Molecular targets for improving arteriovenous fistula maturation and patency

Gorecka, Jolanta; Fereydooni, Arash; Gonzalez, Luis; Lee, Shin Rong; Liu, Shirley; Ono, Shun; Xu, Jianbiao; Liu, Jia; Taniguchi, Rin Ichiro; Matsubara, Yutaka; Gao, Xixiang; Gao, Mingjie; Langford, John; Yatsula, Bogdan; Dardik, Alan

doi:10.4103/vit.vit_9_19

Cited by 19 publications

(16 citation statements)

References 106 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This campaign pushed to attain a target of 40% of autologous AVF in the United States by 2006, and then 66% by 2009 ( 4 ). Despite these efforts to increase AVF use, up to 60% of AVF fail to mature by 5 months contributing to significant patient burden and healthcare cost ( 3 , 5 ). There are several predictors of successful AVF adaptation to the fistula environment and use as a successful conduit for hemodialysis, although none are perfect ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…Vein diameter is the most predictive factor in many studies, with larger preoperative vein diameters correlating with higher rates of maturation ( 7 , 8 ). Other factors, such as diabetes, congestive heart failure, concomitant peripheral arterial disease, and older age may also play a role, as these are negatively correlated with successful AVF creation ( 5 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sex Differences in Inflammation During Venous Remodeling of Arteriovenous Fistulae

Chan

Weininger

Langford

et al. 2021

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

Vascular disorders frequently have differing clinical presentations among women and men. Sex differences exist in vascular access for hemodialysis; women have reduced rates of arteriovenous fistula (AVF) maturation as well as fistula utilization compared with men. Inflammation is increasingly implicated in both clinical studies and animal models as a potent mechanism driving AVF maturation, especially in vessel dilation and wall thickening, that allows venous remodeling to the fistula environment to support hemodialysis. Sex differences have long been recognized in arterial remodeling and diseases, with men having increased cardiovascular events compared with pre-menopausal women. Many of these arterial diseases are driven by inflammation that is similar to the inflammation during AVF maturation. Improved understanding of sex differences in inflammation during vascular remodeling may suggest sex-specific vascular therapies to improve AVF success.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sex Differences in Inflammation During Venous Remodeling of Arteriovenous Fistulae

Chan

Weininger

Langford

et al. 2021

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

show abstract

“…2–4 Successful use of an AVF for hemodialysis requires venous maturation, that is outward remodeling and wall thickening, to support the increased flow and needle punctures required for the hemodialysis sessions. Although the factors that regulate AVF maturation without exuberant thickening are not clearly understood, the immune system and inflammation are important components 5–8 ; however, molecular mechanisms by which the immune system and inflammation regulate venous remodeling during AVF maturation are not yet understood well. 5–8…”

mentioning

confidence: 99%

“…Although the factors that regulate AVF maturation without exuberant thickening are not clearly understood, the immune system and inflammation are important components 5–8 ; however, molecular mechanisms by which the immune system and inflammation regulate venous remodeling during AVF maturation are not yet understood well. 5–8…”

mentioning

confidence: 99%

“…[2][3][4] Successful use of an AVF for hemodialysis requires venous maturation, that is outward remodeling and wall thickening, to support the increased flow and needle punctures required for the hemodialysis sessions. Although the factors that regulate AVF maturation without exuberant thickening are not clearly understood, the immune system and inflammation are important components [5][6][7][8] ; however, molecular mechanisms by which the immune system and inflammation regulate venous remodeling during AVF maturation are not yet understood well. [5][6][7][8] Inflammatory cells such as T cells and macrophages have been observed in the vascular wall during AVF maturation, [9][10][11][12][13] and we have previously shown that M2-type macrophages appear to be required for wall thickening during AVF maturation.…”

mentioning

confidence: 99%

See 1 more Smart Citation

PD-L1 (Programmed Death Ligand 1) Regulates T-Cell Differentiation to Control Adaptive Venous Remodeling

Matsubara

Gonzalez²,

Kiwan³

et al. 2021

ATVB

Self Cite

View full text Add to dashboard Cite

Objective: Patients with end-stage renal disease depend on hemodialysis for survival. Although arteriovenous fistulae (AVF) are the preferred vascular access for hemodialysis, the primary success rate of AVF is only 30% to 50% within 6 months, showing an urgent need for improvement. PD-L1 (programmed death ligand 1) is a ligand that regulates T-cell activity. Since T cells have an important role during AVF maturation, we hypothesized that PD-L1 regulates T cells to control venous remodeling that occurs during AVF maturation. Approach and results: In the mouse aortocaval fistula model, anti-PD-L1 antibody (200 mg, 3×/wk intraperitoneal) was given to inhibit PD-L1 activity during AVF maturation. Inhibition of PD-L1 increased T-helper type 1 cells and T-helper type 2 cells but reduced regulatory T cells to increase M1-type macrophages and reduce M2-type macrophages; these changes were associated with reduced vascular wall thickening and reduced AVF patency. Inhibition of PD-L1 also inhibited smooth muscle cell proliferation and increased endothelial dysfunction. The effects of anti-PD-L1 antibody on adaptive venous remodeling were diminished in nude mice; however, they were restored after T-cell transfer into nude mice, indicating the effects of anti-PD-L1 antibody on venous remodeling were dependent on T cells. Conclusions: Regulation of PD-L1 activity may be a potential therapeutic target for clinical translation to improve AVF maturation.

show abstract

Vascular Cast to Program Antistenotic Hemodynamics and Remodeling of Vein Graft

Park²,

Lee

et al. 2023

Advanced Science

View full text Add to dashboard Cite

The structural stability of medical devices is established by managing stress distribution in response to organ movement. Veins abruptly dilate upon arterial grafting due to the mismatched tissue property, resulting in flow disturbances and consequently stenosis. Vascular cast is designed to wrap the vein‐artery grafts, thereby adjusting the diameter and property mismatches by relying on the elastic fixity. Here, a small bridge connection in the cast structure serves as an essential element to prevent stress concentrations due to the improved elastic fixity. Consequently, the vein dilation is efficiently suppressed, healthy (laminar and helical) flow is induced effectively, and the heathy functions of vein grafting are promoted, as indicated by the flow directional alignment of endothelial cells with arterialization, muscle expansion, and improved contractility. Finally, collaborative effects of the bridge drastically suppress stenosis with patency improvement. As a key technical point, the advantages of the bridge addition are validated via the computational modeling of fluid–structure interaction, followed by a customized ex vivo set‐up and analyses. The calculated effects are verified using a series of cell, rat, and canine models towards translation. The bridge acted like “Little Dutch boy” who saved the big mass using one finger by supporting the cast function.

show abstract

Molecular targets for improving arteriovenous fistula maturation and patency

Cited by 19 publications

References 106 publications

Sex Differences in Inflammation During Venous Remodeling of Arteriovenous Fistulae

Sex Differences in Inflammation During Venous Remodeling of Arteriovenous Fistulae

PD-L1 (Programmed Death Ligand 1) Regulates T-Cell Differentiation to Control Adaptive Venous Remodeling

Vascular Cast to Program Antistenotic Hemodynamics and Remodeling of Vein Graft

Contact Info

Product

Resources

About