Introdução: Um dos fatores mais comuns de falha do procedimento das angioplastias vasculares periféricas é a estenose recorrente (reestenose). A inflamação vascular após angioplastia e implante de stent desempenha papel importante na proliferação de células do músculo liso vascular e posterior crescimento de neoíntima hipertrófica. Diversos estudos têm sugerido que a superfície dos stents, quando impregnada com determinadas moléculas, pode limitar a reestenose de forma eficaz. O carbono diamante, polímero de hidrocarboneto amorfo, pode ser usado para essa finalidade, reduzindo liberação de íons metálicos e a trombogenicidade. Diversos mediadores têm sido implicados na resposta inflamatória vascular, como o sistema calicreína-cinina (SCC), as citocinas, proteína C reativa (PCR) e o óxido nítrico (NO). Portanto, estudos clínicos específicos correlacionando o implante do stent aos níveis séricos destes possíveis marcadores podem contribuir no entendimento desse processo. Objetivo: Estudar a perviedade do dispositivo e a evolução clínica de doentes submetidos a angioplastia com stents impregandos de carbono no território vascular periférico, assim como o comportamento de mediadores séricos envolvidos nas fases mais precoces do processo inflamatório pós angioplastia. População e Método: Estudo prospectivo envolvendo 32 pacientes submetidos à angioplastia com stent no segmento ilíacofêmoro-poplíteo, selecionados no Ambulatório de Cirurgia Vascular e Endovascular do HCFMRP/USP. Foram tratadas lesões estenosantes ou oclusivas com angioplastia e colocação de stents de nitinol, com superfície impregnada de carbono (Carbostent®). Foram estudados os seguintes marcadores: SCC - com quantificação dos substratos (cininogênio de alto e baixo peso molecular - CAPM / CBPM) e das enzimas calicreína plasmática e tecidual, além da quantificação da cininase II; a determinação dos níveis de nitrito e nitratos para a avaliação de óxido nítrico; dosagem sérica de PCR e citocinas (IL-1 beta, IL-6, IL-8, IL-10, TNF-alfa e TGFbeta). Também foi realizado a dosagem dos leucócitos. Amostras séricas foram coletadas antes, 24 horas e 6 meses após o implante do stent. Os pacientes foram seguidos por um ano, para avaliação da perviedade nesse período. Resultados: Dos 27 pacientes que completaram seis meses de estudo, houve apenas uma reestenose (3,7%) e nenhuma oclusão (96,3% de perviedade). No período de um ano, quatro pacientes perderam seguimento e todos os 23 doentes avaliados, mantiveram a perviedade dos stents, com exceção do paciente no qual houve reestenose no tempo seis meses. Houve redução significativa das concentrações das citocinas inflamatórias (IL-1 beta, IL-6, IL-8 e TNF-?) no tempo 24 horas e seis meses quando comparado com o pré-procedimento (p<0,05); exceto a IL-8 no tempo 24 horas. As citocinas anti-inflamatórias (IL10 e TGF-beta) comportaram-se de maneira antagônica, com elevação do TGF-beta no tempo 24 horas e elevação, tanto do TGF-beta quanto da IL-10, no tempo 6 meses versus pré-tratamento e 6 meses versus 24 horas (P<0,05). A PCR apresentou queda no tempo seis meses em relação ao tempo 24h (p<0,05). Os níveis de NO não se alteraram entre os tempos; os de leucócitos elevaram-se no tempo 24 horas e reduziram-se no tempo seis meses em relação ao tempo 24 horas (p<0,05). Conclusão: No presente estudo a taxa de reestenose precoce foi de 3,7% nos primeiros 6 meses e 5% em 12 meses de seguimento. O comportamento dos marcadores inflamatórios evidenciou sua correlação direta com o processo de angioplastia e implante de carbostent, em especial o SCC, as citocinas, PCR e os leucócitos. Contudo, não foi possível relacionar a variação dos seus níveis séricos com o processo de reestenose. / Background: One of the most common factors of failure of the peripheral vascular angioplasty procedure is recurrent stenosis (restenosis). Vascular inflammation following angioplasty and stent implantation plays an important role in vascular smooth muscle cell proliferation and subsequent hypertrophic neointimal growth. Several studies have suggested that the surface of stents, when impregnated with certain molecules, can limit restenosis effectively. Diamond carbon, amorphous hydrocarbon polymer, can be used for this purpose, reducing release of metal ions and thrombogenicity. Several mediators have been implicated in the vascular inflammatory response, such as the kallikrein-kinin system (SCC), cytokines, C-reactive protein (CRP) and nitric oxide (NO). Therefore, specific clinical studies correlating stent implantation with serum levels of these possible markers may contribute to the understanding of this process. Objective: To study the patency of the device and the clinical evolution of patients undergoing angioplasty with carbon-impregnated stents in the peripheral vascular territory, as well as the behavior of serum mediators involved in the earlier stages of the inflammatory process after angioplasty. Population and Method: Prospective study involving 32 patients submitted to angioplasty with stent in the iliac-femoro-popliteal segment, selected at the HCFMRP / USP Outpatient Vascular and Endovascular Outpatient Clinic. Stenosis or occlusive lesions were treated with angioplasty and placement of nitinol stents with a carbon impregnated surface (Carbostent®). The following markers were studied: SCC - with quantification of substrates (high and low molecular weight cincinogens - HMWC / LMWC) and plasma and tissue kallikrein enzymes, besides quantification of kininase II; determination of nitrite and nitrate levels for the evaluation of nitric oxide; serum levels of CRP and cytokines (IL-1 beta, IL-6, IL-8, IL-10, TNF-a and TGF-b). Leucocytes were also dosed. Serum samples were collected before, 24 hours and 6 months after stent implantation. The patients were followed for one year to assess the patency in this period. Results: Of the 27 patients who completed six months of study, there was only one restenosis (3.7%) and no occlusion (96.3% of patency). In one year, four patients lost follow-up and all 23 patients evaluated, maintained stent patency, with the exception of the patient who had restenosis over time for six months. There was a significant reduction in the concentrations of inflammatory cytokines (IL-1 b, IL-6, IL-8 and TNF-a) in the time 24 hours and six months when compared with the pre-procedure (p <0.05); except for IL-8 in the 24 hour time. Anti-inflammatory cytokines (IL10 and TGF-b) behaved in an antagonistic manner, with TGF-b elevation in the 24 hour time and elevation of both TGF-b and IL-10, at 6 months versus pre- treatment and 6 months versus 24 hours (P <0.05). CRP showed a decrease in time six months in relation to time 24h (p <0.05). NO levels did not change between the times; the leukocytes increased in time 24 hours and reduced in time six months in relation to time 24 hours (p <0.05). Conclusion: In the present study, the rate of early restenosis was 3.7% in the first 6 months and 5% in 12 months of follow-up. The behavior of the inflammatory markers showed its direct correlation with the angioplasty and carbostent implantation process, especially SCC, cytokines, CRP and leukocytes. However, it was not possible to relate the variation of their serum levels to the restenosis process.

