PhotoPoint™ photodynamic therapy with local drug delivery eliminates vessel wall cells in arteriovenous graft models

Burgher, Julie M.; Barton, Jennifer M.; Farooq, Michael M.; Vasek, Jeff; Scott, Robert W.; Freischlag, Julie A.; Grove, Robert I.

doi:10.1016/s1522-1865(03)00080-5

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…The rationale behind photodynamic therapy is to administer a photosensitizer, either systemically or locally, and then expose the region of vascular injury to light radiation (external or endovascular), resulting in the production of singlet oxygen that can cause cell death in the region that is exposed to light radiation. Photodynamic therapy has been used in experimental models of peripheral and coronary angioplasty (115,116) and in an arteriovenous graft model (Miravant Medical Technologies, Santa Barbara, CA) (117) and has demonstrated safety, feasibility, and preliminary efficacy. Some anecdotal clinical data also are available, but a large phase III study in a clinical model of vascular injury is lacking.…”

Section: Other Therapiesmentioning

confidence: 99%

Hemodialysis Vascular Access Dysfunction

Roy‐Chaudhury

Sukhatme

Cheung³

2006

Journal of the American Society of Nephrology

505

283

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Hemodialysis vascular access dysfunction is a major cause of morbidity and hospitalization in the hemodialysis population. The major cause of hemodialysis vascular access dysfunction is venous stenosis as a result of neointimal hyperplasia. Despite the magnitude of the clinical problem, however, there has been a paucity of novel therapeutic interventions in this field. This is in marked contrast to a recent plethora of targeted interventions for the treatment of arterial neointimal hyperplasia after coronary angioplasty. The reasons for this are two-fold. First there has been a relative lack of cellular and molecular research that focuses on venous neointimal hyperplasia in the specific setting of hemodialysis vascular access. Second, there have been inadequate efforts by the nephrology community to translate the recent advances in molecular and interventional cardiology into therapies for hemodialysis vascular access. This review therefore (1) briefly examines the different forms of hemodialysis vascular access that are available, (2) describes the pathology and pathogenesis of hemodialysis vascular access dysfunction in both polytetrafluoroethylene grafts and native arteriovenous fistulae, (3) reviews recent concepts about the pathogenesis of vascular stenosis that could potentially be applied in the setting of hemodialysis vascular access dysfunction, (4) summarizes novel experimental and clinical therapies that could potentially be used in the setting of hemodialysis vascular access dysfunction, and, finally, (5) offers some broad guidelines for future innovative translational and clinical research in this area that hopefully will reduce the huge clinical morbidity and economic costs that are associated with this condition.

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Section: Other Therapiesmentioning

confidence: 99%

Hemodialysis Vascular Access Dysfunction

Roy‐Chaudhury

Sukhatme

Cheung³

2006

Journal of the American Society of Nephrology

505

283

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“…Based on the thickness reduction revealed histologically, the authors concluded that PDT effectively inhibited the formation of NIH. The same group reported a similar study ( 66 ), but using the 664-nm radiation delivered by a diode laser and a photosensitizer known as MV2101 (composition not disclosed), also with similarly positive conclusions.…”

Section: Introductionmentioning

confidence: 71%

“… AVF, arteriovenous fistula; FIR, far infrared; NIH, neointimal hyperplasia; PDT, photodynamic therapy; PTP, photochemical tissue passivation; ROS, reactive oxygen species; SMC, smooth muscle cell; UV, ultraviolet. a Barton et al ( 65 ); Burgher et al ( 66 ); Jerjes et al ( 67 ); Houthoofd et al ( 68 ). b Lin et al ( 69 ); Lin et al ( 70 ); Bashar et al ( 71 ); Wan et al ( 72 ); Shemilt et al ( 73 ); Lindhard et al ( 74 ).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic strategies based on non-ionizing radiation to prevent venous neointimal hyperplasia: the relevance for stenosed arteriovenous fistula, and the role of vascular compliance

Russu,

Arbanasi,

Chirila

et al. 2024

Front. Cardiovasc. Med.

