Effect of Stents Coated with Artemisinin or Dihydroartemisinin in a Porcine Coronary Restenosis Model

Abstract

Background and ObjectivesArtemisinin and dihydroartemisinin are drugs used to treat malaria. These drugs suppress inflammatory reactions. The aim of this study was to examine the anti-intima hyperplasia effect of a novel drug-eluting stent with artemisinin or dihydroartemisinin in a porcine coronary restenosis model.Materials and MethodsPigs were randomized into four groups; in the first, the coronary arteries (20 pigs, a total of 40 coronary arteries, with 10 coronary arteries in each group) was implanted with bare metal stents (BMS, n=10); the second group was given polymer-coated stents (PCS, n=10); the third group was treated with artemisinin-eluting stents (AES, n=10); and the fourth group was given dihydroartemisinin-eluting stents (DAES, n=10). Histopathologic analysis was performed 28 days after stenting.ResultsThe injury and fibrin scores among the four groups were not significantly different. However, the internal elastic lamina, lumen area, and neointima area were significantly different. Moreover, the percent area of stenosis (46.2±18.66% in BMS vs. 89.4±10.92% in PCS vs. 83.3±17.07% in AES vs. 36.7±11.20% in DAES, p<0.0001) and inflammation score (1.0 [range: 1.0-1.0] vs. 3.0 [range: 2.25-3.0] vs. 3.0 [range: 1.0-3.0] vs. 2.0 [range: 1.75-3.0] in BMS, PCS, AES, and DAES, respectively; p<0.001) were markedly decreased in the DAES group compared to the PCS group.ConclusionDES, which uses a natural substance, dihydroartemisinin, showed a neointima and inflammatory suppressive effect in a porcine coronary restenosis model.

Dihydroartemisinin ameliorates balloon injury‐induced neointimal formation in rats

“…In addition, a recent study showing that the DHA-coated stent suppresses restenosis in a porcine coronary restenosis model (Jang et al, 2017) supports our findings.…”

“…Taken together, our study provides data for the potential application of DHA in a drug‐eluting stent for the reduction of neointimal hyperplasia and restenosis after angioplasty. In addition, a recent study showing that the DHA‐coated stent suppresses restenosis in a porcine coronary restenosis model (Jang et al, ) supports our findings.…”

“…DHA: dihydroartemisinin; DMSO: dimethyl sulfoxide; ELISA: enzyme-linked immunosorbent assay; IL-6: interleukin-6; IκB: inhibitor of NF-κB; MMP-1: matrix metalloproteinase-1; NF-κB: nuclear factor kappa B; TNF-α: tumor necrosis factor-ɑ; TUNEL: terminal deoxynucleotidyl transferase dUTP nick end labeling [Color figure can be viewed at wileyonlinelibrary.com]primary VSMCs in vitro. Taken together, our study provides data for the potential application of DHA in a drug-eluting stent for the reduction of neointimal hyperplasia and restenosis after angioplasty.In addition, a recent study showing that the DHA-coated stent suppresses restenosis in a porcine coronary restenosis model(Jang et al, 2017) supports our findings.…”

Can Artemisinin Be a Game Changer Even as an Antiarrhythmic Drug?

“…On the other hand, as treatment experience has accumulated, drug repositioning of artemisinin is being actively attempted in various fields, including antiviral, antiparasitic, antifungal, anticancer, anti-immune, and anti-inflammatory activities. 6) In this issue of the Korean Circulation Journal , Jeong et al 7) reported the results of their investigation regarding the anti-arrhythmic effect of artemisinin. They used a canine experimental model of BrS induced by NS5806, an I to channel agonist.…”