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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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, Turkçan 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.	黄俊杰, 栗力. 流出道对于股-腘人工血管旁路术后重度狭窄闭塞的影响. 中国血管外科杂志(电子版), 2011, 3(2):98-100.

1. 胡波, 何延政. 人工血管内皮化的研究进展. 中国组织工程研究与临床康复, 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. 吉绍葵, 马琦琳, 罗秀菊, 等. 胰岛素样生长因子-1对高胆固醇血症患者内皮的保护作用及机制. 中南大学学报:医学版, 2013, 38(1):36-42.
5. 卢伶俐. 重组人生长激素对人造血管内皮化的影响. 长沙:中南大学, 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, Turkçan 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. 黄俊杰, 栗力. 流出道对于股-腘人工血管旁路术后重度狭窄闭塞的影响. 中国血管外科杂志(电子版), 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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