Background - The hypothesis that thrombin mediates the formation of neointimal vascular lesions at sites of mechanical vascular injury has been tested in baboons by measurement of the effects of hirudin delivered by retrovirus-transduced hirudin-secreting vascular endothelial cells (ECs) lining surgically implanted arterial vascular grafts (AVGs). Methods and Results - The antithrombotic efficacy of baboon ECs transduced with cDNA encoding hirudin was assessed in vitro and in vivo on thrombogenic segments in chronically exteriorized femoral arteriovenous (AV) shunts. Bilateral brachial AVGs lined with hirudin-transduced versus nonhirudin control ECs at confluent density were surgically implanted, and vascular lesion formations at distal graft-vessel anastomoses were compared after 30 days. Hirudin- transduced ECs secreted 20 ± 6 ng · 106 cells-1 · 24 h-1 (range, 14 to 24 ng · 106 cells-1 · 24 h-1) hirudin in supernatants of static cultures. Hirudin-secreting ECs on segments of collagen-coated graft interposed in chronic AV shunts decreased the accumulation of 111In- labeled platelets to 0.52 ± 0.34 x 109 platelets, compared with 0.82 ± 0.49 x 109 platelets in controls (P = 0.03) and reduced platelet deposition in propagated thrombotic tails extending downstream from segments of vascular graft from 1.38 ± 0.41 x 109 platelets in controls to 0.59 ± 0.22 x 109 platelets (P=0.04). ECs recovered from 30-day AVG implants generated 17 ± 9 ng · 106 cells-1 · 24 h-1 (range, 9 to 25 ng · 106 cells-1 · 24 h-1) hirudin. Hirudin-secreting ECs reduced neointimal lesion formation at distal graft-vessel anastomoses, ie, 1.02 mm2 (range, 0.88 to 1.95 mm2) versus 1.82 mm2 (range, 0.88 to 2.56 mm2) in contralateral AVGs beating nonhirudin control ECs (P<0.01). Conclusions - Viral vector-directed secretion of hirudin from ECs lining implanted AVGs significantly reduces the formation of thrombus and neointimal vascular lesions.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)