Manipulating the matrix to improve arteriovenous fistula patency
操纵基质以改善动静脉内瘘的通畅
基本信息
- 批准号:10648012
- 负责人:
- 金额:$ 75.1万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-09-01 至 2027-07-31
- 项目状态:未结题
- 来源:
- 关键词:AddressArteriovenous fistulaBiologyBlood VesselsBlood flowCell ProliferationCellsChronic Kidney FailureClinicalClinical TrialsCollagenDataDepositionEnd stage renal failureEndothelial CellsEnvironmentExpenditureExtracellular MatrixFailureFemaleFistulaFundingGoalsHealthcareHemodialysisHumanHyperplasiaImmuneImmunityInflammationInterventionInvestigationKnockout MiceKnowledgeLegal patentMacrophageMechanicsMediatingMediatorMethodologyModelingMusNeedlesNephrectomyOperative Surgical ProceduresOutcomePathway interactionsPatientsPharmaceutical PreparationsPhysiologyProceduresProteinsPuncture procedureResourcesSex DifferencesSignal PathwaySignal TransductionSmooth Muscle MyocytesSpecimenT-Lymphocyte SubsetsTechniquesTenascinTestingTransforming Growth Factor betaVeinsVenousWild Type MouseWomanWorkclinical translationdensityexperiencehemodynamicshuman diseaseimmunoregulationimprovedin vivoin vivo Modelinnovationlocal drug deliverymalemenmouse modelnanoparticlenext generationnovelnovel strategiesshear stresstooltranscriptomics
项目摘要
The preferred vascular access for hemodialysis uses an arteriovenous fistula (AVF) to increase blood
flow through a vein. Successful adaptation of the venous conduit to the arterial-like fistula environment requires
remodeling of the vein wall without excessive wall thickening, enabling mechanical strength to resist
hemodialysis procedures that puncture the AVF wall with large bore needles 3 times a week. However, the
poor maturation and patency of AVF, especially in women and requiring additional re-do procedures and
surgery, reflects our imperfect understanding of the biology of venous remodeling that leads to successful
venous adaptation to the fistula environment. This knowledge gap creates an unmet need for novel
approaches to enhance venous remodeling and thereby increase successful clinical use of venous conduits.
During the funding period, we used an innovative mouse AVF model to show that TGF-β signaling
regulates venous adaptive remodeling to improve AVF patency; activation of both the smad2/3 (canonical) and
tak1 (noncanonical) pathways regulate venous remodeling; and endothelial cell-targeted TGF-β inhibition
regulates both collagen density and smooth muscle cell proliferation to improve AVF patency. We present
exciting new data that: 1) expression of the matricellular protein tenascin-C (TnC) is greatly increased and
colocalizes with the remodeling venous wall; 2) TnC regulates AVF patency and TGF-β signaling during
venous remodeling; 3) TnC expression is not downregulated in failed AVF; and 4) TnC knockout mice have
altered proportions of immune cells in the AVF wall. In addition, we have developed the mouse model further to
incorporate chronic kidney disease (CKD) via 5/6-nephrectomy and these AVF faithfully recapitulate human
AVF maturation. We hypothesize that modulating tenascin-C activity will alter venous remodeling, thereby
improving AVF maturation and patency. We will use our translationally relevant in vivo model, an innovative
tool using nanoparticles for local drug delivery, innovative methodology to analyze the cell composition within
the AVF wall, as well as advanced next-generation analyses using transcriptomics techniques that are
available at Yale, to test our innovative hypothesis with the following specific aims:
Aim I: Determine sex differences in TnC expression during human AVF remodeling in vivo. Aim II: Determine
whether TnC function mediates venous remodeling in mice with CKD. Aim III: Determine whether regulation of
immune cells is a mechanism of TnC-mediated venous remodeling.
A successful outcome of this investigation will have lasting impact by establishing whether TnC
mediates venous remodeling, and thus whether regulating TnC activity is a valuable strategy for clinical
translation to enhance AVF maturation. We will also determine whether reduced AVF maturation in women is
due to sex differences in TnC function as well as in inflammation and/or immunity. We use an innovative
strategy and novel tools and models to alter venous remodeling and thereby improve AVF maturation.
