| Project/Area Number |
16K19384
|
|---|
| Research Category |
Grant-in-Aid for Young Scientists (B)
|
| Allocation Type | Multi-year Fund |
|---|
| Research Field |
Cardiovascular medicine
|
|---|
| Research Institution | Tohoku University |
|---|
Principal Investigator |
|
|---|
| Research Collaborator |
Shimokawa Hiroaki
Matsumoto Yasuharu
Uzuka Hironori
Ohyama Kazuma
Amamizu Hirokazu
Tuchiya Satoshi
Tearney Guillermo J.
|
|---|
| Project Period (FY) |
2016-04-01 – 2019-03-31
|
| Project Status |
Completed (Fiscal Year 2018)
|
| Budget Amount *help |
¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2016: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
|
|---|
| Keywords | 薬剤溶出性ステント / 経皮的冠動脈インターベンション / 虚血性心疾患 / 外膜 / 冠攣縮 / ステント / OCT / 炎症 / ポリマー / Vasa vasorum / 光干渉 / リンパ管 / 内皮細胞 / アセチルコリン / PET / 冠動脈外膜 |
|---|
| Outline of Final Research Achievements |
Drug-eluting stent (DES) has potentially reduced the rate of in-stent restenosis. Among those who underwent percutaneous coronary intervention (PCI) with DES, some are suffer from unremitting chest pain even after DES implantation, and then limit their quality of life. We have demonstrated that DES induces coronary hyperconstricting responses through adventitial inflammation caused by non-biocompatible durable polymer. This study examined whether or not newly developed bioabsorbable polymer DES (BP-DES) suppresses the DES-induced coronary hyperconstriction when compared to durable-polymer DES (DP-DES). In the swine study, BP-DES allowed to prevent adventitial inflammation around polymers followed by cancellation of coronary hyperconstriction in swine in vivo. Second, in the human study, BP-DES significantly reduced optical coherence tomography (OCT) delineated adventitial vasa vasorum augmentation as compared to DP-DES in patients in vivo.
|
| Academic Significance and Societal Importance of the Research Achievements |
薬剤溶出性ステント（DES）留置によって冠動脈狭窄症を解除しても、約20-40%の症例に胸痛の再燃が起こるといわれる。持続性胸痛は患者の生活の質を著しく損ない、薬剤増量や入院によるカテーテル再検査が必要となり、医療費の面で悪影響を及ぼす。我々は持続性胸痛の主因がDES留置後の冠動脈過収縮反応であること、薬剤溶出を一定化させるポリマーがその本態であることを報告した。今回、生体吸収性の向上したポリマーDES（BP-DES）が冠動脈過収縮の予防効果をもつことを証明した。BP-DESによって冠動脈過収縮を制御できれば、薬剤増量や再入院を減らすことで患者の生活の質と医療費削減の両面に効果を期待できる。
|
