Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
권호 표지
DOI QR코드

DOI QR Code

The Control of Drug Release and Vascular Endothelialization after Hyaluronic Acid-Coated Paclitaxel Multi-Layer Coating Stent Implantation in Porcine Coronary Restenosis Model

  • Bae, In-Ho (The Cardiovascular Convergence Research Center of Chonnam National University Hospital, Designated by Korea Ministry of Health and Welfare) ;
  • Jeong, Myung Ho (The Cardiovascular Convergence Research Center of Chonnam National University Hospital, Designated by Korea Ministry of Health and Welfare) ;
  • Kim, Ju Han (Korea Cardiovascular Stent Research Institute) ;
  • Park, Yong Hwan (Korea Cardiovascular Stent Research Institute) ;
  • Lim, Kyung Seob (The Cardiovascular Convergence Research Center of Chonnam National University Hospital, Designated by Korea Ministry of Health and Welfare) ;
  • Park, Dae Sung (The Cardiovascular Convergence Research Center of Chonnam National University Hospital, Designated by Korea Ministry of Health and Welfare) ;
  • Shim, Jae Won (The Cardiovascular Convergence Research Center of Chonnam National University Hospital, Designated by Korea Ministry of Health and Welfare) ;
  • Kim, Jung Ha (The Cardiovascular Convergence Research Center of Chonnam National University Hospital, Designated by Korea Ministry of Health and Welfare) ;
  • Ahn, Youngkeun (Korea Cardiovascular Stent Research Institute) ;
  • Hong, Young Joon (Korea Cardiovascular Stent Research Institute) ;
  • Sim, Doo Sun (Korea Cardiovascular Stent Research Institute)
  • Received : 2016.05.20
  • Accepted : 2016.10.07
  • Published : 2017.01.31
⟨ Previous Next ⟩

Abstract

Background and Objectives: Hyaluronic acid (HA) is highly biocompatible with cells and the extracellular matrix. In contrast to degradation products of a synthetic polymer, degradation products of HA do not acidify the local environment. The aim of this study was to fabricate an HA-coated paclitaxel (PTX)-eluting stent via simple ionic interactions and to evaluate its effects in vitro and in vivo. Materials and Methods: HA and catechol were conjugated by means of an activation agent, and then the stent was immersed in this solution (resulting in a HA-coated stent). After that, PTX was immobilized on the HA-coated stent (resulting in a hyaluronic acid-coated paclitaxel-eluting stent [H-PTX stent]). Study groups were divided into 4 groups: bare metal stent (BMS), HA, H-PTX, and poly (L-lactide)-coated paclitaxel-eluting stent (P-PTX). Stents were randomly implanted in a porcine coronary artery. After 4 weeks, vessels surrounding the stents were isolated and subjected to various analyses. Results: Smoothness of the surface was maintained after expansion of the stent. In contrast to a previous study on a PTX-eluting stent, in this study, the PTX was effectively released up to 14 days (a half amount of PTX in 4 days). The proliferation of smooth muscle cells was successfully inhibited (by $80.5{\pm}12.11%$ at 7 days of culture as compared to the control) by PTX released from the stent. Animal experiments showed that the H-PTX stent does not induce an obvious inflammatory response. Nevertheless, restenosis was clearly decreased in the H-PTX stent group ($9.8{\pm}3.25%$) compared to the bare-metal stent group ($29.7{\pm}8.11%$). Conclusion: A stent was stably coated with PTX via simple ionic interactions with HA. Restenosis was decreased in the H-PTX group. These results suggest that HA, a natural polymer, is suitable for fabrication of drug-eluting stents (without inflammation) as an alternative to a synthetic polymer.