O objetivo do presente trabalho foi avaliar a morfologia e a ultraestrutura da hiperplasia intimal arterial decorrente de um modelo de estenose aórtica experimental, através da inserção de um pino de acrílico no orifício da artéria renal esquerda. Realizamos um estudo morfológico e ultraestrutural em 64 ratos Wistar, machos, com peso médio de 250 g, divididos em 4 subgrupos de acordo com o dia da eutanásia (1, 7, 15 e 30 dias de pós-operatório). O segmento da aorta envolvendo o pino foi retirado e estudado com diferentes protocolos para: microscopia óptica de alta resolução, microscopia eletrônica de transmissão e de varredura. Uma trombose se formou ao redor do pino 24 horas após a cirurgia, mostrando sinais de organização com 7 dias. Com 15 dias, uma hiperplasia intimal adjacente à base do pino foi visualizada. Esta alteração permaneceu com 30 dias de pós-operatório. Este espessamento era caracterizado principalmente por células musculares lisas provenientes da camada muscular média. A obstrução gera alterações hemodinâmicas locais com repercussão sobre as células endoteliais localizadas próximas à base do pino. Esses achados são discutidos. / Objective: To study the light and electron microscopy of intimal hyperplasia induced by experimental aortic stenosis after insertion of a plug into the aorta through the left renal artery. Methods: Sixty-four Wistar male rats, weighing an average of 250g, were allocated into two groups: group control, sham-operated, and group experimental, operated. The animals were killed on days 1, 7, 15, and 30 after surgery. The fragments of aorta implicating the plug were excised and studied using high resolution light microcopy and transmission and scanning electron microscopy. Results and Conclusions: A thrombus was observed around the plug 24 hours after surgery, organized at day 7. An intimal hyperplasia could be observed closed to the basis of the plug 15 and 30 days after surgery. The intimal thickening detected was mainly composed of smooth muscle cells migrated from the medial layer of the aorta intermixed with extracellular matrix. Moreover, the endothelial cells around the plug lost their orientation. Theses findings are discussed.

Cardiovascular diseases (CVD) remain the most common cause of death in the United States. Additionally, peripheral artery disease affects thousands of people each year. A major underlying cause of these diseases is the occlusion of the coronary or peripheral arteries due to arteriosclerosis. To overcome this, a number of vascular interventions have been developed including angioplasty, stenting, endarterectomies and bypass grafts. Although all of these methods are capable of restoring blood flow to the distal organ after occlusion, they are all plagued by unacceptably high restenosis rates. While the biological reactions that occur as a result of each of these methods differ, the initiating factor of both the primary atherosclerosis and subsequent failure of vascular interventions appears to be intimal hyperplasia (IH). Intimal hyperplasia is most simply defined as the expansion of multiple layers of cells internally to the internal elastic lamina of the blood vessel. This excessive cellular growth leads to arterial stenosis, plaque formation and inflammatory reactions. Despite extensive research the underlying factors that cause IH remain unclear. A quantity of research to date has implicated endothelial cell mechanosensation as the mechanism by which IH is initiated with evidence positively correlating wall shear stress with IH. Others, however, have demonstrated that changes in the stresses applied to the wall in vitro can modulate IH independent of hemodynamic shear stress. Thus, relations between wall tensile stress and IH in vivo may shed light on the underlying mechanisms of IH. Since noninvasive measurement of wall tensile stress in vivo is difficult, it is most feasible to measure oscillatory wall strain which is intimately related to wall tensile stress through the mechanical properties of the arterial wall. In this dissertation, we hypothesize that reductions in oscillatory wall strain precede the formation of intimal hyperplasia in a murine model. To test our hypothesis, we first developed a novel, high spatial and temporal resolution method to measure oscillatory wall strains in the murine common carotid artery. We validated this method both in vitro using an arterial phantom and in vivo using a murine model of abdominal aortic aneurysms. To assess relationships between strain and IH, we applied our strain measurement technique to a recently developed mouse model of IH. In this model, a suture is used to create a focal stenosis and reduce flow through the common carotid artery by 85%; resulting in proximal IH formation. Using this approach, we identified a relationship between oscillatory strain reductions and IH. Subsequent analysis demonstrated that early reductions in mechanical strain just 4 days after focal stenosis creation correlate with IH formation nearly 1 month later. Since IH is not expected to form by day 4 in this model, we went on to assess changes in gross vascular morphology at day 4. We discovered that, although strains are significantly reduced by day 4, no significant IH can be observed, suggesting that changes in wall structure are resulting in strain reductions. At day 4 post-op, we observed cellular proliferation and leukocyte recruitment to the wall without intimal hyperplasia. These studies suggest that early reductions in mechanical strain may be an important predictor of IH formation. Clinically, this relation could be important for the development of novel techniques for predicting IH formation before it becomes hemodynamically significant.

