BACKGROUND: Haemodialysis vascular access dysfunction (due to venous stenosis and thrombosis) is a leading cause of hospitalization and morbidity. The aim of the current study was to identify the specific cell types present within stenotic tissue samples from patients with AV fistula and graft failure. METHODS: Discarded tissue segments were collected from the stenotic portions (usually near the graft-vein anastomosis or the AV anastomosis) of 23 dialysis grafts and 20 AV fistulae, and examined for expression of smooth muscle alpha actin, desmin, vimentin and a macrophage marker. RESULTS: The majority of cells within the venous neointima (both grafts and fistulae) were myofibroblasts, with a smaller number of desmin positive smooth muscle cells. The graft neointima had a similar cellular phenotype, albeit without any desmin positive contractile smooth muscle cells. The majority of cells within the PTFE graft material were macrophages. Analysis of sequential sections revealed the presence of fibroblasts within the venous neointima and intragraft region. CONCLUSIONS: Our results demonstrate that contractile smooth muscle cells, myofibroblasts, fibroblasts and macrophages all play a role in the pathogenesis of dialysis access dysfunction (grafts and fistulae). Targeting these specific cell types might result in the development of novel therapeutic paradigms for haemodialysis vascular access dysfunction.
BACKGROUND:Haemodialysis vascular access dysfunction (due to venous stenosis and thrombosis) is a leading cause of hospitalization and morbidity. The aim of the current study was to identify the specific cell types present within stenotic tissue samples from patients with AV fistula and graft failure. METHODS: Discarded tissue segments were collected from the stenotic portions (usually near the graft-vein anastomosis or the AV anastomosis) of 23 dialysis grafts and 20 AV fistulae, and examined for expression of smooth muscle alpha actin, desmin, vimentin and a macrophage marker. RESULTS: The majority of cells within the venous neointima (both grafts and fistulae) were myofibroblasts, with a smaller number of desmin positive smooth muscle cells. The graft neointima had a similar cellular phenotype, albeit without any desmin positive contractile smooth muscle cells. The majority of cells within the PTFE graft material were macrophages. Analysis of sequential sections revealed the presence of fibroblasts within the venous neointima and intragraft region. CONCLUSIONS: Our results demonstrate that contractile smooth muscle cells, myofibroblasts, fibroblasts and macrophages all play a role in the pathogenesis of dialysis access dysfunction (grafts and fistulae). Targeting these specific cell types might result in the development of novel therapeutic paradigms for haemodialysis vascular access dysfunction.
Authors: M Maeng; P G Olesen; N C Emmertsen; M Thorwest; T T Nielsen; B O Kristensen; E Falk; H R Andersen Journal: Coron Artery Dis Date: 2001-06 Impact factor: 1.439
Authors: P Roy-Chaudhury; B S Kelly; M A Miller; A Reaves; J Armstrong; N Nanayakkara; S C Heffelfinger Journal: Kidney Int Date: 2001-06 Impact factor: 10.612
Authors: Helen Lee; Braden Manns; Ken Taub; William A Ghali; Stafford Dean; David Johnson; Cam Donaldson Journal: Am J Kidney Dis Date: 2002-09 Impact factor: 8.860
Authors: Jeffrey J Tomas; V Emily Stark; Jimmy L Kim; Randal A Wolff; Debra A Hullett; Thomas F Warner; John R Hoch Journal: J Vasc Res Date: 2003 May-Jun Impact factor: 1.934
Authors: Wenguang Feng; Phillip Chumley; Michael Allon; James George; David W Scott; Rakesh P Patel; Silvio Litovsky; Edgar A Jaimes Journal: J Am Soc Nephrol Date: 2013-11-07 Impact factor: 10.121
Authors: William G Sanders; Christophe Morisseau; Bruce D Hammock; Alfred K Cheung; Christi M Terry Journal: Am J Physiol Cell Physiol Date: 2012-05-23 Impact factor: 4.249
Authors: Eddie Manning; Nikolaos Skartsis; Armando M Orta; Omaida C Velazquez; Zhao-Jun Liu; Arif Asif; Loay H Salman; Roberto I Vazquez-Padron Journal: J Vasc Res Date: 2012-01-13 Impact factor: 1.934
Authors: Daniel Y Lu; Elizabeth Y Chen; Daniel J Wong; Kota Yamamoto; Clinton D Protack; Willis T Williams; Roland Assi; Michael R Hall; Nirvana Sadaghianloo; Alan Dardik Journal: J Surg Res Date: 2014-01-30 Impact factor: 2.192