CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 9, October 2012
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AFRICA
platelets within the circulation which not only are a source of
PDGF-B, but also, in turn, adhere to the injured artery.
Rat studies have been shown to halt the formation of NIH
by specific inhibition of the PDGF receptor, tyrosine kinase.
37
Similarly, FGF is an important growth factor for SMC, as well
as endothelial cell proliferation. Vascular injury releases FGF
from the extracellular matrix, after which it is free to bind to
its receptors on both SMCs and endothelial cells, promoting
cellular proliferation and, as a result, NIH. IGF may play an
important role in remodelling the extracellular matrix and, to
a lesser extent, increase the ability of PDGF to induce SMC
proliferation.
The role of VEGF along with other growth factors (FGF,
PDGFs and IGF) involved in stimulating the change required by
SMCs to proliferate and migrate to form the neo-intima, as well
as its influence on the degree of NIH in the tibial or femoro-
popliteal artery has not been investigated.
Conclusion
This research review highlights the need for future studies
to investigate whether the profile of VPC differentiation also
predicts the severity of post-stent NIH in the femoro-popliteal
or tibial artery, as well as the association of neo-intimal
growth factors, NF-
κ
B and CAMs with VPC differentiation and
formation of the neo-intima. Results from future studies will (1)
better our understanding of the regulation on NIH in general, (2)
determine whether combinations of any of the vascular factors
discussed are predictive of the extent of NIH post operatively,
and (3) potentially facilitate future therapeutic targets and/or
change preventive strategies.
Specifically, studies from Africa are needed to not only
establish and record the incidence of NIH from our local
population, as currently, no published data exist, but also to
determine which of these factors could predict neo-intimal
formation in our population. We also need to determine whether
this profiling differs from that of others internationally.
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