Keywords

Acknowledgement

Supported by : Korean Society of Cardiology

References

  1. Kirtane AJ, Gupta A, Iyengar S, et al. Safety and efficacy of drugeluting and bare metal stents: comprehensive meta-analysis of randomized trials and observational studies. Circulation 2009;119:3198-206. https://doi.org/10.1161/CIRCULATIONAHA.108.826479
  2. Kamath KR, Barry JJ, Miller KM. The Taxus drug-eluting stent: a new paradigm in controlled drug delivery. Adv Drug Deliv Rev 2006;58:412-36. https://doi.org/10.1016/j.addr.2006.01.023
  3. Kee WJ, Jeong MH, Jang SY, et al. Very late stent thrombosis due to neointimal rupture after paclitaxel-eluting stent implantation. Korean Circ J 2011;41:754-8. https://doi.org/10.4070/kcj.2011.41.12.754
  4. Herdeg C, Oberhoff M, Baumbach A, et al. Local paclitaxel delivery for the prevention of restenosis: biological effects and efficacy in vivo. J Am Coll Cardiol 2000;35:1969-76. https://doi.org/10.1016/S0735-1097(00)00614-8
  5. Albrecht T, Speck U, Baier C, Wolf KJ, Bohm M, Scheller B. Reduction of stenosis due to intimal hyperplasia after stent supported angioplasty of peripheral arteries by local administration of paclitaxel in swine. Invest Radiol 2007;42:579-85. https://doi.org/10.1097/RLI.0b013e31804f5a60
  6. Regar E, Sianos G, Serruys PW. Stent development and local drug delivery. Br Med Bull 2001;59:227-48. https://doi.org/10.1093/bmb/59.1.227
  7. McFadden EP, Stabile E, Regar E, et al. Late thrombosis in drugeluting coronary stents after discontinuation of antiplatelet therapy. Lancet 2004;364:1519-21. https://doi.org/10.1016/S0140-6736(04)17275-9
  8. Stone GW, Moses JW, Ellis SG, et al. Safety and efficacy of sirolimusand paclitaxel-eluting coronary stents. N Engl J Med 2007;356:998-1008. https://doi.org/10.1056/NEJMoa067193
  9. Nebeker JR, Virmani R, Bennett CL, et al. Hypersensitivity cases associated with drug-eluting coronary stents: a review of available cases from the Research on Adverse Drug Events and Reports (RADAR) project. J Am Coll Cardiol 2006;47:175-81. https://doi.org/10.1016/j.jacc.2005.07.071
  10. Otsuka Y, Chronos NA, Apkarian RP, Robinson KA. Scanning electron microscopic analysis of defects in polymer coatings of three commercially available stents: comparison of BiodivYsio, Taxus and Cypher stents. J Invasive Cardiol 2007;19:71-6.
  11. Nakazawa G, Vorpahl M, Finn AV, Narula J, Virmani R. One step forward and two steps back with drug-eluting-stents: from preventing restenosis to causing late thrombosis and nouveau atherosclerosis. JACC Cardiovasc Imaging 2009;2:625-8. https://doi.org/10.1016/j.jcmg.2009.01.011
  12. Goueffic Y, Guilluy C, Guerin P, Patra P, Pacaud P, Loirand G. Hyaluronan induces vascular smooth muscle cell migration through RHAMM-mediated PI3K-dependent Rac activation. Cardiovasc Res 2006;72:339-48. https://doi.org/10.1016/j.cardiores.2006.07.017
  13. Barbucci R, Lamponi S, Magnani A, et al. Influence of Sulfation on Platelet Aggregation and Activation with Differentially Sulfated Hyaluronic Acids. J Thromb Thrombolysis 1998;6:109-15. https://doi.org/10.1023/A:1008841303634
  14. Buszman P, Trznadel S, Zurakowski A, et al. Prospective registry evaluating safety and efficacy of cobalt-chromium stent implantation in patients with de novo coronary lesions. Kardiol Pol 2007;65:1041-6; discussion 1047-8.
  15. Bae IH, Lim KS, Park JK, et al. Mechanical behavior and in vivo properties of newly designed bare metal stent for enhanced flexibility. J Indst Eng Chem 2015;21:1295-300. https://doi.org/10.1016/j.jiec.2014.05.045
  16. Ding D, Tang X, Cao X, et al. Novel self-assembly endows human serum albumin nanoparticles with an enhanced antitumor efficacy. AAPS Pharm Sci Tech 2014;15:213-22. https://doi.org/10.1208/s12249-013-0041-3
