Abstract
Atherosclerosis underlies late occlusion of human saphenous vein (HSV) coronary artery bypass grafts. Monocyte infiltration is implicated, but its mechanisms are unclear given that HSV normally expresses the ICAM-1 but not the VCAM-1 adhesion molecule. To define the mechanisms underlying monocyte adhesion, samples of HSV taken from coronary artery bypass graft patients were co-cultured with human monocytes and adherent monocytes were quantified by immunocytochemistry for CD68 on transverse sections. Pre-treatment of veins with anti-ICAM-1 antibodies reduced monocyte adhesion (monocytes/mm of section) from 7.2 ± 1.5 to 3.1 ± 0.7 (p < 0.05, n = 6), but the effect of anti-VCAM-1 was not significant (4.1 ± 0.7). Paradoxically, pre-treatment of monocytes with either anti-β<sub>2</sub>-integrins, the counter-receptor of ICAM-1, or anti-α<sub>4</sub> integrins, the counter-receptor of VCAM-1, significantly reduced adhesion (1.8 ± 0.6 and 2.4 ± 0.7, respectively, p < 0.05). These results were clarified by immunocytochemistry, which confirmed that VCAM-1 expression was absent in harvested vein but was induced in the endothelium during co-culture. Consistent with this, when anti-ICAM-1 or anti-VCAM-1 was present throughout co-culture, either of them reduced adhesion (from 4.2 ± 0.9 to 2.3 ± 0.5 and 2.2 ± 0.4, respectively, p < 0.02, n = 8) and there was no further effect of adding both (2.0 ± 0.5). These results demonstrate that both ICAM-1/β<sub>2</sub> and VCAM-1/α<sub>4</sub> integrin interactions mediate monocyte adhesion to HSV, possibly as part of a common pathway. These experiments imply that either integrin might be targeted to reduce monocyte infiltration into HSV grafts.
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