Arterial response to mild balloon injury in the normal rabbit: evidence for low proliferation rate in the adventitia.
BACKGROUND
The role of constrictive remodeling, spasm and proliferation (particularly in the adventitia) in the genesis of chronic lumen narrowing after balloon injury remains under debate. This study analyzed the time course of these components following mild injury in normal arteries.


METHODS
Iliac injury was induced by balloon overstretch in 32 rabbits, sacrificed at timed intervals from day 3 to 28. Angiographic response to nitrates, morphometric, immunohistochemical and biochemical analysis were performed at each time point.


RESULTS
Quantitative angiography showed a decrease in lumen diameter and no change in response to nitrates over time. On morphometric analysis, remodeling was usually constrictive, appeared as early as day 3 and was responsible for 69+/-14% of the histologic lumen area stenosis at day 28. Constrictive remodeling was correlated negatively to intimal hyperplasia (r= 0.51, P< 0.002) and positively to the lumen area stenosis (r= 0.92, P< 0.0001). Macrophages (labeled by anti-RAM 11 antibodies) were very rare at all time points. Immunohistochemistry identified a high rate of proliferating smooth muscle cells in the media (13+/-7%) and intima (49+/-8%) at day 7, which decreased rapidly. Proliferating cells in the adventitia were rare (3+/-2% at day 7). The number of proliferating cells was time-dependent (r= 0.82, P< 0.0001) and related to cyclin A mRNA measured by reverse transcription-polymerase chain reaction (r= 0.84, P< 0.0001).


CONCLUSIONS
In this model, luminal loss was mainly caused by constrictive remodeling rather than intimal hyperplasia. Constrictive remodeling appeared early and was not time-dependent. Macrophages, spasm and adventitial proliferation did not contribute to this constrictive remodeling.
Le Feuvre
C
C
Unité Physiopathologie du Coeur et des Artères, Faculté Xavier Bichat, Paris, France.
Tahlil
O
O
Paterlini
P
P
Maillard
L
L
Brousse
N
N
Lacour
B
B
Guettier
C
C
Vacheron
A
A
Feldman
L
L
Steg
P G
PG
D000800:Angioplasty, Balloon / Q000009:adverse effects*; D000818:Animals; D002455:Cell Division; D019925:Cyclin A / Q000096:biosynthesis; D006965:Hyperplasia; D007083:Iliac Artery / Q000293:injuries*; D008297:Male; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D012333:RNA, Messenger / Q000235:genetics; D011817:Rabbits; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D017539:Tunica Intima / Q000473:pathology
D019925:Cyclin A; D012333:RNA, Messenger