血管內膜的進行性增厚是動脈粥樣硬化的重要標誌，並最終導致閉塞性血管病。血管內膜增生的一個主要因素是血管中膜的平滑肌細胞遷移至內膜層並增殖。大量研究證實，在動脈粥樣硬化的發生發展中，過量產生的活性氧簇（ROS）參與了血管壁的增厚。M型瞬時受體電位通道亞家族的成員TRPM2在血管平滑肌細胞中有表達，它能被ROS激活並對Ca²⁺通透，但其在血管平滑肌中的功能以及與心血管疾病的聯繫尚未見報道。 / 本論文著眼於探討TRPM2在鼠和人血管內膜增生中的作用。用血管外周套管法建立在體齧齒類動脈內膜增生模型。套管放置2周後，大鼠股動脈可見明顯的內膜增厚。免疫染色顯示新生內膜及其鄰近中膜區域內有大量增殖細胞核抗原陽性細胞，提示在增生的動脈中，細胞週期活動增強。動脈內膜和中膜内二氫乙錠螢光信號顯著增強，提示了ROS的過量生成。免疫染色和免疫印跡法均顯示，套管損傷導致TRPM2表達上調。免疫螢光雙標TRPM2與α-平滑肌肌動蛋白顯示內膜區域有大量TRPM2陽性的平滑肌細胞。與正常股動脈中膜平滑肌細胞相比，次黃嘌呤和黃嘌呤氧化酶在套管損傷的動脈來源的新生內膜平滑肌細胞中引起更大幅度的細胞內鈣離子濃度升高，而TRPM2抑制性抗體TM2E3預處理可消除這種差異。套管放置3周可引起小鼠頸動脈新生內膜形成，並伴隨著TRPM2表達上調。敲除TRPM2基因可顯著抑制內膜增生。取冠狀動脈搭橋術後殘餘的大隱靜脈，離體培養2周誘導內膜增生。免疫螢光雙標TRPM2與α-平滑肌肌動蛋白顯示新生內膜內含有大量TRPM2陽性的平滑肌細胞。TM2E3和另一TRPM2抑制劑2-氨乙氧基二苯酯硼酸處理均可有效降低內膜的增生。培養齧齒類主動脈平滑肌細胞，用劃痕試驗和MTT法檢測TRPM2阻斷劑和TRPM2基因敲除對過氧化氫誘導的細胞遷移和增殖的影響。結果顯示，暴露於過氧化氫48小時，細胞的遷移和增殖均明顯加快。TM2E3和2-氨乙氧基二苯酯硼酸處理有效抑制過氧化氫誘導的大鼠主動脈平滑肌細胞遷移和增殖；類似地，TRPM2基因敲除可顯著抑制過氧化氫誘導的小鼠主動脈平滑肌細胞遷移和增殖。 / 以上結果表明，血管內膜增生伴隨著TRPM2表達的上調；TRPM2參與了血管內膜增生以及血管平滑肌細胞的遷移、增殖；抑制TRPM2可能是對抗血管內膜增厚的潛在治療手段。 / A hallmark in atherosclerosis is progressive intimal thickening, which leads to occlusive vascular diseases. A causation of neointimal hyperplasia is the migration of medial smooth muscle cells (SMCs) to the intima where they proliferate. It is well recognized that excessive production of reactive oxide species (ROS) contributes to vascular wall thickening during arteriosclerotic development. TRPM2, a member of the melastatin-like transient receptor potential channel subfamily, is a Ca²⁺-permeable cation channel activated by ROS and is expressed in vascular smooth muscle cells (VSMCs). The functional properties of TRPM2 in vascular smooth muscle remain to be identified and an association between TRPM2 and cardiovascular diseases has not been reported. / In the present study, I investigated the involvement of TRPM2 in rodent and human neointimal hyperplasia. In vivo neointimal hyperplasia in rodent arteries was induced by perivascular cuff placement. After the cuff placement for 2 weeks, rat femoral arteries showed distinct intimal thickening. Immunostaining showed a great number of PCNA-positive proliferating cells in the neointima and its adjacent media region, indicating the enhanced cell cycle activity in the hyperplasic arteries. Dihydroethidium signal was markedly increased in the neointima and media of the cuffed arteries, suggesting that ROS is over-produced. Interestingly, both immunostaining and immunoblot showed that cuff-injury also led to an up-regulated expression of TRPM2. Double immunofluorescent labeling of TRPM2 and α-smooth muscle actin showed a large amount of TRPM2-positive SMCs in the neointimal region. Compared with the normal medial SMCs isolated from non-cuffed arteries, the neointimal SMCs from cuff-injured arteries displayed a greater [Ca²⁺] rise in response to hypoxanthine-xanthine oxidase, which was inhibited by pre-treatment with a TRPM2-specific blocking antibody TM2E3. In mouse carotid arteries, cuff placement for 3 weeks caused clear neointimal formation, accompanied by up-regulated expression of TRPM2. Trpm2 disruption dramatically reduced the neointimal growth. Human saphenous vein samples obtained during CABG surgery were organ-cultured for 2 weeks to allow growth of neointima. Double immunofluorescent labeling of TRPM2 and α-smooth muscle actin showed that the neointima contained numerous TRPM2-positive SMCs. Neointimal hyperplasia in the veins was effectively suppressed by in vitro treatment with TM2E3 or a chemical blocker 2-aminoethoxydiphenyl borate. Furthermore, the effect of TRPM2 blockers and Trpm2 disruption on hydrogen peroxide-induced migration and proliferation of cultured rodent aortic SMCs were evaluated by scratch wound healing assay and MTT assay, respectively. It was found that exposure to hydrogen peroxide for 48 hour substantially enhanced the migration and proliferation of rodent aortic SMCs. In rat aortic SMCs, both TM2E3 and 2-aminoethoxydiphenyl borate significantly inhibited the hydrogen peroxide-induced cell migration and proliferation. The hydrogen peroxide-induced cell migration and proliferation of SMCs was also reduced in Trpm2 knockout mice. / Taking together, these results provide strong evidences that in vivo neointimal hyperplasia is accompanied by an up-regulated expression of TRPM2 and that TRPM2 plays a key role in neointimal hyperplasia, VSMCs migration and proliferation. Blocking TRPM2 can be a potential therapeutic approach for protecting blood vessels against intimal thickening. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Ru, Xiaochen. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 125-151). / Abstracts also in Chinese. / Declaration of Originality --- p.i / Abstract --- p.ii / 論文摘要 --- p.iv / Acknowledgements --- p.vi / Abbreviations and Units --- p.vii / Table of Content --- p.x / List of Figures --- p.xvi / List of Tables --- p.xviii / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Neointimal hyperplasia --- p.1 / Chapter 1.1.1 --- Definition of neointimal hyperplasia --- p.2 / Chapter 1.1.2 --- Medical significance of coronary neointimal hyperplasia --- p.3 / Chapter 1.1.3 --- Pathogenesis of neointimal hyperplasia --- p.5 / Chapter 1.1.3.1 --- “Response to injury“ hypothesis --- p.6 / Chapter 1.1.3.2 --- Role of VSMCs --- p.7 / Chapter 1.1.3.2.1 --- VSMC phenotypic switch --- p.7 / Chapter 1.1.3.2.2 --- Ca²⁺ channel modulation in VSMCs --- p.8 / Chapter 1.1.3.2.3 --- VSMC migration --- p.9 / Chapter 1.1.3.2.4 --- VSMC proliferation --- p.10 / Chapter 1.1.3.2.5 --- Extracellular matrix production by VSMCs --- p.11 / Chapter 1.1.3.3 --- Endothelial dysfunction --- p.11 / Chapter 1.1.3.4 --- Platelet adhesion --- p.12 / Chapter 1.1.3.5 --- Inflammation --- p.13 / Chapter 1.1.4 --- Role of ROS in neointimal hyperplasia --- p.14 / Chapter 1.1.4.1 --- Types of ROS --- p.15 / Chapter 1.1.4.1.1 --- Superoxide anion --- p.16 / Chapter 1.1.4.1.2 --- Hydroxyl radical --- p.16 / Chapter 1.1.4.1.3 --- Hydrogen peroxide --- p.16 / Chapter 1.1.4.1.4 --- Nitric oxide --- p.17 / Chapter 1.1.4.2 --- Sources of ROS in vessel wall --- p.17 / Chapter 1.1.4.3 --- ROS signaling in endothelial cells --- p.19 / Chapter 1.1.4.4 --- ROS signaling in VSMCs --- p.20 / Chapter 1.1.4.5 --- ROS and atherosclerosis --- p.21 / Chapter 1.1.5 --- Current therapeutic approaches to neointimal hyperplasia --- p.23 / Chapter 1.1.5.1 --- Pharmacological approaches --- p.23 / Chapter 1.1.5.2 --- Technical Approaches --- p.25 / Chapter 1.2 --- Transient receptor potential melastatin 2 (TRPM2) channel --- p.27 / Chapter 1.2.1 --- TRP Channels --- p.27 / Chapter 1.2.2 --- TRPM2 structure and expression --- p.29 / Chapter 1.2.2.1 --- Structure --- p.29 / Chapter 1.2.2.2 --- Alternative splicing isoforms --- p.30 / Chapter 1.2.2.3 --- Expression pattern --- p.32 / Chapter 1.2.3 --- TRPM2 channel properties --- p.32 / Chapter 1.2.4 --- TRPM2 activators and inhibitors --- p.32 / Chapter 1.2.4.1 --- Activators --- p.33 / Chapter 1.2.4.1.1 --- ADPR --- p.33 / Chapter 1.2.4.1.2 --- NAD, cADPR and NAADP --- p.33 / Chapter 1.2.4.1.3 --- H₂O₂ and oxidative stress --- p.34 / Chapter 1.2.4.1.4 --- Ca²⁺ --- p.34 / Chapter 1.2.4.1.5 --- Other regulators --- p.35 / Chapter 1.2.4.2 --- Inhibitors --- p.35 / Chapter 1.2.5 --- Biological relevance of TRPM2 --- p.36 / Chapter 1.2.5.1 --- TRPM2 in insulin release --- p.36 / Chapter 1.2.5.2 --- TRPM2 in inflammation --- p.36 / Chapter 1.2.5.3 --- TRPM2 in cell death --- p.37 / Chapter 1.2.5.4 --- TRPM2-mediated lysosomal Ca²⁺ release --- p.38 / Chapter 1.2.5.5 --- TRPM2 and cardiovascular diseases --- p.39 / Chapter Chapter 2 --- Objectives of the Present Study --- p.40 / Chapter Chapter 3 --- Materials and Methods --- p.42 / Chapter 3.1 --- Materials --- p.42 / Chapter 3.1.1 --- Chemicals --- p.42 / Chapter 3.1.2 --- Media, supplements and other reagents for cell/tissue culture --- p.44 / Chapter 3.1.3 --- Antibodies --- p.45 / Chapter 3.1.4 --- Solutions --- p.46 / Chapter 3.1.4.1 --- Solutions for immunohistochemical and immunocytochemical staining --- p.46 / Chapter 3.1.4.2 --- solutions for immunoblotting --- p.47 / Chapter 3.1.4.3 --- Solutions for Genotyping --- p.49 / Chapter 3.1.4.4 --- Solutions for hematoxylin and eosin (HE) staining --- p.50 / Chapter 3.1.4.5 --- Solutions for [Ca²⁺]i measurement --- p.51 / Chapter 3.1.4.6 --- Solutions for IgG purification --- p.51 / Chapter 3.1.5 --- Animals --- p.51 / Chapter 3.1.5.1 --- Rat --- p.51 / Chapter 3.1.5.2 --- Trpm2 knockout mice --- p.52 / Chapter 3.1.5.3 --- Rabbit --- p.52 / Chapter 3.1.5.4 --- Ethics --- p.52 / Chapter 3.1.6 --- Human Tissue --- p.52 / Chapter 3.2 --- Methods --- p.54 / Chapter 3.2.1 --- Rodent models of neointimal hyperplasia --- p.54 / Chapter 3.2.1.1 --- Cuff-induced vascular injury in rat femoral artery --- p.54 / Chapter 3.2.1.2 --- Cuff-induced vascular injury in mouse carotid artery --- p.54 / Chapter 3.2.2 --- Genotyping for Trpm2 knockout mice --- p.55 / Chapter 3.2.2.1 --- Genomic DNA extraction from tail --- p.55 / Chapter 3.2.2.2 --- Polymerase Chain Reaction (PCR) --- p.55 / Chapter 3.2.2.3 --- Agarose gel electrophoresis of DNA --- p.56 / Chapter 3.2.3 --- Human saphenous vein culture and treatment --- p.56 / Chapter 3.2.4 --- Generation of anti-TRPM2 antibody, TRPM2-specific blocking antibody TM2E3 and preimmune IgG --- p.57 / Chapter 3.2.5 --- Histological analysis and immunohistochemistry --- p.58 / Chapter 3.2.6 --- Western blotting --- p.59 / Chapter 3.2.7 --- Detection of ROS production by dihydroethidium fluorescence --- p.60 / Chapter 3.2.8 --- Isolation of rodent neointimal and medial smooth muscle cells --- p.60 / Chapter 3.2.9 --- Culture of rodent aortic smooth muscle cells --- p.61 / Chapter 3.2.9.1 --- Cell culture --- p.61 / Chapter 3.2.9.2 --- Cell identification --- p.61 / Chapter 3.2.10 --- [Ca²⁺]i measurement --- p.62 / Chapter 3.2.11 --- Cell proliferation assay --- p.63 / Chapter 3.2.12 --- Cell migration assay --- p.63 / Chapter 3.2.13 --- Statistical analysis --- p.64 / Chapter Chapter 4 --- ROS over-production and TRPM2 up-regulation in cuff-induced rodent neointimal hyperplasia --- p.65 / Chapter 4.1 --- Introduction --- p.65 / Chapter 4.2 --- Materials and Methods --- p.66 / Chapter 4.2.1 --- Cuff-induced vascular injury in rat femoral artery --- p.66 / Chapter 4.2.2 --- Preparation of anti-TRPM2 antibody, TM2E3 and preimmune IgG --- p.66 / Chapter 4.2.3 --- Histological analysis and immunohistochemistry --- p.66 / Chapter 4.2.4 --- Western blotting --- p.67 / Chapter 4.2.5 --- Detection of ROS production --- p.67 / Chapter 4.2.6 --- Isolation of rat neointimal and medial smooth muscle cells --- p.68 / Chapter 4.2.7 --- [Ca²⁺]i measurement --- p.68 / Chapter 4.2.8 --- Statistical analysis --- p.68 / Chapter 4.3 --- Results --- p.69 / Chapter 4.3.1 --- Cuff-induced neointimal hyperplasia in rat femoral arteries --- p.69 / Chapter 4.3.2 --- ROS over-production in neointimal region of cuff-injured rat femoral arteries --- p.69 / Chapter 4.3.3 --- TRPM2 up-regulation in neointimal region of cuff-injured rat femoral arteries --- p.69 / Chapter 4.3.4 --- Enhanced [Ca²⁺]i response to HX-XO in rat neointimal smooth muscle cells --- p.70 / Chapter 4.4 --- Discussion --- p.81 / Chapter Chapter 5 --- TRPM2 contributes to human and rodent neointimal hyperplasia --- p.86 / Chapter 5.1 --- Introduction --- p.86 / Chapter 5.2 --- Materials and