血液透析的首选血管通路使用动静脉内瘘(AVF)来增加血液
通过静脉流动。静脉导管成功适应动脉样瘘管环境需要
静脉壁的重塑而没有过度的壁增厚,使机械强度抵抗
每周3次使用大口径针头穿刺AVF壁的血液透析程序。但
AVF的成熟和通畅性差,尤其是女性,需要额外的重做手术,
手术,反映了我们对静脉重塑生物学的不完善理解,导致成功的
静脉适应瘘管环境。这种知识差距造成了对小说的需求得不到满足。
增强静脉重塑并由此增加静脉导管的成功临床使用的方法。
在资助期间,我们使用了一种创新的小鼠AVF模型,表明TGF-β信号转导
调节静脉适应性重塑以改善AVF通畅性;激活smad 2/3(典型)和
tak 1(非经典)途径调节静脉重塑;内皮细胞靶向TGF-β抑制
调节胶原蛋白密度和平滑肌细胞增殖以改善AVF通畅性。我们提出
令人兴奋的新数据是:1)基质细胞蛋白生腱蛋白-C(TnC)的表达大大增加,
与重塑的静脉壁共定位; 2)在移植过程中,TnC调节AVF通畅性和TGF-β信号传导。
静脉重塑; 3)TnC表达在AVF失败中没有下调; 4)TnC敲除小鼠具有
AVF壁中免疫细胞的比例改变。此外,我们进一步开发了小鼠模型,
通过5/6肾切除术合并慢性肾病(CKD),这些AVF忠实地再现了人类
AVF成熟。我们假设调节腱生蛋白-C活性将改变静脉重塑,从而
改善AVF成熟和通畅性。我们将使用我们的诊断相关的体内模型,一个创新的
使用纳米颗粒进行局部药物输送的工具,分析细胞成分的创新方法
AVF壁,以及先进的下一代分析使用转录组学技术,
耶鲁大学提供的,以测试我们的创新假设与以下具体目标:
目的I:确定在体内人类AVF重构过程中TnC表达的性别差异。目标二:确定
TnC功能是否介导CKD小鼠的静脉重塑。目标三:确定是否对
免疫细胞是TnC介导的静脉重塑的机制。
这项调查的成功结果将通过确定TnC是否
介导静脉重塑,因此调节TnC活性是否是临床治疗的有价值策略。
翻译以增强AVF成熟。我们还将确定女性AVF成熟度降低是否是
这是由于TnC功能以及炎症和/或免疫的性别差异。我们使用创新的
策略和新的工具和模型来改变静脉重塑,从而改善AVF成熟。
项目成果
期刊论文数量(9)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Sex differences in arterial identity correlate with neointimal hyperplasia after balloon injury.
动脉身份的性别差异与球囊损伤后的新内膜增生相关。
- DOI:10.1007/s11033-022-07644-2
- 发表时间:2022-09
- 期刊:
- 影响因子:2.8
- 作者:Gao, Mingjie;Gao, Xixiang;Taniguchi, Ryosuke;Brahmandam, Anand;Matsubara, Yutaka;Liu, Jia;Liu, Hao;Zhang, Weichang;Dardik, Alan
- 通讯作者:Dardik, Alan
Hypoxia and hypoxia-inducible factors promote the development of neointimal hyperplasia in arteriovenous fistula.
- DOI:10.1113/jp281218
- 发表时间:2021-04
- 期刊:
- 影响因子:0
- 作者:Sadaghianloo N;Contenti J;Declemy S;Ambrosetti D;Zdralevic M;Tannour-Louet M;Fabbri L;Pagès G;Bost F;Hassen-Khodja R;Pouysségur J;Jean-Baptiste E;Dardik A;Mazure NM
- 通讯作者:Mazure NM
Endothelial Cell TGF-β (Transforming Growth Factor-Beta) Signaling Regulates Venous Adaptive Remodeling to Improve Arteriovenous Fistula Patency.
