups. In contrast, the maximal endothelium-dependent acetylcholine-induced relaxation of the bFGF-treated animals (Emax, 40±7%) was significantly greater than that of the control group (Emax, 11±9%; P<.05).
Conclusions Systemic administration of bFGF restores, in large part, the responses of previously denuded arterial segments to endothelium-dependent vasodilators. Angiogenic growth factors may help to reestablish normal endothelial cell function in patients who have undergone angioplasty.
Key Words: endothelium angioplasty growth substances vasodilation
| Introduction |
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Previous studies have demonstrated the feasibility of using recombinant angiogenic growth factors such as bFGF or VEGF for increasing the rate and the extent of endothelial regrowth after arterial injury.13 14 However, although these studies clearly demonstrated a beneficial anatomic effect, the function of the regenerated endothelium was not assessed.
It has recently been shown that the administration of VEGF in an animal model of hindlimb ischemia is associated with an improvement of endothelium-dependent responses of the collateral-perfused arterial bed15 ; similar results have been reported for bFGF in a model of myocardial ischemia.16 These findings suggest that angiogenic growth factors, in addition to having an effect on endothelial cell growth, may also modulate endothelial cell function. We thus designed the present study to test the hypothesis that chronic administration of an angiogenic growth factor, in this case bFGF, in a rabbit model of balloon denudation might not only improve endothelial regrowth but also restore normal physiological responses to endothelium-dependent agonists.
| Methods |
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Balloon Denudation
Rabbits fed a normal diet were
anesthetized with ethyl
carbamate (1 g/kg IV). After exposure of the right femoral artery, a 3F
Fogarty balloon catheter was passed retrogradely to the junction of the
aorta with the iliac artery and inflated until contact was made with
the endothelium. The iliac artery was denuded by
advancement and withdrawal of the catheter three times. The catheter
was then removed, the femoral artery was ligated, and 250 mg
amoxicillin was given locally in the groin incision. The investigator
performing the procedure was blinded to the nature of the
treatment.
Macroscopic Evaluation of
Reendothelialization
Eleven animals (five controls, six receiving
bFGF) were used for
macroscopic evaluation of the degree of
reendothelialization. Thirty minutes before they
were killed, the animals received an intravenous injection
of 5 mL 1% Evans blue dye18 to identify the remaining
denuded area. A catheter inserted into the aorta was used to perfuse
PBS in situ at a pressure of 110 mm Hg until the effluent ran clear.
The iliac arteries (from the aortoiliac bifurcation to the inguinal
ligament) were then harvested, dissected free, incised longitudinally,
pinned to a cork board, and photographed with a dissecting microscope.
Planimetric analysis was then performed with a computerized
sketching program by one analyst, who was blinded to the treatment
regimen. The reendothelialized area was defined
macroscopically as the area that was not stained with Evans blue.
Histological Studies
Eighteen animals (nine in each group)
were used for
histological analysis of neointimal
thickening. A catheter was introduced into the aorta through the right
carotid artery, and the iliac arteries were perfusion-fixed with
4% paraformaldehyde (in PBS) at a pressure of 110 mm
Hg over a period of 30 minutes to maintain the vessels in their in vivo
dimensions for subsequent histological
analysis. After further immersion fixation (in 4%
paraformaldehyde for 24 hours), each iliac artery was
cut into three 5-mm segments, which were embedded in paraffin. Cross
sections of vessels were cut and stained with orcein-van Gieson's
stain or with Mallory's phosphotungstic hematoxylin. Morphometric
analysis of the histological cross sections was
performed by use of digital microscopic planimetry (SMC 2002, Bioblock
Scientific). For each iliac segment, one cross section was
analyzed. Neointimal and medial areas were measured
for each section and averaged for each artery. The ratio of intimal
area to medial area was calculated for each artery. All measurements
were performed by a pathologist unaware of the study design.