Methods --- p.87 / Chapter 5.2.1 --- Cuff-induced vascular injury in mouse carotid artery --- p.87 / Chapter 5.2.2 --- Genotyping for Trpm2 knockout mice --- p.87 / Chapter 5.2.3 --- Organ culture of human saphenous vein --- p.87 / Chapter 5.2.4 --- Preparation of anti-TRPM2 antibody, TM2E3 and preimmune IgG --- p.88 / Chapter 5.2.5 --- Histological analysis and immunohistochemistry --- p.88 / Chapter 5.2.6 --- Western blotting --- p.88 / Chapter 5.2.7 --- Isolation of mouse neointimal and medial smooth muscle cells --- p.89 / Chapter 5.2.8 --- [Ca²⁺]i measurement --- p.89 / Chapter 5.2.9 --- Statistical analysis --- p.90 / Chapter 5.3 --- Results --- p.90 / Chapter 5.3.1 --- Cuff-induced neointimal hyperplasia was reduced in Trpm2 knockout mice --- p.90 / Chapter 5.3.2 --- [Ca²⁺]i response to HX-XO in mouse neointimal smooth muscle cells --- p.90 / Chapter 5.3.3 --- Inhibiting TRPM2 reduced the neointimal hyperplasia in in vitro cultured human saphenous vein --- p.91 / Chapter 5.4 --- Discussion --- p.99 / Chapter Chapter 6 --- Role of TRPM2 in H₂O₂-stimulated migration and proliferation of vascular smooth muscle cells --- p.103 / Chapter 6.1 --- Introduction --- p.103 / Chapter 6.2 --- Materials and Methods --- p.104 / Chapter 6.2.1 --- Culture of rodent aortic smooth muscle cells --- p.104 / Chapter 6.2.2 --- Immunocytochemistry --- p.104 / Chapter 6.2.3 --- Genotyping for Trpm2 knockout mice --- p.104 / Chapter 6.2.4 --- Preparation of anti-TRPM2 antibody, TM2E3 and preimmune IgG --- p.104 / Chapter 6.2.5 --- [Ca²⁺]i measurement --- p.105 / Chapter 6.2.6 --- Cell proliferation assay --- p.105 / Chapter 6.2.7 --- Western blotting --- p.105 / Chapter 6.2.8 --- Cell migration assay --- p.106 / Chapter 6.2.9 --- Statistical analysis --- p.106 / Chapter 6.3 --- Results --- p.106 / Chapter 6.3.1 --- H₂O₂-induced [Ca²⁺]i rises in rodent aortic smooth muscle cells --- p.106 / Chapter 6.3.2 --- Role of TRPM2 in H₂O₂-stimulated smooth muscle cell proliferation --- p.107 / Chapter 6.3.3 --- Role of TRPM2 in H₂O₂-stimulated smooth muscle cell migration --- p.108 / Chapter 6.4 --- Discussion --- p.118 / Chapter Chapter 7 --- General Conclusion and Future Work --- p.121 / Chapter 7.1 --- Concluding remarks --- p.121 / Chapter 7.2 --- Future work --- p.123 / Chapter 7.2.1 --- Specific downstream signaling pathway of TRPM2 that mediates ROS-induced VSMC proliferation and migration --- p.123 / Chapter 7.2.2 --- Involvement of TRPM2 in leukocyte infiltration and inflammation in vascular wall --- p.124 / References --- p.125 / List of Publications --- p.152

Orientador: Luis Guillermo Bahamondes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-11-07T17:27:10Z (GMT). No. of bitstreams: 1 Viola_AlexandredeSouza_M.pdf: 295106 bytes, checksum: 856293649b26acb1bfa52d92a0350707 (MD5) Previous issue date: 2007 / Resumo: Objetivos: Determinar a prevalência de hiperplasia e câncer de endométrio em mulheres assintomáticas com sobrepeso ou obesidade. Sujeitos e métodos: Realizou-se um estudo de corte transversal no qual 193 mulheres voluntárias do Ambulatório de Reprodução Humana, Departamento de Tocoginecologia, Faculdade de Ciências Médicas, CAISM - Unicamp foram avaliadas com biópsia de endométrio com Pipelle de Cornier. Os achados anatomopatológicos foram catalogados como endométrio normal, hiperplasia ou câncer de endométrio e estes resultados foram comparados com o ìndice de massa corporal (IMC; kg/m2). Para a análise dos dados, as mulheres foram divididas em dois grupos: em idade reprodutiva e na pós-menopausa e pelo IMC (kg/m2) em sobrepeso ou obesidade. Resultados: A prevalência de hiperplasia na amostra total foi de 7,3%, na idade reprodutiva de 5,8% e na pós-menopausa de 12,1%. A prevalência de adenocarcinoma de endométrio na amostra total foi de 1,5%, na idade reprodutiva de 1% e na pósmenopausa de 3%. A regressão logística multivariada mostrou que o risco de apresentar hiperplasia e câncer de endométrio foi de 1,19 (IC 95%; 0,36¿3,90) para as mulheres na pós-menopausa, de 1,58 (IC 95%; 0,30-8,23) para as que tinham obesidade severa e de 2,72 (IC 95%; 0,65¿11,5) para as que tinham obesidade morbida. Estar na idade reprodutiva, com sobrepeso ou obesidade moderada não alterou o risco. Conclusões: No grupo avaliado, mulheres assintomaticas na pós-menopausa com obesidade severa ou mórbida apresentaram risco aumentado de apresentar hiperplasia ou câncer de endométrio. O mesmo não ocorreu com mulheres em idade reprodutiva / Abstract: Objetives: To determine the prevalence of endometrial cancer and hyperplasia in non-symptomatic women with overweight or obesity. Subjects and methods: A cross-sectional study was carried-out at the Obstetrics and Gynecology Departament, School of Medicine, Unicamp, with 193 women. The women were evaluated through endometrial biopsy with a Pipelle de Cornier. The hystophatologic findings were classified as normal endometrium, hyperplasia and cancer and those results were compared to the body mass index (BMI; kg/m2). For the analysis pourpose the women were divided in two groups: at reproductive age and at the post-menopause and by the BMI (kg/m2) in overweigth and obesity. Results: The prevalence of hyperplasia in the total sample was 7.3%, among women at reproductive age of 5.8% and at the post-menopause it was of 12.1%. The prevalence of endometrial cancer at the total sample was 1.5%, among women at reproductive age it was 1% and at the post-menopause of 3%. The logistic regression showed that the risk of endometrial hyperplasia or cancer was of 1.19 (95% CI: 0.36¿3.90) for women at the post-menopause, 1.58 (95% CI: 0.30¿8.23) for those who presented severe obesity, and of 2.72 (95% CI: 0.65¿11.5) for those women with morbid obesity. Be at the reproductive age, with overweight or moderate obesity did not modify the risk. Conclusions: At the evaluated group of women, non-symptomatic women at the post-menopause with severe or morbid obesity presented a high risk to have endometrial hyperplasia or cancer. However, the same was not observed among women at reproductive age / Mestrado / Tocoginecologia / Mestre em Tocoginecologia

