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:''Phosphorylcholine refers to the functional group derived from
phosphocholine Phosphocholine is an intermediate in the synthesis of phosphatidylcholine in tissues. Phosphocholine is made in a reaction, catalyzed by choline kinase, that converts ATP and choline into phosphocholine and ADP. Phosphocholine is a molecule ...
. Also not to be confused with
phosphatidylcholine Phosphatidylcholines (PC) are a class of phospholipids that incorporate choline as a headgroup. They are a major component of biological membranes and can be easily obtained from a variety of readily available sources, such as egg yolk or soyb ...
.'' Phosphorylcholine (abbreviated ChoP) is the hydrophilic polar head group of some
phospholipids Phospholipids, are a class of lipids whose molecule has a hydrophilic "head" containing a phosphate group and two hydrophobic "tails" derived from fatty acids, joined by an alcohol residue (usually a glycerol molecule). Marine phospholipids typ ...
, which is composed of a negatively charged phosphate bonded to a small, positively charged choline group. Phosphorylcholine is part of the platelet-activating factor; the
phospholipid Phospholipids, are a class of lipids whose molecule has a hydrophilic "head" containing a phosphate group and two hydrophobic "tails" derived from fatty acids, joined by an alcohol residue (usually a glycerol molecule). Marine phospholipids typ ...
phosphatidylcholine Phosphatidylcholines (PC) are a class of phospholipids that incorporate choline as a headgroup. They are a major component of biological membranes and can be easily obtained from a variety of readily available sources, such as egg yolk or soyb ...
and
sphingomyelin Sphingomyelin (SPH, ˌsfɪŋɡoˈmaɪəlɪn) is a type of sphingolipid found in animal cell membranes, especially in the membranous myelin sheath that surrounds some nerve cell axons. It usually consists of phosphocholine and ceramide, or a ethano ...
, the only phospholipid of the membrane that is not built with a glycerol backbone. Treatment of cell membranes, like those of
RBCs Red blood cells (RBCs), also referred to as red cells, red blood corpuscles (in humans or other animals not having nucleus in red blood cells), haematids, erythroid cells or erythrocytes (from Greek language, Greek ''erythros'' for "red" and ''k ...
, by certain enzymes, like some
phospholipase A2 The enzyme phospholipase A2 (EC 3.1.1.4, PLA2, systematic name phosphatidylcholine 2-acylhydrolase) catalyse the cleavage of fatty acids in position 2 of phospholipids, hydrolyzing the bond between the second fatty acid “tail” and the glyce ...
renders the phosphorylcholine moiety exposed to the external aqueous phase, and thus accessible for recognition by the immune system. Antibodies against phosphorylcholine are naturally occurring autoantibodies that are created by CD5+/ B-1 B cells and are referred to as non-pathogenic
autoantibodies An autoantibody is an antibody (a type of protein) produced by the immune system that is directed against one or more of the individual's own proteins. Many autoimmune diseases (notably lupus erythematosus) are associated with such antibodies. Pr ...
.


Thrombus-resistant stents

In
interventional cardiology Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. Andreas Gruentzig is considered the father of interventional cardiology after the development of angioplasty ...
, phosphorylcholine is used as a synthetic polymer-based coating, applied to
drug-eluting stents A drug-eluting stent (DES) is a peripheral or coronary stent (a scaffold) placed into narrowed, diseased peripheral or coronary arteries that slowly release a drug to block cell proliferation. This prevents fibrosis that, together with clots ...
, to prevent the occurrence of coronary artery
restenosis Restenosis is the recurrence of stenosis, a narrowing of a blood vessel, leading to restricted blood flow. Restenosis usually pertains to an artery or other large blood vessel that has become narrowed, received treatment to clear the blockage and s ...
. The first application of this approach for use of stents evolved from efforts by Hayward and Chapman ''et al.'', who showed that the phosphorylcholine component of the outer surface of the erythrocyte bilayer was non-thrombogenic. To date, over 120,000 Phosphorylcholine-coated stents have been implanted in patients with no apparent deleterious effect in the long term compared to bare metal stent technologies.


Phosphorylcholine polymer-based drug-eluting stents

Drug-eluting stents (DES) are used by interventional cardiologists, operating on patients with
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...
. The stent is inserted into the artery via a
balloon angioplasty Angioplasty, is also known as balloon angioplasty and percutaneous transluminal angioplasty (PTA), is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclero ...
. This will dilate the diameter of the coronary artery and keep it fixed in this phase so that more blood flows through the artery without the risk of blood clots (
atherosclerosis Atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. These lesions may lead to narrowing due to the buildup of atheroma, atheromatous plaque. At onset there are usu ...
).A. L. Lewis, P. W. Stratford, A. L. Lewis, R. T. Freeman, L. Hughes, R. P. Redman, L. A. Tolhurst and T. A. Vick, Abstracts of UKSB 1st Annual Conference, July 2000. https://doi.org/10.1023%2FA%3A1012803503667 Retrieved on 2009-02-09 Phosphorylcholine is used as the polymer-based coating of a DES because its molecular design improves surface biocompatibility and lowers the risk of causing inflammation or
thrombosis Thrombosis (from Ancient Greek "clotting") is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (thro ...
. Polymer coatings of stents that deliver the anti-proliferative drug
Zotarolimus Zotarolimus (International Nonproprietary Name, INN, codenamed ABT-578) is an immunosuppressant. It is a semi-synthetic derivative of sirolimus (rapamycin). It was designed for use in stents with phosphorylcholine as a carrier. Zotarolimus, or ABT ...
to the arterial vessel wall are key components of these revolutionary medical devices. For targeted local delivery of Zotarolimus to the artery, the drug is incorporated into a methacrylate-based copolymer that includes a synthetic form of phosphorylcholine. This use of biomimicry, or the practice of using polymers that occur naturally in biology, provides a coating, with minimal thrombus deposition and no adverse clinical effect on late healing of the arterial vessel wall. Not only is the coating non-thrombogenic, but it also exhibits other features that should be present when applying such a material to a medical device for long-term implantation. These include durability, neutrality to the chemistry of the incorporated drug and ability for sterilization using standard methods which do not affect drug structure or efficacy.


See also

*
Choline Choline is an essential nutrient for humans and many other animals. Choline occurs as a cation that forms various salts (X− in the depicted formula is an undefined counteranion). Humans are capable of some ''de novo synthesis'' of choline but re ...


Notes and references


External links


PubChem
* {{Acetylcholine receptor modulators Cholinergics Phospholipids