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Keywords
- Atherosclerosis (1)
- biomaterial (1)
- bypass graft (1)
- cardiovascular replacement (1)
- restenosis (1)
- stem cell (1)
- stent (1)
- tissue engineering (1)
Despite recent advances in medical procedures, cardiovascular disease remains a clinical challenge and the leading cause of mortality in the western world. The condition causes progressive smooth muscle cell (SMC) dedifferentiation, proliferation, and migration that contribute to vascular restenosis. The incidence of disease of the internal mammary artery (IMA), however, is much lower than in nearly all other arteries. The etiology of this IMA disease resistance is not well understood. Here, using paired primary IMA and coronary artery SMCs, serum stimulation, siRNA knockdowns, and verifications in porcine vessels in vivo, we investigate the molecular mechanisms that could account for this increased disease resistance of internal mammary SMCs. We show that the residue-specific phosphorylation profile of the retinoblastoma tumor suppressor protein (Rb) appears to differ significantly between IMA and coronary artery SMCs in cultured human cells. We also report that the differential profile of Rb phosphorylation may follow as a consequence of differences in the content of cyclin-dependent kinase 2 (CDK2) and the CDK4 phosphorylation inhibitor p15. Finally, we present evidence that siRNA-mediated CDK2 knockdown alters the profile of Rb phosphorylation in coronary artery SMCs, as well as the proliferative response of these cells to mitogenic stimulation. The intrinsic functional and protein composition specificity of the SMCs population in the coronary artery may contribute to the increased prevalence of restenosis and atherosclerosis in the coronary arteries as compared with the internal mammary arteries.
Atherosclerosis is a chronic disease of the arteries and accounts for about 50 percent of all deaths in industrialized countries. For its treatment, patients primarily need to undergo lifestyle changes, concerning their diet or sportive behavior, while additional pharmaceutical approaches help to reduce major risk factors such as hypertension and hyperlipidemia. However, these two areas of treatment are only briefly mentioned here. Instead, this article focuses on literature and patents from the last decade focusing on invasive surgical procedures necessary for treatment of diseased blood vessels in severe cases of atherosclerosis. Described herein are synthetic grafts and so-called autografts, which are harvested from the patient for bypass surgery. In addition, implantable stents are discussed, which deal with different atherosclerotic aspects, such as restenosis, re-endothelialization, neointimal hyperplasia and thrombosis. And finally, publications and inventions are presented from the relatively new field of artificial tissue engineering incorporating stem cells or biomaterials to construct new vessels as substitutes for diseased veins and arteries.