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / As Mucopolissacaridoses (MPS) constituem um grupo de doenÃas raras, caracterizadas por deficiÃncias enzimÃticas que resultam em bloqueio na degradaÃÃo dos glicosaminoglicanos. O objetivo deste estudo foi avaliar a situaÃÃo periodontal de todos os pacientes com Mucopolissacaridose, atendidos no Hospital Infantil Albert Sabin e no Hospital Geral CÃsar Cals, FortalezaâCE. Foram avaliados 18 pacientes, por um cirurgiÃo-dentista previamente calibrado, que registrou os Ãndice de Pernus, Ãndice de Placa Bacteriana VisÃvel, Ãndice de Sangramento Gengival, PSR e Ãndice CPO-D/ceo-d. Em relaÃÃo ao volume gengival, observou-se que 72,2% dos pacientes apresentaram Ãndice de Pernus nos escores 1, 2 ou 3, que corresponde à presenÃa de hiperplasia gengival. Quando se avaliaram os cuidados com relaÃÃo à higiene oral dos pacientes, observou-se que quanto ao Ãndice de Sangramento Gengival 77,8% dos pacientes apresentaram Ãndice maior que 10%, 66,6% dos pacientes apresentaram Ãndice de Placa Bacteriana VisÃvel maior que 40%. Com relaÃÃo ao PSR 94,4% dos pacientes apresentou escore 1, correspondendo a sangramento, e 5,6% escore 2, correspondendo à presenÃa de cÃlculo alÃm de sangramento, e quanto ao CPO-D/ceo-d 61,1% apresentou Ãndice maior que 5. De uma maneira geral, observou-se que a situaÃÃo periodontal dos pacientes portadores de mucopolissacaridose à uma situaÃÃo que inspira maior cuidado, mostrando caracterÃsticas prevalentes como o aumento gengival, alÃm de altos Ãndices de Sangramento Gengival, Placa Bacteriana VisÃvel e CPO-D/ceo-d. / The Mucopolysaccharidosis (MPS) are a group of rare diseases characterized by enzyme deficiency that results in nondegradation of the glicosaminoglicans (GAGs). The aim of this study was to evaluate the periodontal status of all the patiente with MPS that are treated at the Hospital Infantil Albert Sabin and at the Hospital Geral CÃsar Cals, in Fortaleza, CearÃ, Brazil. A number of 18 patients were evaluated by a dentist that was previously calibrated, which registered the Pernus Index (IP), Visible Bacterium Plaque Index (IPB-V), Gingival Bleeding Index (ISG), PSR and Index that shows number of teeth that showed cavities, tooth loss or restoration (CPO-D/ceo-d). In relation to the gingival volume it was observed that 72,2% of the patients showed that the gingival was not in itÂs regular size. On the evaluation of dental hygiene, it was observed that 77,8% of the patients showed ISG greater than 10% and 66,6% of the patients showed IPB-V greater than 40%. In relation to PSR, 94,4% of the patients showed scored 1 which means gingival bleeding and 5,6% showed score 2 which means calculus besides gingival bleeding. And in relation to CPO-D/ceo-d 61,1% of the patients showed score greater than 5. In a general way it was observed that the periodontal status of the patients is a situation that requires more care, showing characteristics like gingival hyperplasias besides high scores of ISG, IPB-V and CPO-D/ceo-d.

O objetivo do presente trabalho foi avaliar a morfologia e a ultraestrutura da hiperplasia intimal arterial decorrente de um modelo de estenose aórtica experimental, através da inserção de um pino de acrílico no orifício da artéria renal esquerda. Realizamos um estudo morfológico e ultraestrutural em 64 ratos Wistar, machos, com peso médio de 250 g, divididos em 4 subgrupos de acordo com o dia da eutanásia (1, 7, 15 e 30 dias de pós-operatório). O segmento da aorta envolvendo o pino foi retirado e estudado com diferentes protocolos para: microscopia óptica de alta resolução, microscopia eletrônica de transmissão e de varredura. Uma trombose se formou ao redor do pino 24 horas após a cirurgia, mostrando sinais de organização com 7 dias. Com 15 dias, uma hiperplasia intimal adjacente à base do pino foi visualizada. Esta alteração permaneceu com 30 dias de pós-operatório. Este espessamento era caracterizado principalmente por células musculares lisas provenientes da camada muscular média. A obstrução gera alterações hemodinâmicas locais com repercussão sobre as células endoteliais localizadas próximas à base do pino. Esses achados são discutidos. / Objective: To study the light and electron microscopy of intimal hyperplasia induced by experimental aortic stenosis after insertion of a plug into the aorta through the left renal artery. Methods: Sixty-four Wistar male rats, weighing an average of 250g, were allocated into two groups: group control, sham-operated, and group experimental, operated. The animals were killed on days 1, 7, 15, and 30 after surgery. The fragments of aorta implicating the plug were excised and studied using high resolution light microcopy and transmission and scanning electron microscopy. Results and Conclusions: A thrombus was observed around the plug 24 hours after surgery, organized at day 7. An intimal hyperplasia could be observed closed to the basis of the plug 15 and 30 days after surgery. The intimal thickening detected was mainly composed of smooth muscle cells migrated from the medial layer of the aorta intermixed with extracellular matrix. Moreover, the endothelial cells around the plug lost their orientation. Theses findings are discussed.