Regenerated endothelium was identified by
immunostaining with
plateletendothelial cell adhesion molecule-1
(PECAM-1/CD-31)related antigens (Dako Co) as previously
described.19
In Vitro Vasoreactivity
Ten animals (five in each group) were
used for assessment of
vasoreactivity. Four weeks after unilateral balloon denudation, the two
iliac arteries were removed and placed in iced oxygenated
Krebs-Henseleit solution consisting of the following (in mmol/L): NaCl
118, KCl 4.6, NaHCO3 27.2, MgSO4 1.2,
KH2PO4 1.2, CaCl2 1.75,
Na2EDTA 0.03, and D-glucose 11.1 (pH 7.35 to
7.45). Intravenous heparin (1000 IU) was given before
removal of the vessels to prevent coagulation. Vessels were cleaned of
surrounding fat and connective tissue and cut into rings 4.5 to 5 mm
long. Rings were then suspended in organ chambers (Radnoti Glass
Technology) filled with 40 mL warmed (37°C) and
oxygenated (95% O2/5% CO2)
Krebs-Henseleit solution. Rings were connected to force transducers,
and changes in isometric force were recorded continuously. During a
60-minute period, the vascular rings were stretched to 3.0 g,
previously determined as the optimal point of their length-tension
relation. The output from the transducers was amplified by signal
conditioners and sent to an Intel 486based computer (Kenitec) for
analog-to-digital conversion. In each animal, the nondenuded
contralateral iliac artery served as a control. For each iliac artery,
two rings were studied. The contractile response to a depolarizing
concentration of KCl (70 mmol/L) provided a measure of maximal
contractile responsiveness in each ring. All of the rings were then
preconstricted with phenylephrine
(10-9 to
3x10-5 mol/L).
Endothelium-dependent or -independent relaxant
effects then were established when the constrictor response to
phenylephrine was stable. First, the relaxant response to
acetylcholine (10-8 to
3x10-5 mol/L) was investigated. When the
maximal responses produced by this agonist were stable, the rings were
washed and allowed to stabilize at a resting tension. The
smooth-muscle relaxant sodium nitroprusside
(10-9 to
3x10-5 mol/L) then was given to vessels
preconstricted with phenylephrine
(3x10-5 mol/L).
Drugs
Human recombinant bFGF, ethyl carbamate,
phenylephrine hydrochloride, acetylcholine, and sodium
nitroprusside were purchased from Sigma Chemical Co. bFGF (2.5 µg/mL)
was dissolved in 0.5% albumin. Drugs used for vasomotor
experiments were dissolved in 0.9% NaCl solution. Gases were purchased
from the Compagnie Française des Produits Oxygénés
and were within a tolerance of 1% of the desired mixture.
Statistical Analysis
Data are given as mean±SEM.
Statistical evaluation of the data
(comparisons between control animals and bFGF-treated animals) was
performed with unpaired Student's t test. Relaxations to
the vasodilator agents are expressed as percentages of the initial
contraction to phenylephrine. To analyze
vasodilation, we determined the Emax, expressed as
percent relaxation of the contraction to phenylephrine, and
the EC50.
| Results |
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Neointimal Thickening
The degree of neointimal thickening was
similar in the
two groups (neointimal area: control, 0.32±0.03
mm2; bFGF, 0.31±0.05 mm2; P=NS;
neointima-to-media ratio: control, 0.84±0.16;
bFGF, 0.99±0.13; P=NS). Histological
analysis of nondenuded arteries showed a normal appearance of
the vessel wall with no neointimal thickening in both the
control and the bFGF-treated groups (not shown).
In Vitro Vasoreactivity
Nondenuded iliac arteries.
In nondenuded arteries,
endothelium-independent responses to
phenylephrine and sodium nitroprusside and
endothelium-dependent responses to acetylcholine
did not differ significantly in bFGF-treated and control animals
(Table
, Fig 2
).
|
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Previously denuded
iliac arteries. Four weeks after
denudation, endothelium-independent responses did
not differ significantly between the two groups. The maximal tension
induced by phenylephrine
(3x10-5 mol/L) was not different between
groups (Table
). Similarly, there were no differences between
the two
groups in maximal vasodilation to sodium nitroprusside
(Emax, 102±4% for bFGF-treated animals versus
105±3% for control animals) (Fig 2
).
