Ozonetherapy protects from in-stent coronary neointimal proliferation. Role of redoxins

Abstract Background In-stent restenosis and poor re-endothelization usually follow percutaneous transluminal coronary angioplasty, even using drug-eluting stents, due to inflammation and oxidative stress. Medical ozone has antioxidant and anti-inflammatory properties and has not been evaluated in th...

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Bibliographic Details
Published in:International journal of cardiology 2016-11, Vol.223, p.258-261
Main Authors: Barone, A, Otero-Losada, M, AM, Grangeat, Cao, G, Azzato, F, Rodríguez, A, Milei, J
Format: Article
Language:English
Subjects:
Animals
Cardiovascular
Coronary angioplasty
Coronary Restenosis - blood
Coronary Restenosis - etiology
Coronary Restenosis - prevention & control
Endothelization
Male
Neointima - blood
Neointima - etiology
Neointima - prevention & control
Neointimal hyperplasia
Ozone - administration & dosage
Ozonetherapy
Prospective Studies
Random Allocation
Restenosis
Single-Blind Method
Stents - adverse effects
Swine
Thioredoxin-1
Thioredoxins - blood
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Summary:Abstract Background In-stent restenosis and poor re-endothelization usually follow percutaneous transluminal coronary angioplasty, even using drug-eluting stents, due to inflammation and oxidative stress. Medical ozone has antioxidant and anti-inflammatory properties and has not been evaluated in this context. Objectives To evaluate whether ozonotherapy might reduce restenosis following bare metal stents implantation in relation to the redoxin system in pigs. Methods Twelve male Landrace pigs (51 ± 9 kg) underwent percutaneous transluminal circumflex coronary arteries bare metal stent implantation under heparine infusion and fluoroscopical guidance, using standard techniques. Pigs were randomized to ozonetherapy (n = 6) or placebo (n = 6) treatment. Before stenting (24 h) and twice a week for 30 days post-stenting, venous blood was collected, ozonized and reinfused. Same procedure was performed in placebo group except for ozonation. Both groups received antiplatelet treatment. Histopathology and immunohistochemistry studies were performed. Results Severe inflammatory reaction and restenosis with increase in the immunohistochemical expression of thioredoxin-1 were observed in placebo group 30 days after surgery. Oppositely, ozonetherapy drastically reduced inflammatory reaction and restenosis, and showed no increase in the Trx-1 immunohistochemical expression 30 days after surgery. Immunolabeling for Prx-2 was negative in both groups. Ozonated autohemotherapy strikingly reduced restenosis 30 days following PTCA with BMS implantation in pigs. Conclusions Stimulation of the redoxin system by ozone pretreatment might neutralize oxidative damage from the start and increase antioxidative buffering capacity post-injury, reducing further damage and so the demand for antioxidant enzymes. Our interpretation agrees with the ozone oxidative preconditioning mechanism, extensively investigated.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2016.07.177