The influence of stent material and diabetes on macrophages trans-differentiation pathways in the progression of in-stent restenosis

Abstract

The outcome of the deployment of cardiovascular stents in coronary arteries compromised by atherosclerosis may be affected by the deposition of a myofibroblast-driven neointimal tissue and consequent re-blockage of the vessel lumen known as in-stent restenosis (ISR). Its incidence is particularly high in people with diabetes unless drug-eluting stents (DES) are implanted as alternatives to the traditional bare metal stents (BMS) made of stainless steel (ST). However, the long-term outcome of the use of DES is under debate due to evidence of late thrombosis. Monocytes/macrophages (MM) play a key role in ISR participating in the different phases of the host response to the implant. This in-vitro study investigates differences in the distribution and response of MM that may be significant for a better understanding of the causes of the increased ISR occurrence among diabetic patients, particularly focusing on the trans-differentiation potential of MM into myofibroblast-like cells when in contact with ST.

Date of Award	Jun 2014
Original language	English
Awarding Institution	University of Brighton