EFFECT OF RECOMBINANT HUMAN GROWTH HORMONE ON ENDOTHELIALIZATION OF VASCULAR PROSTHESES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANGZhe ,  CHENXueming , LIChenyu , FENGHai , YUHongzhi , ZHURenming , CAIZhimin

Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, P. R. China;

Corresponding?author：

CHENXueming, Email: chenxueming04@sohu.com

Keywords：

Recombinant human growth hormone; Vascular prostheses; Endothelialization; Intimal hyperplasia

DOI：

10.7507/1002-1892.20150162

Video：

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Objective To investigate whether the recombinant human growth hormone (rhGH) can promote endothelialization, inhibit vascular intimal hyperplasia, and improve long-term patency rate by the treatment of rhGH after vascular prostheses bypass. Methods Between August 2007 and January 2009, 94 patients with lower extremity arteriosclerotic occlusive disease were treated. Among them, 32 patients (34 limbs) who met the selection criteria were enrolled in this study. All cases were randomly divided into study group (16 cases, 18 limbs) and control group (16 cases, 16 limbs). There was no significant difference (P>0.05) in gender, age, disease time, location of lesions, the Trans-Atlantic Inter-Society Consensus (TASC) grade, and basic diseases between 2 groups. The patients with superficial femoral artery disease received above-knee femoro-popliteal prostheses bypass. The patients who had combined abdominal-iliac artery disease received concurrent abdominal-femoral and femoro-popliteal prostheses bypass. Subcutaneous injection of 9 U rhGH was given every night for 7 days in study group, and saline was applied in control group. Ultrasonography was taken after 2 weeks and 3 months of operation to observe the patency and measure the wall thickness of vascular prostheses. Results After operation, 1 patient of control group died of renal failure caused by acute thrombosis. After 2 weeks, ultrasonography showed no obvious intimal hyperplasia in 2 groups; the wall thickness was (0.13±0.02) cm in study group and (0.15±0.03) cm in control group, showing no significant difference (t=-1.720, P=0.108). After 3 months, the wall thickness was (0.17±0.06) cm in study group and was (0.26±0.09) cm in control group, showing significant difference (t=-2.240, P=0.045). All cases were followed up 36-60 months (mean, 56.4 months). The 5-year primary patency rate was 52.5% in study group and 35.7% in control group, showing no significant difference (χ²=1.470, P=0.225). Conclusion The rhGH can improve endothelialization in vascular prostheses and can inhibit postoperative vascular intimal hyperplasia in clinical application.

Citation： ZHANGZhe, CHENXueming, LIChenyu, FENGHai, YUHongzhi, ZHURenming, CAIZhimin. EFFECT OF RECOMBINANT HUMAN GROWTH HORMONE ON ENDOTHELIALIZATION OF VASCULAR PROSTHESES. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 756-760. doi: 10.7507/1002-1892.20150162 Copy

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2.	Patel SD, Waltham M, Wadoodi A, et al. The role of endothelial cells and their progenitors in intimal hyperplasia. Ther Adv Cardiovasc Dis, 2010, 4(2):129-141.
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9.	Goh ET, Wong E, Farhatnia Y, et al. Accelerating in situ endothelialisation of cardiovascular bypass grafts. Int J Mol Sci, 2015, 16(1):597-627.
10.	Shi Q, Wu MH, Hayashida N, et al. Proof of fallout endothelialization of impervious Dacron grafts in the aorta and inferior vena cava of the dog. J Vasc Surg, 1994, 20(4):546-556.
11.	Hayden MR, Habibi J, Joginpally T, et al. Ultrastructure Study of Transgenic Ren2 Rat Aorta-Part 1:Endothelium and Intima. Cardiorenal Med, 2012, 2(1):66-82.
12.	Asahara T, Murohara T, Sullivan A, et al. Isolation of putative progenitor endothelial cells for angiogenesis. Science, 1997, 275 (5302):964-967.
13.	Li J, Zou Y, Ge J, et al. The effects of G-CSF on proliferation of mouse myocardial microvascular endothelial cells. Int J Mol Sci, 2011, 12(2):1306-1315.
14.	Peichev M, Naiyer AJ, Pereira D, et al. Expression of VEGFR-2 and AC133 by circulating human CD34+ cells identifies a population of functional endothelial precursors. Blood, 2000, 95(3):952-958.
15.	Ohki Y, Heissig B, Sato Y, et al. Granulocyte colony-stimulating factor promotes neovascularization by releasing vascular endothelial growth factor from neutrophils. Faseb J, 2005, 19(14):2005-2007.
16.	Hattori K, Dias S, Heissig B, et al. Vascular endothelial growth factor and angiopoietin-1 stimulate postnatal hematopoiesis by recruitment of vasculogenic and hematopoietic stem cells. J Exp Med, 2001, 193(9):1005-1014.
17.	Lisa M, Haleagrahara N, Chakravarthi S. Insulin-Like Growth Factor-1 (IGF-1) Reduces ischemic changes and increases circulating angiogenic factors in experimentally induced myocardial infarction in rats. Vasc Cell, 2011, 3(1):13.
18.	Dobrucki LW, Tsutsumi Y, Kalinowski L, et al. Analysis of angiogenesis induced by local IGF-1 expression after myocardial infarction using microSPECT-CT imaging. J Mol Cell Cardiol, 2010, 48(6):1071-1079.
19.	Bosma J, Turk?an K, Assink J, et al. Long-term quality of life and mobility after prosthetic above-the-knee bypass surgery. Ann Vasc Surg, 2012, 26(2):225-232.
20.	黃俊杰, 栗力. 流出道對于股-腘人工血管旁路術后重度狹窄閉塞的影響. 中國血管外科雜志(電子版), 2011, 3(2):98-100.

1. 胡波, 何延政. 人工血管內皮化的研究進展. 中國組織工程研究與臨床康復, 2007, 11(10):1923-1926.
2. Patel SD, Waltham M, Wadoodi A, et al. The role of endothelial cells and their progenitors in intimal hyperplasia. Ther Adv Cardiovasc Dis, 2010, 4(2):129-141.
3. Thum T, Hoeber S, Froese S, et al. Age-dependent impairment of endothelial progenitor cells is corrected by growth hormone mediated increase of insulin-like growth factor-1. Circ Res, 2007, 100(3):434-443.
4. 吉紹葵, 馬琦琳, 羅秀菊, 等. 胰島素樣生長因子-1對高膽固醇血癥患者內皮的保護作用及機制. 中南大學學報:醫學版, 2013, 38(1):36-42.
5. 盧伶俐. 重組人生長激素對人造血管內皮化的影響. 長沙:中南大學, 2008.
6. Dormandy JA, Rutherford RB. Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC). J Vasc Surg, 2000, 31(1 Pt 2):S1-S296.
7. Park KM, Kim YW, Yang SS, et al. Comparisons between prosthetic vascular graft and saphenous vein graft in femoro-popliteal bypass. Ann Surg Treat Res, 2014, 87(1):35-40.
8. Rychlik IJ, Davey P, Murphy J, et al. A meta-analysis to compare Dacron versus polytetrafluroethylene grafts for above-knee femoropopliteal artery bypass. J Vasc Surg, 2014, 60(2):506-515.
9. Goh ET, Wong E, Farhatnia Y, et al. Accelerating in situ endothelialisation of cardiovascular bypass grafts. Int J Mol Sci, 2015, 16(1):597-627.
10. Shi Q, Wu MH, Hayashida N, et al. Proof of fallout endothelialization of impervious Dacron grafts in the aorta and inferior vena cava of the dog. J Vasc Surg, 1994, 20(4):546-556.
11. Hayden MR, Habibi J, Joginpally T, et al. Ultrastructure Study of Transgenic Ren2 Rat Aorta-Part 1:Endothelium and Intima. Cardiorenal Med, 2012, 2(1):66-82.
12. Asahara T, Murohara T, Sullivan A, et al. Isolation of putative progenitor endothelial cells for angiogenesis. Science, 1997, 275 (5302):964-967.
13. Li J, Zou Y, Ge J, et al. The effects of G-CSF on proliferation of mouse myocardial microvascular endothelial cells. Int J Mol Sci, 2011, 12(2):1306-1315.
14. Peichev M, Naiyer AJ, Pereira D, et al. Expression of VEGFR-2 and AC133 by circulating human CD34+ cells identifies a population of functional endothelial precursors. Blood, 2000, 95(3):952-958.
15. Ohki Y, Heissig B, Sato Y, et al. Granulocyte colony-stimulating factor promotes neovascularization by releasing vascular endothelial growth factor from neutrophils. Faseb J, 2005, 19(14):2005-2007.
16. Hattori K, Dias S, Heissig B, et al. Vascular endothelial growth factor and angiopoietin-1 stimulate postnatal hematopoiesis by recruitment of vasculogenic and hematopoietic stem cells. J Exp Med, 2001, 193(9):1005-1014.
17. Lisa M, Haleagrahara N, Chakravarthi S. Insulin-Like Growth Factor-1 (IGF-1) Reduces ischemic changes and increases circulating angiogenic factors in experimentally induced myocardial infarction in rats. Vasc Cell, 2011, 3(1):13.
18. Dobrucki LW, Tsutsumi Y, Kalinowski L, et al. Analysis of angiogenesis induced by local IGF-1 expression after myocardial infarction using microSPECT-CT imaging. J Mol Cell Cardiol, 2010, 48(6):1071-1079.
19. Bosma J, Turk?an K, Assink J, et al. Long-term quality of life and mobility after prosthetic above-the-knee bypass surgery. Ann Vasc Surg, 2012, 26(2):225-232.
20. 黃俊杰, 栗力. 流出道對于股-腘人工血管旁路術后重度狹窄閉塞的影響. 中國血管外科雜志(電子版), 2011, 3(2):98-100.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECT OF RECOMBINANT HUMAN GROWTH HORMONE ON ENDOTHELIALIZATION OF VASCULAR PROSTHESES

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