Distinct subsets of T cells and macrophages impact venous remodeling during arteriovenous fistula maturation

Matsubara, Yutaka; Kiwan, Gathe; Fereydooni, Arash; Langford, John; Dardik, Alan

doi:10.1016/j.jvssci.2020.07.005

Cited by 20 publications

(31 citation statements)

References 121 publications

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“…After surgical creation, AVF requires maturation time before use. After AVF creation, the AVF efferent vein begins a new function as its wall becomes more similar to an artery wall and this triggers a new continuous remodelling process [9]. To be successful for haemodialysis, the AVF efferent vein needs to be enlarged and thickened in order for it to sustain both the stronger force of arterial flow compared to venous flow and the intensity of dialysis treatment.…”

Section: Arteriovenous Fistulamentioning

confidence: 99%

Roles of PI3K/AKT/mTOR Axis in Arteriovenous Fistula

et al. 2022

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Renal failure is a worldwide disease with a continuously increasing prevalence and involving a rising need for long-term treatment, mainly by haemodialysis. Arteriovenous fistula (AVF) is the favourite type of vascular access for haemodialysis; however, the lasting success of this therapy depends on its maturation, which is directly influenced by many concomitant processes such as vein wall thickening or inflammation. Understanding the molecular mechanisms that drive AVF maturation and failure can highlight new or combinatorial drugs for more personalized therapy. In this review we analysed the relevance of critical enzymes such as PI3K, AKT and mTOR in processes such as wall thickening remodelling, immune system activation and inflammation reduction. We focused on these enzymes due to their involvement in the modulation of numerous cellular activities such as proliferation, differentiation and motility, and their impairment is related to many diseases such as cancer, metabolic syndrome and neurodegenerative disorders. In addition, these enzymes are highly druggable targets, with several inhibitors already being used in patient treatment for cancer and with encouraging results for AVF. Finally, we delineate how these enzymes may be targeted to control specific aspects of AVF in an effort to propose a more specialized therapy with fewer side effects.

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Section: Arteriovenous Fistulamentioning

confidence: 99%

Roles of PI3K/AKT/mTOR Axis in Arteriovenous Fistula

et al. 2022

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“…Outward remodeling is driven by immune and inflammatory processes, particularly CD4+ T cells ( 53 ). Rats devoid of mature T cells have decreased lumen sizes following AVF surgery and lower inflammatory cell counts at the fistula site; rescue with euthymic CD4+ T cells leads to increased blood flow through the fistula ( 54 ).…”

Section: Venous Dilationmentioning

confidence: 99%

“…Macrophages and T cells contribute significantly to venous neointimal hyperplasia and may further contribute to sex differences observed during AVF maturation ( 53 ). Following angioplasty of fistulae, female mice had increased neointimal area-to-media ratio, accompanied by increased numbers of CD68+ cells, suggesting sex differences in macrophages during venous remodeling ( 102 ).…”

Section: Venous Wall Thickeningmentioning

confidence: 99%

“…Following angioplasty of fistulae, female mice had increased neointimal area-to-media ratio, accompanied by increased numbers of CD68+ cells, suggesting sex differences in macrophages during venous remodeling ( 102 ). M2-type macrophages are important for vascular wall thickening by secreting IL-10 that is necessary for wall thickening during AVF maturation ( 53 , 103 ). Rapamycin, an immunosuppressant, decreases AVF wall thickness, ECM deposition, and smooth muscle cell proliferation via suppression of both M1-type and M2-type macrophages ( 104 ).…”

Section: Venous Wall Thickeningmentioning

confidence: 99%

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Sex Differences in Inflammation During Venous Remodeling of Arteriovenous Fistulae

Chan

Weininger

Langford

et al. 2021

Front. Cardiovasc. Med.

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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.

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“…JVS-VS , the official publication of the Society for Vascular Surgery (SVS) is the fourth member of the JVS portfolio ( Table ). 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 2021 has been a year of growth and transformation for all the journals of the JVS family. The Journal of Vascular Surgery (JVS) earned an all-time-high impact factor of 4.268, the Journal of Vascular Surgery: Venous and Lymphatic Disorders (JVS-VL) reinforced its position as the leading publication in the international venous and lymphatic field with an impact factor of 2.859, and the Journal of Vascular Surgery Cases, Innovations and Techniques substantially increased the content and number of its open access, on-line publications.…”

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confidence: 99%