A Hiperplasia Papilar (HP) é considerada uma forma de candidose bucal, em especial uma forma de estomatite por dentadura, tipo III segundo a classificação de Newton (1962), a qual obedece a critérios clínicos e microscópicos. Sua etiologia é ainda pouco esclarecida, mas diversos fatores têm sido associados, tais como próteses dentárias mal adaptadas, má higiene oral, material utilizado na confecção das próteses resultando em hipersensibilidade, trauma, imunodeficiência e o fungo Candida albicans. A aderência e a invasão deste fungo no tecido epitelial já foram comprovadas e relatadas na literatura, entretanto ainda não há trabalhos que identifiquem a presença e a localização exata do fungo C. albicans no revestimento epitelial das lesões de HP. Os linfócitos T e os macrófagos são as principais células envolvidas no mecanismo de defesa do hospedeiro contra leveduras do gênero Candida, contudo é necessário estabelecer uma relação entre a presença do fungo e as alterações epiteliais, bem como o tipo e intensidade do infiltrado inflamatório presente nas HPs. O presente trabalho teve como objetivo avaliar a presença de Candida albicans no revestimento epitelial de lesões de HP, por meio de imunofluorescência, e correlacionar os valores quantitativos obtidos com as características demográficas, do epitélio e do infiltrado inflamatório subepitelial. Mucosa palatal normal foi utilizada como controle. A análise estatística comparativa múltipla entre o número médio de fungos nos diferentes grupos experimentais (Grupo HP e Grupo controle) foi obtida pelo teste de Mann Whitney, e a correlação do número médio de Candida albicans imunomarcadas com as características do revestimento epitelial e do infiltrado inflamatório subepitelial por meio do teste de Spearman. Em ambos os testes, foram adotados o nível de significância de 5% (p<0,05). Apenas as lesões de HP demonstraram a presença de C. albicans, e o número médio foi de 14 C. albicans/mm2. Não se observou correlação entre o número médio de C. albicans e as diferentes características epiteliais ou do infiltrado inflamatório subjacente ou ainda as características demográficas. / The papillary hyperplasia (PH) is considered a form of oral candidosis, in particular a form of denture stomatitis, type III according to the classification of Newton (1962), which fulfills the clinical and microscopic criteria. Its etiology is still unclear, but several factors have been associated, such as prostheses poorly adapted, poor oral hygiene, material used in the manufacture of prostheses resulting in hypersensitivity, trauma, immune and fungus Candida albicans. The adhesion and invasion of this fungus in the epithelial tissue have been demonstrated and reported in the literature, however there is not a work to identify the presence and exact location of the fungus C. albicans in the epithelial lining of the lesions of PH. T-lymphocytes and macrophages are the main cells involved in host defense mechanism against the yeast of Candida, however it is necessary to establish a relationship between the presence of the fungus and the epithelial changes, and the type and intensity of inflammatory infiltrate present in PHs. This study aimed to evaluate the presence of Candida albicans in the epithelial lining of lesion of PH, by immunofluorescence and to correlate the quantitative values obtained with the demographic characteristics, the epithelium and the subepithelial inflammatory infiltrate. Normal palatal mucosa was used as control. Comparative statistical analysis between the multiple number of fungi in different experimental groups (PH group and Control group) was obtained by Mann Whitney test, and correlation of the average number of Candida albicans immunomarked with the characteristics of the epithelial lining and subepithelial inflammatory infiltrate by Spearman test. In both tests were used a significance level of 5% (p <0.05). Only the lesions of PH demonstrated the presence of C. albicans, and the average number was 14 C. albicans/mm2. There was no correlation between the average number of C. albicans and the different characteristics of epithelial or underlying inflammatory infiltrate or demographic characteristics.

O objetivo do presente estudo foi o de investigar, pela primeira vez: os efeitos da administração prolongada de sementes Senna occidentalis (S. occidentalis) em órgãos hematopoiéticos de ratos, utilizando metodologias que poderão ser sugeridas para estudo pré-clínico de medicamentos. Avaliou-se nestes animais: consumo de ração e água; peso médio semanal; parâmetros hematológicos e bioquímicos; padrões histopatológicos; estoque de ferro e ensaios clonogênicos. O estudo foi realizado em ratos Wistar machos de 90 dias de idade, os quais foram expostos a diferentes concentrações de S. occidentalis na ração, a saber: 0% (controle), 0,5% (So0,5%), 1% (So1%) e 2% (So2%) durante 90 dias. Foi importante incluir um grupo pair-fed (PF), o qual recebeu a mesma quantidade de ração consumida pelo grupo So2%, porém, isenta da planta, uma vez que a S. occidentalis é sabidamente anorexígena. O presente estudo demonstrou que os ratos do grupo So2% apresentaram diminuição no número de leucócitos totais bem como alterações nos parâmetros referentes a série vermelha, tais como diminuição do VCM e HCM, caracterizando uma anemia microcítica hipocrômica. Os dados do hemograma corroboram as alterações observadas no mielograma destes animais, uma vez que foi constatada a redução significante da relação Mielóide/Eritróide (M/E) e, portanto, um possível efeito tóxico da S. occidentalis sobre a medula óssea durante o tratamento de 90 dias. A redução significante da relação M/E nos animais pertencentes aos diferentes grupos experimentais ocorreu devido ao aumento progressivo de eritroblastos jovens e policromáticos na medula óssea destes animais. Índices baixos da relação M/E podem estar associados a uma anemia regenerativa em função de hemólise extravascular ou, ainda, à eritropoiese ineficaz. A partir do mielograma observou-se, também, redução significante de células blásticas e de todos os tipos celulares, especialmente, da linhagem granulocítica, com predomínio da linhagem linfocitária. No entanto, uma vez que os linfócitos estão, continuadamente, recirculando, o aumento ou a diminuição destas células não reflete, necessariamente, alteração na linfopoiese. A análise anatomopatológica da medula óssea de animais dos grupos experimentais apontou um aumento progressivo da celularidade, caracterizando hiperplasia medular. Estes resultados se correlacionam aos dados do mielograma. Na anemia regenerativa ocorre diminuição da sobrevida das hemácias na circulação, resultante de hemólise extravascular realizada por macrófagos, especialmente, do tecido esplênico. Assim, o tratamento prolongado com S. occidentalis poderia estar associado ao um processo hemolítico, haja vista a observação de aumento do peso relativo deste órgão; acúmulo de hemossiderina no baço e ainda, reticulocitose em animais tratados com esta planta. O tratamento de 90 dias com S. occidentalis promoveu, também, redução significante na celularidade do baço bem como alterações anatomopatológicas, incluindo espessamento de cápsula e rarefação celular. Os ensaios clonogênicos padronizados neste estudo apontaram redução da porcentagem de colônias BFU-E e CFU-E em animais do grupo So2%, indicando uma provável ação tóxica da S.occidentalis sobre os progenitores medulares. A partir