On cellular sources for intimal hyperplasia after vascular interventions

Vascular interventions for the treatment of symptomatic atherosclerosis fail in up to 40 % of the cases during the first year. One important reason is the development of a narrowing process known as intimal hyperplasia (IH). The cells forming IH resemble smooth muscle cells (SMCs) from the media of the arterial wall. Therefore the media has generally been regarded as the cellular origin for IH. However, there are reports indicating that other cellular sources might be involved. The aim of this thesis was to investigate which cellular sources participate in the development of intimal hyperplasia after bypass surgery and balloon injury. Furthermore, we wanted to investigate, if the inhibition of one cellular source could reduce initimal hyperplasia. Studies were made in pig and rabbit. Specific aims were: 1/ To evaluate the blood, the adjacent artery, the media, the adventitia, and the surrounding tissue as cellular sources to intimal hyperplasia 2/ To evaluate the contribution of blood-borne mononuclear cells to IH 3/ To evaluate, if depletion of the cells in the media reduces intimal hyperplasia after vascular interventions. We found that the adjacent artery at the anastomoses and the surrounding tissue contributed cells in a bypass model in pig. Blood-borne mononuclear cells were labeled ex vivo and retransfused after bypass implantation and balloon injury in pig. These cells were later found in the IH. Some of these cells co-expressed markers for smooth muscle cells suggesting a trandifferation from a blood-borne mononuclear to a tissue forming cell. In a ballon injury model in rabbit we found that the media with its SMCs was the main cellular source and that adventitial cells did not contribute to the IH. After depletion of the medial SMCs by a more severe balloon trauma in rabbit and by photodynamic therapy in the bypass model in pig we found less IH compared with controls, suggesting the media and its cells to be an important source after both interventions. In conclusion, the results presented in this thesis show that cells from the media, the surrounding tissue, the adjacent artery, and blood-borne mononuclear cells can contribute to IH. By depletion of the cells in the media, intimal hyperplasia following both bypass surgery and balloon injury is reduced

Role of endothelium-derived nitric oxide in the regulation of tonus in large-bore arterial resistance vessels, arterioles and veins in cat skeletal muscle

The role of endothelium-derived nitric oxide in the regulation of vascular resistance (tonus) in cat skeletal muscle was studied with the use of NG-monomethyl-L-arginine (L-NMMA), a specific inhibitor of nitric oxide formation from L-arginine. The study was performed with a whole-organ technique which permits simultaneous, continuous and quantitative recordings of resistance reactions in the whole vascular bed (RT) and in its three consecutive sections: large-bore arterial resistance vessels (greater than 25 microns; Ra,prox), small arterioles (less than 25 microns; Ra,micro) and veins (Rv). NG-monomethyl-L-arginine (3-100 mg kg-1 tissue, i.a.) induced a dose-dependent increase in resistance that was preferentially, but not selectively, confined to the large-bore arterial resistance vessels. At a maximally effective dose (100 mg kg-1), the nitric oxide inhibitor caused a marked constriction, within 5 min, on average increasing RT by 99%, Ra,prox by 138%, Ra,micro by 18% and Rv by 23%. The constrictor response to NG-monomethyl-L-arginine was long-lasting but disappeared gradually over a period of about 1 h. However, it could be abruptly abolished by excess L-arginine (300 mg kg-1, i.a.). The vasodilator response (RT) to acetylcholine was significantly attenuated in the presence of NG-monomethyl-L-arginine compared with the control response. The results suggested that nitric oxide formation from L-arginine by the vascular endothelium plays a fundamental role in the regulation of vascular resistance (tone) in vivo, with its main site of action located in the large-bore arterial resistance vessels

Endogenous nitric oxide as a physiological regulator of vascular tone in cat skeletal muscle during haemorrhage

The problem whether endogenous nitric oxide (NO) may serve as a true physiological regulator of vascular tone in vivo was approached by testing its role during graded acute haemorrhage with the aid of the nitric oxide synthase (NOS) inhibitor L-NAME. The study was performed on the vascular bed of cat skeletal muscle with a technique permitting quantitative recordings of vascular resistance in the whole vascular bed (RT) and in its consecutive sections, the proximal arterial resistance ('feeder') vessels (> 25 microns; Ra,prox), the small arterioles (< 25 microns) and the veins. NO blockade by close-arterial L-NAME infusion in the control situation increased RT from 16.3 to 33.0 PRU (+102%), because of a selective increase in Ra,prox by 16.7 PRU. A 35% blood loss per se raised RT from 13.6 to 21.7 PRU. Superimposed NO blockade in this state caused a much stronger vasoconstriction than in the control situation, increasing RT to 60.9 PRU (+181%) and Ra,prox by 40.5 PRU, which indicated an approximately 2.4-fold increase (P < 0.001) in the NO dilator influence in the Ra,prox section above control. The effect was independent of autonomic nerves. The increased NO dilator influence during haemorrhage most likely was caused by an increased production of endothelium-derived nitric oxide (EDNO), The constrictor response to L-NAME was graded in relation to the blood loss (17.5 vs. 35%). The results indicate that EDNO functions as a physiological regulator of vascular tone in the arterial 'feeder' vessels during haemorrhage, serving to counterbalance to a significant extent the concomitant adrenergic constriction, and thereby preventing critical reduction of blood flow and untoward heterogeneous flow distribution within the tissue

Alpha 2-adrenoceptor activation may trigger the increased production of endothelium-derived nitric oxide in skeletal muscle during acute haemorrhage

Our previous studies indicated that acute haemorrhage leads to a pronounced increase in the release of endothelium-derived nitric oxide (EDNO) graded in relation to the magnitude of the blood loss. The EDNO-induced vasodilatation, confined selectively to the arterial 'feeder' vessels, attenuates the concomitant reflex adrenergic constriction and thereby prevents deleterious reduction of blood flow. The present study aimed at investigating whether the reflex release of blood-borne catecholamines might trigger this EDNO release via activation of endothelial alpha 2-adrenoceptors. The study was performed on the sympathectomized vascular bed of cat skeletal muscle with a technique permitting quantitative recordings of resistance (tone) in consecutive vascular sections. Selection alpha 2-adrenoceptor blockade with idazoxan applied at steady state vasoconstriction after a 35% blood loss evoked an initial generalized dilator response (attributable to inhibition of post-synaptic smooth muscle alpha 2-adrenoceptors), followed by a constrictor response selectively in the arterial feeder vessels, the latter compatible with the hypothesis of reduced EDNO release by alpha 2-adrenoceptor blockade. More direct evidence for the hypothesis was obtained from studies of the vascular response to EDNO blockade (L-NAME) after haemorrhage in the presence and absence of alpha 2-adrenoceptor blockade. The constrictor response to EDNO blockade, which is a measure of the pre-existing EDNO dilator influence (EDNO production), was significantly smaller (P < 0.01) in the presence than absence of alpha 2-adrenoceptor blockade. The results indicate that blood-borne catecholamines, via activation of endothelial alpha 2-adrenoceptors, trigger the increase in the EDNO release in acute haemorrhage, implying a functionally important negative feedback in the integrated control of vascular tone in bleeding

Phase transitions in KTP isostructures: correlation between structure and T-c in germanium-doped RbTiOPO4

Crystals of germanium-doped rubidium titanyl phosphate, Rb-2(Ti)(Ge0.121Ti0.879)O-2(PO4)(2) (GeRTP#1) and Rb-2(Ge-0.125-Ti-0.875)(Ge0.225Ti0.775)O-2(PO4)(2) (GeRTP#2), have been structurally characterized from X-ray diffraction data at room temperature. In addition, a third structure, Rb-2(TiO)(2)(PO4)(2) (RTP), has been reinvestigated. The exchange of titanium for germanium results in a less distorted octahedral coordination around the two crystallographically independent titanium sites. Additionally, rubidium split-cation positions have been found in these doped RTP crystals. Dielectric measurements show that the phase-transition temperature, T-c, decreases with increasing germanium concentration, and a direct correlation between the room-temperature split of the rubidium cations and T-c has been discovered. General trends regarding the relationship between the room-temperature structures of KTP-like compounds and their T-c values are discussed

Phase transitions in KTP isostructures: correlation between structure and T-c in germanium-doped RbTiOPO4

Crystals of germanium-doped rubidium titanyl phosphate, Rb-2(Ti)(Ge0.121Ti0.879)O-2(PO4)(2) (GeRTP#1) and Rb-2(Ge-0.125-Ti-0.875)(Ge0.225Ti0.775)O-2(PO4)(2) (GeRTP#2), have been structurally characterized from X-ray diffraction data at room temperature. In addition, a third structure, Rb-2(TiO)(2)(PO4)(2) (RTP), has been reinvestigated. The exchange of titanium for germanium results in a less distorted octahedral coordination around the two crystallographically independent titanium sites. Additionally, rubidium split-cation positions have been found in these doped RTP crystals. Dielectric measurements show that the phase-transition temperature, T-c, decreases with increasing germanium concentration, and a direct correlation between the room-temperature split of the rubidium cations and T-c has been discovered. General trends regarding the relationship between the room-temperature structures of KTP-like compounds and their T-c values are discussed

Cardiovascular regulation by endogenous nitric oxide is essential for survival after acute haemorrhage

Our previous studies have indicated that endogenous nitric oxide serves as a physiologically important inhibitor of vascular tone during acute haemorrhage. This vasodilator action attenuates the concomitant reflex adrenergic constriction and thereby prevents critical reduction of tissue blood flow. The present study aimed to evaluate the overall importance of this nitric oxide regulation for survival after acute haemorrhage. This was done by comparative observations of survival time and circulatory, metabolic and histopathological changes after an acute standardized lethal blood loss (45%) in cats exposed to nitric oxide synthase (NOS) inhibition and in matched control animals with intact nitric oxide regulation. NOS inhibition was instituted by intravenously administered N omega-nitro-L-arginine methyl ester. The survival time averaged 2 h 49 min in the NOS-blocked animals and 10 h 14 min in the control animals (P < 0.001). NOS inhibition thus reduced the posthaemorrhagic survival time to < 30% of that in the control cats. Haemorrhage in the NOS-blocked animals led to rapidly developing arterial hypotension, increased anaerobic metabolism, metabolic lactacidosis, hyperkalaemia, and morphological tissue damage especially in heart and liver, in spite of maintained arterial normoxia, which signifies tissue hypoxia caused by seriously impaired nutritional blood supply. At the time of death of the NOS-blocked cats, the control animals still exhibited a virtually normal circulatory/metabolic state. A much later, and more slowly developing circulatory/metabolic deterioration was observed in the control animals. These differences between the two groups of animals indicate that nitric oxide release, by its vasodilator action, to a significant extent helps to maintain an adequate nutritional blood supply to the tissues in acute haemorrhage