title: Combination coating of chitosan and anti-CD34 antibody applied on sirolimus-eluting stents can promote endothelialization while reducing neointimal formation.
abstract: BACKGROUND
  Circulating endothelial progenitor cells (EPCs) capture technology improves endothelialization rates of sirolimus-eluting stents (SES), but the problem of delayed re-endothelialization, as well as endothelial dysfunction, has still not been overcome. Therefore, we investigated whether the combination coating of hyaluronan-chitosan (HC) and anti-CD34 antibody applied on an SES (HCASES) can promote endothelialization, while reducing neointimal formation and inflammation.
  
  
  METHODS
  Sirolimus-eluting stents(SES), anti-CD34 antibody stents (GS) and HC-anti-CD34 antibody combined with sirolimus-eluting stents (HCASES) were deployed in 54 normal porcine arteries and harvested for scanning electron microscopy (SEM) and histological analysis. The ratio of endothelial coverage above the stents was evaluated by SEM analysis at 7, 14 and 28 days. The percentage of in-stent stenosis was histologically analyzed at 14 and 28 days.
  
  
  RESULTS
  SEM analysis at 7 days showed that endothelial strut coverage was increased in the HCASES group (68±7%) compared with that in the SES group (31±4%, p=0.02). At 14 days, stent surface endothelialization, evaluated by SEM, showed a significantly higher extent of endothelial coverage above struts in the GS (95 ± 2%) and the HCASES groups (87±4%) compared with that in the SES group (51±6%, p=0.02). Histological examination showed that the percentage of stenosis in the HCASES group was not significantly different to that of the SES and GS groups (both p> 0.05). At 28 days, there was no difference in the rates of endothelial coverage between the HCASES and GS groups. The HCASES group showed less stenosis than that in the GS group (P < 0.05), but it was not significantly different from the SES group (P=0.068).
  
  
  CONCLUSIONS
  SEM and histology demonstrated that HCASESs can promote re-endothelialization while enhancing antiproliferative effects.
authors.affiliation: Interventional Radiology Department, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China.
authors.forename: Feng
authors.initials: F
authors.lastname: Yang
authors.forename: Shi-Chao
authors.initials: SC
authors.lastname: Feng
authors.forename: Xiang-Jun
authors.initials: XJ
authors.lastname: Pang
authors.forename: Wei-Xiao
authors.initials: WX
authors.lastname: Li
authors.forename: Yong-Hua
authors.initials: YH
authors.lastname: Bi
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhao
authors.forename: Shi-Xuan
authors.initials: SX
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Bo
authors.initials: B
authors.lastname: Feng
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D018952:Antigens, CD34 / Q000276:immunology*; D048271:Chitosan / Q000008:administration & dosage*; D054855:Drug-Eluting Stents; D042783:Endothelial Cells / Q000502:physiology*; D008855:Microscopy, Electron, Scanning; D058426:Neointima / Q000517:prevention & control*; D020123:Sirolimus / Q000008:administration & dosage*; D013552:Swine
chemical_list: D018952:Antigens, CD34; D048271:Chitosan; D020123:Sirolimus