title: Pioglitazone Attenuates Drug-Eluting Stent-Induced Proinflammatory State in Patients by Blocking Ubiquitination of PPAR.
abstract: The inflammatory response after polymer-based drug-eluting stent (DES) placement has recently emerged as a major concern. The biologic roles of peroxisome proliferator-activated receptor-γ (PPAR-γ) activators thiazolidinedione (TZD) remain controversial in cardiovascular disease. Herein, we investigated the antiinflammatory effects of pioglitazone (PIO) on circulating peripheral blood mononuclear cells (MNCs) in patients after coronary DES implantation. Methods and Results. Twenty-eight patients with coronary artery disease and who underwent DES implantations were randomly assigned to pioglitazone (30 mg/d; PIO) or placebo (control; Con) treatment in addition to optimal standard therapy. After 12 weeks of treatment, plasma concentrations of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and matrix metalloproteinase-9 (MMP-9) were significantly decreased in PIO group compared to the Con group (P = 0.035, 0.011, 0.008, and 0.012, resp.). DES-induced mRNA expressions of IL-6, TNF-α, and MMP-9 in circulating MNC were significantly blocked by PIO (P = 0.031, 0.012, and 0.007, resp.). In addition, PIO markedly inhibited DES-enhanced NF-κB function and DES-blocked PPAR-γ activity. Mechanically, DES induced PPAR-γ ubiquitination and degradation in protein level, which can be totally reversed by PIO. Conclusion. PIO treatment attenuated DES-induced PPAR loss, NF-κB activation, and proinflammation, indicating that PIO may have a novel direct protective role in modulating proinflammation in DES era.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Department of Medicine, Gansu Provincial Hospital of TCM, Lanzhou 730050, China.
authors.forename: Zhongxia
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Department of Cardiology, Xi'an Central Hospital, Xi'an 710003, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
authors.forename: Lizhe
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
authors.forename: Ruifeng
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
authors.forename: Xiaojuan
authors.identifier: 0000-0001-7002-4671
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
authors.forename: Zuyi
authors.initials: Z
authors.lastname: Yuan
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
authors.forename: Junhui
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Department of Medicine, Gansu Provincial Hospital of TCM, Lanzhou 730050, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen