Comparison of reendothelialization and neointimal formation with stents coated with antibodies against endoglin and CD34 in a porcine model

Abstract

Song Cui,1* Xian-Tao Song,1 Chao Ding,2* Li-Jun Meng,3 Shu-Zheng Lv,1 Kefeng Li4,5 1The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Department of Cardiology, Anzhen Hospital Affiliated to Capital Medical University, Beijing, People’s Republic of China; 2Department of Cardiology, Huimin People’s Hospital, Binzhou, People’s Republic of China, 3Department of Cardiology, Binzhou Central Hospital, Binzhou, People’s Republic of China; 4School of Medicine, University of California, San Diego, CA, USA; 5Tianjin SunnyPeak Biotech Co, Ltd, Tianjin, People’s Republic of China *These authors contributed equally to this work Abstract: Anti-CD34 coated stents are the only commercialized antibody-coated stents currently used for coronary artery diseases with various limitations. Endoglin plays important roles in the proliferation of endothelial cells and vascular remodeling and could be an ideal target surface molecule. The objective of this study was to investigate the efficacy of stents coated with anti-endoglin antibodies (ENDs) in terms of endothelial recovery and the reduction of neointimal formation. The performance of ENDs was evaluated by comparing with stents coated with anti-CD34 antibodies (CD34s), sirolimus-eluting stents (SESs), and bare metal stents (BMSs). Stents were randomly assigned and placed in the coronary arteries of juvenile pigs. Histomorphometric analysis and scanning electron microscopy were performed after stent implantation. Our results showed at 14 days after stent implantation, the neointima area and percent area stenosis in ENDs and CD34s were remarkably decreased compared with those in BMSs and SESs (P<0.05). Moreover, the percentage of reendothelialization was significantly higher in ENDs and CD34s than that in SESs or BMSs at both 7 and 14 days (P<0.05). There was no difference in the neointima area, percent area stenosis, and percentage of reendothelialization in ENDs compared with CD34s. The artery injury and the inflammation scores were similar in all groups at both 7 and 14 days. Our results demonstrate that the performance of ENDs is similar to the commercial CD34s, without the disadvantages of CD34s, and both are better than SESs and BMSs. ENDs potentially offer an alternative approach to reduce restenotic process and enhance reendothelialization after stent implantation. Keywords: endothelialization, restenosis, anti-CD34