Effect of sex differences in treatment response to angioplasty in a murine arteriovenous fistula model.

Abstract

Failure to mature and venous neointimal hyperplasia formation are the two major causes of hemodialysis arteriovenous fistula (AVF) vascular access failure. Percutaneous transluminal angioplasty (PTA) is the firstline treatment for both of these conditions, but, clinically, women have decreased patency rates compared with men. The hypothesis to be tested in the present study was that female mice after PTA of venous areas of higher intimal thickening have increased gene expression of transforming growth factor-β1 (TGF-β1) and TGF-β receptor 1 (TGFβ-R1) accompanied with histological changes of fibrosis compared with male mice. Seventeen male and eighteen female C57BL/6J mice were used in this study. Chronic kidney disease was induced by partial nephrectomy, and, 28 days later, an AVF was created to connect the left carotid artery to the right jugular vein. Two weeks later, the higher intimal thickening area was treated with PTA, and mice were euthanized 3 days later for gene expression analysis or 14 days later for histopathological analysis. Doppler ultrasound was performed weekly after AVF creation. At day 3, female AVF had significantly higher average gene expression of TGF-β1 and TGFβ-R1 compared with male AVF. At day 14, female outflow veins had a smaller venous diameter, lumen vessel area, decreased wall shear stress, lower average peak systolic velocity, and an increased neointima area-to-media area ratio. Moreover, female outflow veins showed a significant increase in α-smooth muscle actin and fibroblast-specific protein-1. There was a decrease in M1/M2 with an increase in CD68.

• Authors: Chuanqi Cai, Chenglei Zhao, Sreenivasulu Kilari, Amit Sharma, Avishek K Singh, Michael L Simeon, Avanish Misra, Yiqing Li, Sanjay Misra
• Journal: American journal of physiology. Renal physiology (Am J Physiol Renal Physiol) Vol. 318 Issue 3 Pg. F565-F575 (03 01 2020) ISSN: 1522-1466 [Electronic] United States
• PMID: 31813252 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Actins
• Antigens, CD
• Antigens, Differentiation, Myelomonocytic
• CD68 protein, mouse
• Platelet Endothelial Cell Adhesion Molecule-1
• S100 Calcium-Binding Protein A4
• S100a4 protein, mouse
• Transforming Growth Factor beta1
• alpha-smooth muscle actin, mouse
• myosin 11, mouse
• Receptor, Transforming Growth Factor-beta Type I
• Arg1 protein, mouse
• Arginase
• Myosin Heavy Chains

Topics

• Actins (genetics, metabolism)
• Angioplasty
• Animals
• Antigens, CD (genetics, metabolism)
• Antigens, Differentiation, Myelomonocytic (genetics, metabolism)
• Arginase (genetics, metabolism)
• Arteriovenous Fistula (pathology, surgery)
• Female
• Gene Expression Regulation
• Male
• Mice, Inbred C57BL
• Myosin Heavy Chains (genetics, metabolism)
• Platelet Endothelial Cell Adhesion Molecule-1 (genetics, metabolism)
• Receptor, Transforming Growth Factor-beta Type I (genetics, metabolism)
• S100 Calcium-Binding Protein A4 (genetics, metabolism)
• Sex Factors
• Transforming Growth Factor beta1 (genetics, metabolism)
• Up-Regulation