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We have reviewed the development and current status of therapies based on exposure to non-ionizing radiation (with a photon energy less than 10 eV) aimed at suppressing the venous neointimal hyperplasia, and consequentially at avoiding stenosis in arteriovenous grafts. Due to the drawbacks associated with the medical use of ionizing radiation, prominently the radiation-induced cardiovascular disease, the availability of procedures using non-ionizing radiation is becoming a noteworthy objective for the current research. Further, the focus of the review was the use of such procedures for improving the vascular access function and assuring the clinical success of arteriovenous fistulae in hemodialysis patients. Following a brief discussion of the physical principles underlying radiotherapy, the current methods based on non-ionizing radiation, either in use or under development, were described in detail. There are currently five such techniques, including photodynamic therapy (PDT), far-infrared therapy, photochemical tissue passivation (PTP), Alucent vascular scaffolding, and adventitial photocrosslinking. The last three are contingent on the mechanical stiffening achievable by the exogenous photochemical crosslinking of tissular collagen, a process that leads to the decrease of venous compliance. As there are conflicting opinions on the role of compliance mismatch between arterial and venous conduits in a graft, this aspect was also considered in our review.

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“…Recently, Russu et al [50] published a review presenting therapeutic strategies based on non-ionizing radiation that have shown interesting results in improving AVF functionality. Photodynamic therapy has been demonstrated in animal models of AVF to inhibit the development of IH [51][52][53][54]. Far infrared therapy has had the best results in human clinical trials, improving AVF flow, AVF maturation, and primary and secondary patency [55][56][57][58][59][60].…”

Section: Discussionmentioning

confidence: 99%

Elevated Leukocyte Glucose Index Is Associated with Long-Term Arteriovenous Fistula Failure in Dialysis Patients

Mureșan,

Florea,

Arbănași

et al. 2024

JCM

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(1) Background: Arteriovenous fistula (AVF) is the preferred type of vascular access for dialysis in patients with end-stage kidney disease (ESKD). However, the primary patency of AVF at one year is under 70% due to several risk factors and comorbidities. Leukocyte glucose index (LGI), a new biomarker based on blood leukocytes and glucose values, has been found to be associated with poor outcomes in cardiovascular disease. The aim of this study is to analyze the impact of LGI on the long-term primary patency of AVF following dialysis initiation. (2) Methods: We conducted a retrospective observational study in which we initially enrolled 158 patients with ESKD admitted to the Vascular Surgery Department of the Emergency County Hospital of Targu Mures, Romania, to surgically create an AVF for dialysis between January 2020 and July 2023. The primary endpoint was AVF failure, defined as the impossibility of performing a chronic dialysis session due to severe restenosis or AVF thrombosis. After follow-up, we categorized patients into two groups based on their AVF status: “functional AVF” for those with a permeable AVF and “AVF failure” for those with vascular access dysfunction. (3) Results: Patients with AVF failure had a higher prevalence of atrial fibrillation (p = 0.013) and diabetes (p = 0.028), as well as a higher LGI value (1.12 vs. 0.79, p < 0.001). At ROC analysis, LGI had the strongest association with the outcome, with an AUC of 0.729, and an optimal cut-off value of 0.95 (72.4% sensitivity and 68% specificity). In Kaplan–Meier survival analyses, patients in the highest tertile (T3) of LGI had a significantly higher incidence of AVF failure compared to those in tertile 1 (p = 0.019). Moreover, we found that patients with higher baseline LGI values had a significantly higher risk of AVF failure during follow-up (HR: 1.48, p = 0.003). The association is independent of age and sex (HR: 1.65, p = 0.001), cardiovascular risk factors (HR: 1.63, p = 0.012), and pre-operative vascular mapping determinations (HR: 3.49, p = 0.037). (4) Conclusions: In conclusion, high preoperative values of LGI are positively associated with long-term AVF failure. The prognostic role of the biomarker was independent of age, sex, cardiovascular risk factors, and pre-operative vascular mapping determinations.

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PhotoPoint™ photodynamic therapy with local drug delivery eliminates vessel wall cells in arteriovenous graft models

Cited by 4 publications

References 9 publications

Hemodialysis Vascular Access Dysfunction

Hemodialysis Vascular Access Dysfunction

Therapeutic strategies based on non-ionizing radiation to prevent venous neointimal hyperplasia: the relevance for stenosed arteriovenous fistula, and the role of vascular compliance

Elevated Leukocyte Glucose Index Is Associated with Long-Term Arteriovenous Fistula Failure in Dialysis Patients

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