The upregulation of endothelin and its receptors in porcine coronary arteries in a double balloon injury model of restenosis

Endothelin, a potent vasoconstrictor, mitogen, and stimulant of collagen synthesis, is reported to be increased after vascular injury. We tested the hypothesis that tissue endothelin levels and its receptor expression are increased following double balloon injury in a porcine coronary artery model of restenosis. Male miniature swine maintained on a hyperlipidemic diet underwent oversized balloon injury to both the proximal right coronary artery and left circumflex coronary artery. Two weeks following the initial injury, the arteries were repeat injured at the same site and subsequently harvested four weeks later. Proximal balloon injured (BI) and distal non-balloon-injured (NBI) segments from the same artery were collected. Tissue endothelin-1 (ET-1) levels were measured by ELISA. Endothelin receptors were assayed by radioligand binding using 125I-ET-1 and also immunolabeling. Tissue endothelin levels were 4-5 fold greater in BI arteries as compared to NBI. There was a significant increase in tissue ET-1 levels and endothelin receptor binding following double balloon injury relative to NBI control arteries. Western blots showed an increased expression of ET(A) receptor protein in injured vessels compared to non-injured arteries. Immunohistochemistry using an ET(A) receptor specific antibody confirmed increased receptor density following balloon injury. Thus, in an in vivo double balloon injury model for coronary artery restenosis, the response to vascular injury is increased tissue ET-1 content and upregulation of ET(A) receptor density associated with increased receptor protein.