Anti-CD34 antibodies immobilized on the surface of sirolimus-eluting stents enhance stent endothelialization.
OBJECTIVE
In this study, we hypothesized that an antihuman-CD34 antibody immobilized on the surface of commercially available sirolimus-eluting stents (SES) could enhance re-endothelialization compared with SES alone.


BACKGROUND
Previous experience with antihuman-CD34 antibody surface modified Genous stents (GS) (OrbusNeich Medical, Fort Lauderdale, Florida) has shown enhanced stent endothelialization in vivo.


METHODS
In the phase 1 study, stents were deployed in 21 pig coronary arteries for single stenting (9 vessels: 3 GS, 3 SES, and 3 bare-metal stents) and overlapping stenting with various combinations (12 vessels: 4 GS+GS, 4 SES+SES, and 4 GS+SES) and harvested at 14 days for scanning electron and confocal microscopy. In phase 2, immobilized anti-CD34 antibody coating was applied on commercially available SES (SES-anti-CD34, n = 7) and compared with GS (n = 8) and SES (n = 7) and examined at 3 and 14 days by scanning electron/confocal microscopy analysis.


RESULTS
In phase 1, single stent implantation showed greatest endothelialization in GS (99%) and in bare-metal stent (99%) compared with SES (55%, p = 0.048). In overlapping stents, endothelialization at the overlapping zone was significantly greater in GS+GS (95 +/- 6%) and GS+SES (79 +/- 5%) compared with the SES+SES (36 +/- 14%) group (p = 0.007). In phase 2, SES-anti-CD34 resulted in increased endothelialization compared with SES alone at 3 days (SES-anti-CD34 36 +/- 26%; SES 7 +/- 3%; and GS 76 +/- 8%; p = 0.01), and 14 days (SES-anti-CD34 82 +/- 8%; SES 53 +/- 20%; and GS 98 +/- 2%; p = 0.009).


CONCLUSIONS
Immobilization of anti-CD34 antibody on SES enhances endothelialization and may potentially be an effective therapeutic alternative to improve currently available drug-eluting stents.
Nakazawa
Gaku
G
CVPath Institute, Inc, Gaithersburg, Maryland.
Granada
Juan F
JF
Alviar
Carlos L
CL
Tellez
Armando
A
Kaluza
Greg L
GL
Guilhermier
Margaret Yoklavich
MY
Parker
Sherry
S
Rowland
Stephen M
SM
Kolodgie
Frank D
FD
Leon
Martin B
MB
Virmani
Renu
R
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D000818:Animals; D000906:Antibodies / Q000008:administration & dosage*; D018952:Antigens, CD34 / Q000276:immunology*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D049109:Cell Proliferation / Q000187:drug effects; D002478:Cells, Cultured; D023903:Coronary Restenosis / Q000209:etiology / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D054855:Drug-Eluting Stents; D042783:Endothelial Cells / Q000187:drug effects* / Q000276:immunology / Q000648:ultrastructure; D006801:Humans; D008670:Metals; D018613:Microscopy, Confocal; D008855:Microscopy, Electron, Scanning; D023421:Models, Animal; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome
D000906:Antibodies; D018952:Antigens, CD34; D002317:Cardiovascular Agents; D008670:Metals; D020123:Sirolimus