  17. Che HL, Bae IH, Lim KS, et al. Novel fabrication of microRNA nanoparticle-coated coronary stent for prevention of postangioplasty restenosis. Korean Circ J 2016;46:23-32. https://doi.org/10.4070/kcj.2016.46.1.23
  18. Qian Z, Haessler M, Lemos JA, et al. Targeting vascular injury using Hantavirus-pseudotyped lentiviral vectors. Mol Ther 2006;13:694-704. https://doi.org/10.1016/j.ymthe.2005.11.016
  19. Schwartz RS, Edelman E, Virmani R, et al. Drug-eluting stents in preclinical studies: updated consensus recommendations for preclinical evaluation. Circ Cardiovasc Interv 2008;1:143-53. https://doi.org/10.1161/CIRCINTERVENTIONS.108.789974
  20. Kolodgie FD, John M, Khurana C, et al, Sustained reduction of instent neointimal growth with the use of a novel systemic nanoparticle paclitaxel. Circulation 2002;106:1195-8. https://doi.org/10.1161/01.CIR.0000032141.31476.15
  21. Rodrigues SN, Goncalves IC, Martins MC, Barbosa MA, Ratner BD. Fibrinogen adsorption, platelet adhesion and activation on mixed hydroxyl-/methyl-terminated self-assembled monolayers. Biomaterials 2006;27:5357-67. https://doi.org/10.1016/j.biomaterials.2006.06.010
  22. Jabara R, Chronos N, Conway D, Molema W, Robinson K. Evaluation of a novel slow-release paclitaxel-eluting stent with a bioabsorbable polymeric surface coating. JACC Cardiovasc Interv 2008;1:81-7. https://doi.org/10.1016/j.jcin.2007.11.009
  23. Seidel CL. Cellular heterogeneity of the vascular tunica media. Implications for vessel wall repair. Arterioscler Thromb Vasc Biol 1997;17:1868-71. https://doi.org/10.1161/01.ATV.17.10.1868
  24. Waugh J, Wagstaff AJ. The paclitaxel (TAXUS)-eluting stent: a review of its use in the management of de novo coronary artery lesions. Am J Cardiovasc Drugs 2004;4:257-68. https://doi.org/10.2165/00129784-200404040-00006
  25. Popma JJ, Califf RM, Topol EJ. Clinical trials of restenosis after coronary angioplasty. Circulation 1991;84:1426-36. https://doi.org/10.1161/01.CIR.84.3.1426
  26. Clowes AW, Clowes MM, Kinetics of cellular proliferation after arterial injury. II. Inhibition of smooth muscle growth by heparin. Lab Invest 1985;52:611-6.
  27. Baek S, March KL, Gene therapy for restenosis: getting nearer the heart of the matter. Circ Res 1998;82:295-305. https://doi.org/10.1161/01.RES.82.3.295
  28. Park S, Bhang SH, La WG, Seo J, Kim BS, Char K. Dual roles of hyaluronic acids in multilayer films capturing nanocarriers for drugeluting coatings. Biomaterials 2012;33:5468-77. https://doi.org/10.1016/j.biomaterials.2012.04.005
  29. Ceonzo K, Gaynor A, Shaffer L, Kojima K, Vacanti CA, Stahl GL. Polyglycolic acid-induced inflammation: role of hydrolysis and resulting complement activation. Tissue Eng 2006;12:301-8. https://doi.org/10.1089/ten.2006.12.301
  30. Commandeur S, van Beusekom HM, van der Giessen WJ. Polymers, drug release, and drug-eluting stents. J Interv Cardiol 2006;19:500-6. https://doi.org/10.1111/j.1540-8183.2006.00198.x
  31. Bangalore S, Toklu B, Amoroso N, et al. Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysis. BMJ 2013;347:f6625. https://doi.org/10.1136/bmj.f6625
  32. Meng S, Liu Z, Shen L, et al. The effect of a layer-by-layer chitosanheparin coating on the endothelialization and coagulation properties of a coronary stent system. Biomaterials 2009;30:2276-83. https://doi.org/10.1016/j.biomaterials.2008.12.075

Cited by

  1. Novel Polymer-Free Everolimus-Eluting Stent Fabricated using Femtosecond Laser Improves Re-endothelialization and Anti-inflammation vol.8, pp.None, 2017, https://doi.org/10.1038/s41598-018-25629-9
  2. Fabrication and Evaluation of Polyelectrolyte Complexes of Dextran Derivatives for Drug Coating of Coronary Stents vol.30, pp.5, 2017, https://doi.org/10.14478/ace.2019.1057