- DOI:10.1161/atvbaha.122.317676
- 发表时间:2022-07
- 期刊:
- 影响因子:8.7
- 作者:Taniguchi, Ryosuke;Ohashi, Yuichi;Lee, Jung Seok;Hu, Haidi;Gonzalez, Luis;Zhang, Weichang;Langford, John;Matsubara, Yutaka;Yatsula, Bogdan;Tellides, George;Fahmy, Tarek M.;Hoshina, Katsuyuki;Dardik, Alan
- 通讯作者:Dardik, Alan
EphB4 monomer inhibits chronic graft vasculopathy in an aortic transplant model.
- DOI:10.1016/j.jvssci.2023.100109
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:Langford, John T;Gonzalez, Luis;Taniguchi, Ryosuke;Brahmandam, Anand;Zhang, Weichang;Dardik, Alan
- 通讯作者:Dardik, Alan
A central arteriovenous fistula reduces systemic hypertension in a mouse model.
中央动静脉瘘可降低小鼠模型的全身性高血压。
- DOI:10.1016/j.jvssci.2024.100191
- 发表时间:2024
- 期刊:
- 影响因子:0
- 作者:Brahmandam,Anand;Alves,Rafael;Liu,Hao;Gonzalez,Luis;Aoyagi,Yukihiko;Ohashi,Yuichi;Langford,JohnT;Thaxton,Carly;Taniguchi,Ryosuke;Zhang,Weichang;Bai,Hualong;Yatsula,Bogdan;Dardik,Alan
- 通讯作者:Dardik,Alan
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Alan Dardik其他文献
Alan Dardik的其他文献
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{{ truncateString('Alan Dardik', 18)}}的其他基金
Molecular control of vascular smooth muscle reprogramming in arteriovenous fistula maturation
动静脉内瘘成熟过程中血管平滑肌重编程的分子控制
- 批准号:
10735849 - 财政年份:2023
- 资助金额:
$ 75.1万 - 项目类别:
Adaptive immunity regulates arteriovenous fistula remodeling
适应性免疫调节动静脉内瘘重塑
- 批准号:
10574913 - 财政年份:2022
- 资助金额:
$ 75.1万 - 项目类别:
Manipulating the matrix to improve arteriovenous fistula patency
操纵基质以改善动静脉内瘘的通畅
- 批准号:
10460349 - 财政年份:2019
- 资助金额:
$ 75.1万 - 项目类别:
Manipulating the matrix to improve arteriovenous fistula patency
操纵基质以改善动静脉内瘘的通畅
- 批准号:
10223421 - 财政年份:2019
- 资助金额:
$ 75.1万 - 项目类别:
Manipulating the matrix to improve arteriovenous fistula patency
操纵基质以改善动静脉内瘘的通畅
- 批准号:
9806370 - 财政年份:2019
- 资助金额:
$ 75.1万 - 项目类别:
Manipulating the matrix to improve arteriovenous fistula patency
操纵基质以改善动静脉内瘘的通畅
- 批准号:
10001593 - 财政年份:2019
- 资助金额:
$ 75.1万 - 项目类别:
Enhancing venous adaptation to the arterial environment
增强静脉对动脉环境的适应
- 批准号:
9460535 - 财政年份:2016
- 资助金额:
$ 75.1万 - 项目类别:
Enhancing venous adaptation to the arterial environment
增强静脉对动脉环境的适应
- 批准号:
9243119 - 财政年份:2016
- 资助金额:
$ 75.1万 - 项目类别:
Enhancing venous adaptation to the arterial environment
增强静脉对动脉环境的适应
- 批准号:
9102364 - 财政年份:2016
- 资助金额:
$ 75.1万 - 项目类别:
Molecular regulation of fistula adaptation for dialysis access
透析通路瘘管适应的分子调控
- 批准号:
8634237 - 财政年份:2014
- 资助金额:
$ 75.1万 - 项目类别:
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