dos dados apresentados no presente estudo, pode-se concluir que o tratamento por 90 dias com S. occidentalis na ração é hematotóxico. Além disto, os resultados aqui obtidos bem como as metodologias empregadas poderão contribuir para o estabelecimento de um protocolo de hematotoxicidade, haja vista que informações relacionadas aso mecanismos de hematopoiese; metabolismo de ferro; características histológicas e citológicas de órgãos hematopoiéticos (baço e medula óssea) de ratos foram levadas em consideração para a realização deste estudo. / The purpose of this study was to investigate, for the first time: the effects of long term administration of Senna occidentalis (S. occidentalis) seeds in hematopoietic organs of rats, using methodology that can be suggested for pre-clinical studies. We evaluated some parameters in these animals: feed intake and water; weight body; hematological and biochemical parameters; histopathology; iron stores and clonogenic assays. The study was conducted in 90-day-old male Wistar rats, which were exposed to different concentrations of S. occidentalis in feed, ie: 0% (control), 0.5% (So0.5%), 1% (So1%) and 2 % (So2%) for 90 days. It was important to include a pair-fed group (PF), which received the same amount of feed consumed by So2% group, however, without the plant, once S. occidentalis is known anorectic. This study showed that rats from So2% group presented a decrease in the number of total leukocytes as well as changes in the parameters for the red series, such as decrease in MCV and MCH values, featuring a hypochromic anemia. The blood count results corroborate the findings from bone marrow smears of these animals, since it was found the significant reduction ratio Myeloid / Erythroid (M / L) and, therefore, a possible toxic effect of the S. occidentalis on the bone marrow during the treatment of 90 days. The significant reduction in the ratio M / E in animals belonging to different experimental groups occurred due to the progressive increase of young and polychromatic erythrocytes in the bone marrow of these animals. Low levels of M / E ratio may be associated with a regenerative anemia in extravascular hemolysis function or even the ineffective erythropoiesis. From the myelogram there was also a significant reduction of blast cells and all cell types, especially of granulocytic lineage, with a predominance of lymphoid lineage. However, since lymphocytes are, continuously by recirculating the increase or decrease in these cells do not necessarily reflect changes in lymphopoiesis. The pathological examination of the bone marrow of the experimental group animals showed a progressive increase in cellularity, featuring medullary hyperplasia. These results correlate to myelogram. In the regenerative anemia occurs a decreased survival of red blood cells in the circulation, resulting from extravascular hemolysis performed by macrophages, especially in the splenic tissue. Thus, the long term administration of S. occidentalis seeds could be associated with hemolytic process, due to the observation of an increase in the relative weight of this body; hemosiderin accumulation in the spleen and also increased reticulocytes in animals treated with this plant. The treatment with S. occidentalis promoted also significant reduction in cellularity of the spleen and pathological changes, including capsule and cell thinning thickening. Clonogenic assays showed decreased percentage of BFU-E and CFU-E colonies in animals from So2% group, indicating a probable toxic action of S.occidentalis on medullary progenitors. Therefore, the treatment for 90 days with S. occidentalis in feed is promotes blood toxicity.

OBJETIVO: analisar, por meio de morfometria digital, a reação intimal presente na artéria carótida de suínos submetidos à angioplastia isoladamente e à angioplastia seguida de implante de stent de cromo - cobalto. MATERIAIS E MÉTODOS: em oito suínos sadios foi realizada a angioplastia isolada da artéria carótida comum (ACC) direita e angioplastia com implante de um stent de cromo – cobalto expansível por balão na artéria carótida comum esquerda. Após período de quatro semanas, os animais foram submetidos à eutanásia para a retirada de amostras de tecido arterial e preparo de lâminas histológicas divididas do seguinte modo: grupo 1, segmento médio da artéria carótida comum direita (angioplastia isolada); grupo 2, segmento médio da artéria carótida comum esquerda em localização “intra stent”. As imagens das lâminas foram digitalizadas e analisadas por programa de morfometria digital com cálculo da área luminal, área da camada íntima e área da camada média dos cortes histológicos. A análise estatística foi realizada através da média e desvio padrão das áreas em cada grupo, utilizando-se Teste t de Student. O valor de p<0,05 foi considerado significativo. RESULTADOS: na análise das médias das áreas obtidas, foi encontrada maior hiperplasia em resposta ao implante de stent e diferença estatisticamente significativa quando realizada a comparação entre a área do lúmen (5,841 x 106μm2 X 1,287 x 106μm2), da lâmina elástica interna (6,566 x 106μm2 X 1,287 x 106μm2) e lâmina elástica externa (9,832 x 106μm2 X 4,559 x 106μm2) dos dois grupos (ATP + STENT X ATP; medidas em micrômetros quadrados). Não se observou diferença significativa do ponto de vista estatístico quando se realizou a comparação entre as camadas médias dos dois grupos (3,266 x 106μm2 X 3,271 x 106μm2). CONCLUSÃO: o implante de stent de cromo-cobalto expansível por balão na ACC do suíno gerou um espessamento intimal maior do que aquele produzido apenas pela angioplastia, porém este não foi suficiente para afetar o lúmen arterial. / OBJECTIVE: to analyze, through digital morphometry, the intimal reaction in the carotid artery of pigs submitted to isolated angioplasty and angioplasty followed by implantation of cobalt-chromium stent. MATERIALS AND METHODS: eight healthy pigs had their common carotid artery (CCA) submitted to isolated angioplasty in the right side and angioplasty plus stenting in the left side. Four weeks latter, all animals were submitted to euthanasia for arterial tissue sampling and preparation of histological blades sorted as follows: group 1, middle segment of common right carotid artery (isolated angioplasty); group 2, middle segment of common left carotid artery (intra-stent). Blade images were scanned and analyzed through a digital morphometry program with calculation of luminal, intimal and media layers area in the histological sections. The statistical analysis was performed through mean values and standard deviations of the areas in each group, using the Student’s t-Test. The value of p<0.05 was considered significant. RESULTS: When compare to angioplasty alone, the stent group showed greater hyperplasia in response to implantation regarding the lumen area (5.841 x 106μm2 X 1.287 x 106μm2), the internal elastic lamina area (6.566 x 106μm2 X 1.287 x 106μm2) and the external elastic lamina area (9.832 x 106μm2 X 4.559 x 106μm2). No statistically significant difference was observed when comparing the media layers of both groups (3.266 x 106μm2 X 3.271 x 106μm2). CONCLUSION: angioplasty followed by the implantation of a cobalt-chromium balloon expandable stent in the CCA of the pig creates more intimal thickening than angioplasty alone. Nevertheless intimal thickening was not enough to affect the luminal area thanks to a positive elastic remodeling effect.