In contrast,
the maximal endothelium-dependent
acetylcholine-induced relaxation of the bFGF-treated animals
(Emax, 40±7%) was significantly greater than that
of the control group (Emax, 11±9%;
P<.05) (Fig 2
). In addition, the Emax
and the
sensitivity (EC50) to acetylcholine in the bFGF group were
restored to the level of nondenuded vessels, with
Emax values of 40±7% and 43±6% (P=NS)
and
EC50 values of 6.4±2.5x10-7
and 4.2±2.2x10-7 mol/L
(P=NS), respectively.
| Discussion |
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We observed a similar degree of neointimal thickening in control and bFGF-treated animals 4 weeks after injury. Previous experimental studies support the notion that certain functions of the endothelium, such as production of NO, are critical to the prevention of luminal narrowing by neointimal thickening.12 21 Accelerated reendothelialization may thus reduce neointimal formation. On the other hand, bFGF, which is a potent growth factor for smooth muscle cells,22 may directly enhance neointimal formation. Previous studies have already investigated the effect of FGFs on the neointimal response to injury and have provided discordant results. Lindner et al,23 using high doses of bFGF (12 µg/d for 2 weeks in a rat model), found a significant increase in neointimal thickening. By contrast, Bjornsson et al,20 using low doses of acidic FGF (a mitogen for smooth muscle cells in vitro24 ) in the same model, observed an inhibition of neointimal thickening. Recently, Lazarous et al25 gave systemic bFGF to dogs after femoral artery balloon denudation, and there was no increase in intimal thickening. These results, taken together with the results of the present study, suggest that the final effect of FGF on neointimal thickening may be the consequence of a balance between stimulatory and inhibitory mechanisms on smooth muscle cell growth; factors such as the dose used, the duration of the treatment, and the animal model studied may explain discrepancies between studies. In the present study, only one dose of bFGF was used; further dose-response studies may provide a better understanding of the effects of bFGF on neointimal thickening. A recent study by Asahara et al14 demonstrated that a single local administration of the angiogenic factor VEGF is sufficient to facilitate endothelial repair in a rat model of balloon injury; in this study, the degree of neointimal thickening at 2 weeks and 4 weeks after balloon injury was correspondingly attenuated to a statistically significant degree in arteries treated with VEGF versus controls. These results have been attributed to a beneficial effect of VEGF on endothelial cells, ie, reendothelialization, without detrimental effect on smooth muscle cells, ie, proliferation, because VEGF high-affinity binding sites are limited to endothelial cells.
To the best of our knowledge, the present study constitutes the first demonstration that an angiogenic growth factor may also restore normal physiological responses of an injured artery to endothelium-dependent agonists. The improvement of endothelium-dependent relaxation in bFGF-treated animals is well demonstrated by the fact that acetylcholine relaxed previously denuded arterial segments to the same extent as nondenuded segments. It appears unlikely that this improved response to acetylcholine observed after treatment with bFGF is due to an increase in the sensitivity of vascular smooth muscle cells to NO generated in endothelial cells. Indeed, the response to sodium nitroprusside, a direct NO donor, is not modified by bFGF administration. The normalized endothelium-dependent responses observed after bFGF treatment are probably not solely related to endothelial regrowth. Previous studies performed in rabbit iliac arteries have demonstrated persistent abnormal endothelium-dependent responses even in the case of complete endothelial regrowth8 ; this suggests that bFGF, in addition to its effects on endothelial cell growth, might also modulate some qualitative aspects of endothelial cells and restore normal physiological responses to endothelium-dependent agonists. Two recent studies demonstrated that the administration of angiogenic growth factors may restore normal endothelium-dependent responses in arterial beds perfused via collaterals.15 16 Chronic administration of bFGF maintained receptor-mediated endothelial function in the coronary microcirculation perfused via collateral vessels soon after gradual coronary occlusion.16 Similarly, a single intra-arterial bolus of VEGF restored, in large part, endothelium-dependent responses in an ischemic limb model.15 Further studies will be needed to characterize the effect of angiogenic growth factors in other models of endothelial dysfunction.
