Background
Metabolic syndrome is now an epidemic in the US population. Intimal hyperplasia remains the principal lesion in the development of restenosis after vessel wall injury. The aim of this study is to characterize the changes induced in wall morphology in the developing intimal hyperplasia within a murine model in the presence of diabetes (type 1) and metabolic syndrome.
Methods
Control (wild-type B6), Diabetic Type 1 (NOD) and Metabolic Syndrome (RCS-10) mice were used. The murine femoral wire injury model was employed in which a micro wire is passed through a branch of the femoral and used to denude the common femoral and iliac arteries. Specimens were perfusion-fixed and sections were stained with H&E and Movat’s stains such that dimensional and compositional morphometry could be performed using an ImagePro system. Additional stains for proliferation and apoptosis were employed.
Results
In control mice, the injured femoral arteries develop intimal hyperplasia, which is maximal at 28 days and remains stable to day 56. Sham-operated vessels do not produce such a response. In diabetic mice, the intimal response increased 5-fold with a 2-fold increase in proteoglycan deposition, while in the metabolic syndrome mice there was a 6-fold increase in the intimal response and a similar increase in proteoglycan deposition. Collagen deposition was different, with a 22-fold increase over control in collagen deposition in diabetes and a 100-fold increase over control in collagen deposition in metabolic syndrome as compared to the control injury mice. Maximal vascular smooth muscle cell (VSMC) proliferation was decreased in both diabetes and metabolic syndrome compared to controls, while early cell apoptosis in both diabetes and metabolic syndrome was sustained over a longer period of time compared to wild-type mice.
Conclusions
These data demonstrate that development of intimal hyperplasia is markedly different in diabetes and metabolic syndrome compared to controls, with an increase in collagen deposition, a reduction in VSMC proliferation and an increase in early VSMC apoptosis. These findings suggest that preventative strategies against restenosis must be tailored for the diabetic and metabolic syndrome patients.