Objective Endothelial dysfunction after percutaneous coronary intervention (PCI) played a key role in perturbations of haemostatic equilibrium. Granulocyte-macrophage colony stimulating factor (GM-CSF) could enhance the restoration of cells' normal phenotype. However, previous studies suggested GM-CSF might induce hypercoagulability. In this study, we discussed the effect of GM-CSF on coagulation and fibrinolysis after artery deendothelialization.
Methods 24 male New Zealand White rabbits underwent primary iliac artery deendothelialization were randomised to two groups (GM-CSF group and control group). GM-CSF group animals received a subcutaneous injection of GM-CSF, the control group animals were given a subcutaneous injection of equivalent saline. The iliac arteries of all animals were damaged by balloon after 7 days. The plasma levels of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and nitric oxide (NO) were detected before, 1 week, 2 weeks and 4 weeks after angioplasty. The repair and hyperplasia of intima were observed by microscope.
Results The NO levels of the GM-CSF group were higher than that of the control group 2 weeks and 4 weeks after operation [(91.9±11.6) μmol/l vs (81.7±12.2) μmol/l]; [(97.7±10.1) μmol/l vs (83.2±12.6) μmol/l]. Although there was no difference between the two groups in both activities of t-PA and PAI-1 in each specific time point, in 1, 2, 4 weeks after operation, the activities of t-PA became higher than the ones before operation, while the activities of PAI-1 stayed almost the same. Pathological examination showed that the level of intima hyperplasia. VSMC and fibrous tissue of neointima were much lower in GM-CSF group and endothelium was more integrated and smooth.
Conclusion GM-CSF could facilitate the repair of intima, better the function of endothelium without disturbing the balance of coagulation and fibrinolysis.
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