Finally, it should be pointed out that, in the present study, endothelium-dependent responses were improved in the absence of inhibition of neointimal thickening. Previous reports have shown a statistically significant correlation between intimal thickness and impairment of endothelium-dependent relaxation,8 26 leading to the hypothesis that intimal thickness can act as a barrier for NO, a factor with a very short half-life. Furthermore, most of the drugs that improved endothelium-dependent relaxation reduced neointimal thickening.12 27 In the present study, bFGF restored normal endothelium-dependent relaxation with no effect on intimal thickening. This suggests that the action of bFGF is solely at the endothelial level and that the observed degree of neointimal thickening does not alter NO diffusion.
In conclusion, the findings reported in the present study indicate that systemic administration of bFGF restores, in large part, the responses of previously denuded arterial segments to endothelium-dependent vasodilators. These results may have important clinical implications. Studies performed after coronary angioplasty in men have demonstrated abnormal response of previously dilated sites to endothelium-dependent agonists such as serotonin28 and acetylcholine.29 Angiogenic growth factors, via both previously documented anatomic13 14 effects and physiological effects on previously denuded arteries described here, may therefore help to reestablish normal endothelial cell function in patients who have undergone angioplasty.
| Selected Abbreviations and Acronyms |
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| Acknowledgments |
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Received September 14, 1995; revision received October 11, 1995; accepted October 24, 1995.
| References |
|---|
|
|
|---|
2.
Casscells W. Migration of smooth muscle and
endothelial cells: critical events in
restenosis. Circulation. 1992;86:723-729.
3. Furchgott RF, Zawadzki JV. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature. 1980;288:373-376. [Medline] [Order article via Infotrieve]
4. Clowes AW, Reidy MA, Clowes MM. Kinetics of cellular proliferation after arterial injury, I: smooth muscle growth in the absence of endothelium. Lab Invest. 1983;49:327-333. [Medline] [Order article via Infotrieve]
5. Haudenschild CC, Schwartz SM. Endothelial regeneration, II: restitution of endothelial continuity. Lab Invest. 1979;41:407-418. [Medline] [Order article via Infotrieve]
6. Stemerman MB, Spaet TH, Pitlick F, Cintron J, Lejnieks I, Tiell ML. The pattern of reendothelialization and intimal thickening. Am J Pathol. 1977;87:125-142. [Abstract]
7. Lindner V, Reidy MA, Fingerle J. Regrowth of arterial endothelium: denudation with minimal trauma leads to complete endothelial cell regrowth. Lab Invest. 1989;61:556-563. [Medline] [Order article via Infotrieve]
8.
Weidinger FF, McLenachan JM, Cybulsky MI, Gordon JB,
Rennke HG, Hollenberg NK, Fallon JT, Ganz P, Cooke JP.
Persistent dysfunction of regenerated endothelium after
balloon angioplasty of rabbit iliac artery.
Circulation. 1990;81:1667-1679.
9.
Reidy MA, Standaert D, Schwartz SM. Inhibition
of endothelial cell regrowth: cessation of aortic
endothelial cell replication after balloon catheter
denudation. Arteriosclerosis. 1982;2:216-220.
10. Reidy MA, Clowes AW, Schwartz SM. Endothelial regeneration, V: inhibition of endothelial regrowth in arteries of rat and rabbit. Lab Invest. 1983;49:569-575. [Medline] [Order article via Infotrieve]
11.
Shimokawa H, Aarhus LL, Vanhoutte PM. Porcine
coronary arteries with regenerated endothelium
have a reduced endothelium-dependent responsiveness
to aggregating platelets and serotonin.
Circ Res. 1987;61:256-270.
12.
Hamon M, Vallet B, Bauters C, Wernert N, McFadden EP,
Lablanche JM, Dupuis B, Bertrand ME. Long-term oral
administration of L-arginine reduces intimal thickening and
enhances neoendothelium-dependent
acetylcholine-induced relaxation after arterial
injury. Circulation. 1994;90:1357-1362.
13. Lindner V, Majack RA, Reidy MA. Basic fibroblast growth factor stimulates endothelial regrowth and proliferation in denuded arteries. J Clin Invest. 1990;85:2004-2008.
14.
Asahara T, Bauters C, Pastore C, Kearney M, Rossow S,
Bunting S, Ferrara N, Symes JF, Isner JM. Local delivery
of vascular endothelial growth factor accelerates
reendothelialization and attenuates intimal
hyperplasia in balloon-injured rat carotid artery.
