UP-REGULATION OF ANGIOTENSIN-CONVERTING ENZYME DURING THE HEALING-PROCESS AFTER INJURY AT THE SITE OF PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IN HUMANS
M. Ohishi et al., UP-REGULATION OF ANGIOTENSIN-CONVERTING ENZYME DURING THE HEALING-PROCESS AFTER INJURY AT THE SITE OF PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IN HUMANS, Circulation, 96(10), 1997, pp. 3328-3337
Background Balloon injury models in rat have shown enhanced expression
of ACE in the developing neointima. However, neointimal lesions in hu
man coronary arteries are complex due to atherosclerosis and different
types of wall laceration. This study was designed to investigate whet
her ACE is present in the neointima of humans, including patients with
restenosis after percutaneous transluminal coronary angioplasty (PTCA
). Methods and Results Thirty-seven sites with angioplasty injury, obt
ained at autopsy, were studied using immunocytochemical techniques. Si
tes with injury limited to a fibrous plaque and those with injury exte
nding into the media (< 2 months after PTCA) showed fibrocellular repa
ir tissue composed mainly of smooth muscle cells that were distinctly
positive for ACE. In cellular reactions at the site of injury limited
to the atheromatous plaque (< 2 months after PTCA), the expression of
ACE appeared first in accumulated macrophages; once smooth muscle cell
s appeared in the repair tissue, they also expressed ACE. At a later s
tage (3 months after PTCA), the number of cells with ACE expression de
creased markedly; from 7 months on, ACE was no longer expressed within
the repair tissue, Basically, there were no differences with regard t
o ACE expression during the healing process after PTCA between segment
s with and those without angiographic evidence of restenosis. Conclusi
ons These results show that PTCA. injury in humans results in upregula
tion of ACE at sites of active repair and, therefore, ACE could play a
n important role as one of the mediators of the healing process after
PTCA.