Circulation. 1995;91:2793-2801.
15.
Bauters C, Asahara T, Zheng LP, Takeshita S, Bunting S,
Ferrara N, Symes JF, Isner JM. Recovery of disturbed
endothelium-dependent flow in the
collateral-perfused rabbit ischemic hindlimb after
administration of vascular endothelial growth
factor. Circulation. 1995;91:2802-2809.
16.
Sellke FW, Wang SY, Friedman M, Harada K, Edelman ER,
Grossman W, Simons M. Basic FGF enhances
endothelium-dependent relaxation of the
collateral-perfused coronary microcirculation.
Am J Physiol. 1994;267:H1303-H1311.
17. Asahara T, Bauters C, Zheng LP, Takeshita S, Bunting S, Ferrara N, Symes JF, Isner JM. In vivo synergistic effects of vascular endothelial growth factor and basic fibroblast growth factor on angiogenesis in rabbit ischemic hindlimb. Circulation. 1994;90(suppl I):I-3153. Abstract.
18. Clowes AW, Collazzo RE, Karnovsky MJ. A morphologic and permeability study of luminal smooth muscle cells after arterial injury in the rat. Lab Invest. 1978;39:141-150. [Medline] [Order article via Infotrieve]
19. Newman PJ. The role of PECAM-1 in vascular cell biology. Ann N Y Acad Sci. 1994;714:165-174. [Medline] [Order article via Infotrieve]
20.
Bjornsson TD, Dryjski M, Tluczek J, Mennie R, Ronan J,
Mellin TN, Thomas KA. Acidic fibroblast growth factor
promotes vascular repair. Proc Natl Acad Sci
U S A. 1991;88:8651-8655.
21. Garg UC, Hassid A. Nitric oxide-generating vasodilators and 8-bromo-cyclic-guanosine monophosphate inhibit mitogenesis and proliferation of cultured rat vascular smooth muscle cells. J Clin Invest. 1989;83:1774-1777.
22.
Lindner V, Reidy MA. Proliferation of smooth
muscle cells after vascular injury is inhibited by an antibody against
basic fibroblast growth factor. Proc Natl Acad Sci
U S A. 1991;88:3739-3743.
23.
Lindner V, Lappi DA, Baird A, Majack RA, Reidy
MA. Role of basic fibroblast growth factor in vascular lesion
formation. Circ Res. 1991;68:106-113.
24.
Winkles JA, Friesel R, Burgess WH, Howk R, Mehlman T,
Weinstein R, Maciag T. Human vascular smooth muscle cells both
express and respond to heparin-binding growth factor I
(endothelial cell growth factor). Proc
Natl Acad Sci U S A. 1987;84:7124-7128.
25. Lazarous DF, Shou M, Scheinowitz M, Epstein SE, Unger EF. Comparative effects of basic fibroblast growth factor and vascular endothelial growth factor on coronary collateral development and the arterial response to injury. J Am Coll Cardiol. 1994;23:177A. Abstract.
26.
Weidinger FF, McLenachan JM, Cybulsky MI, Fallon JT,
Hollenberg NK, Cooke JP, Ganz P.
Hypercholesterolemia enhances
macrophage recruitment and dysfunction of regenerated
endothelium after balloon injury of the rabbit iliac
artery. Circulation. 1991;84:755-767.
27.
Light JT, Bellan JA, Chen IL, Longenecker LL, Murphy
WA, Coy DH, Kadowitz PJ, McNamara DB. Angiopeptin
enhances acetylcholine-induced relaxation and inhibits intimal
hyperplasia after vascular injury. Am J Physiol. 1993;265:H1265-H1274.
28.
McFadden EP, Bauters C, Lablanche JM, Quandalle P,
Leroy F, Bertrand ME. Response of human coronary
arteries to serotonin after injury by coronary
angioplasty. Circulation. 1993;88:2076-2085.
29. Kirigaya H, Aisawa T, Ogasawara K, Sato H, Nagashima K, Onoda M, Ogawa K, Yabe K, Kato K. Incidence of acetylcholine-induced spasm of coronary artery subjected to balloon angioplasty. Jpn Circ J. 1993;57:883-890.[Medline] [Order article via Infotrieve]
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