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Brennan PG, Mota L, Aridi T, Patel N, Liang P, Ferran C. Advancements in Omics and Breakthrough Gene Therapies: A Glimpse into the Future of Peripheral Artery Disease. Ann Vasc Surg 2024; 107:229-246. [PMID: 38582204 DOI: 10.1016/j.avsg.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 01/01/2024] [Indexed: 04/08/2024]
Abstract
Peripheral artery disease (PAD), a highly prevalent global disease, associates with significant morbidity and mortality in affected patients. Despite progress in endovascular and open revascularization techniques for advanced PAD, these interventions grapple with elevated rates of arterial restenosis and vein graft failure attributed to intimal hyperplasia (IH). Novel multiomics technologies, coupled with sophisticated analyses tools recently powered by advances in artificial intelligence, have enabled the study of atherosclerosis and IH with unprecedented single-cell and spatial precision. Numerous studies have pinpointed gene hubs regulating pivotal atherogenic and atheroprotective signaling pathways as potential therapeutic candidates. Leveraging advancements in viral and nonviral gene therapy (GT) platforms, gene editing technologies, and cutting-edge biomaterial reservoirs for delivery uniquely positions us to develop safe, efficient, and targeted GTs for PAD-related diseases. Gene therapies appear particularly fitting for ex vivo genetic engineering of IH-resistant vein grafts. This manuscript highlights currently available state-of-the-art multiomics approaches, explores promising GT-based candidates, and details GT delivery modalities employed by our laboratory and others to thwart mid-term vein graft failure caused by IH, as well as other PAD-related conditions. The potential clinical translation of these targeted GTs holds the promise to revolutionize PAD treatment, thereby enhancing patients' quality of life and life expectancy.
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Affiliation(s)
- Phillip G Brennan
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Lucas Mota
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Tarek Aridi
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Nyah Patel
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Patric Liang
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Christiane Ferran
- Division of Vascular and Endovascular Surgery, and Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Division of Nephrology and the Transplant Institute, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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Michaud ME, Mota L, Bakhtiari M, Thomas BE, Tomeo J, Pilcher W, Contreras M, Ferran C, Bhasin SS, Pradhan-Nabzdyk L, LoGerfo FW, Liang P, Bhasin MK. Early Injury Landscape in Vein Harvest by Single-Cell and Spatial Transcriptomics. Circ Res 2024; 135:110-134. [PMID: 38808504 PMCID: PMC11189745 DOI: 10.1161/circresaha.123.323939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/03/2024] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Vein graft failure following cardiovascular bypass surgery results in significant patient morbidity and cost to the healthcare system. Vein graft injury can occur during autogenous vein harvest and preparation, as well as after implantation into the arterial system, leading to the development of intimal hyperplasia, vein graft stenosis, and, ultimately, bypass graft failure. Although previous studies have identified maladaptive pathways that occur shortly after implantation, the specific signaling pathways that occur during vein graft preparation are not well defined and may result in a cumulative impact on vein graft failure. We, therefore, aimed to elucidate the response of the vein conduit wall during harvest and following implantation, probing the key maladaptive pathways driving graft failure with the overarching goal of identifying therapeutic targets for biologic intervention to minimize these natural responses to surgical vein graft injury. METHODS Employing a novel approach to investigating vascular pathologies, we harnessed both single-nuclei RNA-sequencing and spatial transcriptomics analyses to profile the genomic effects of vein grafts after harvest and distension, then compared these findings to vein grafts obtained 24 hours after carotid-carotid vein bypass implantation in a canine model (n=4). RESULTS Spatial transcriptomic analysis of canine cephalic vein after initial conduit harvest and distention revealed significant enrichment of pathways (P<0.05) involved in the activation of endothelial cells (ECs), fibroblasts, and vascular smooth muscle cells, namely pathways responsible for cellular proliferation and migration and platelet activation across the intimal and medial layers, cytokine signaling within the adventitial layer, and ECM (extracellular matrix) remodeling throughout the vein wall. Subsequent single-nuclei RNA-sequencing analysis supported these findings and further unveiled distinct EC and fibroblast subpopulations with significant upregulation (P<0.05) of markers related to endothelial injury response and cellular activation of ECs, fibroblasts, and vascular smooth muscle cells. Similarly, in vein grafts obtained 24 hours after arterial bypass, there was an increase in myeloid cell, protomyofibroblast, injury response EC, and mesenchymal-transitioning EC subpopulations with a concomitant decrease in homeostatic ECs and fibroblasts. Among these markers were genes previously implicated in vein graft injury, including VCAN, FBN1, and VEGFC, in addition to novel genes of interest, such as GLIS3 and EPHA3. These genes were further noted to be driving the expression of genes implicated in vascular remodeling and graft failure, such as IL-6, TGFBR1, SMAD4, and ADAMTS9. By integrating the spatial transcriptomics and single-nuclei RNA-sequencing data sets, we highlighted the spatial architecture of the vein graft following distension, wherein activated and mesenchymal-transitioning ECs, myeloid cells, and fibroblasts were notably enriched in the intima and media of distended veins. Finally, intercellular communication network analysis unveiled the critical roles of activated ECs, mesenchymal-transitioning ECs, protomyofibroblasts, and vascular smooth muscle cells in upregulating signaling pathways associated with cellular proliferation (MDK [midkine], PDGF [platelet-derived growth factor], VEGF [vascular endothelial growth factor]), transdifferentiation (Notch), migration (ephrin, semaphorin), ECM remodeling (collagen, laminin, fibronectin), and inflammation (thrombospondin), following distension. CONCLUSIONS Vein conduit harvest and distension elicit a prompt genomic response facilitated by distinct cellular subpopulations heterogeneously distributed throughout the vein wall. This response was found to be further exacerbated following vein graft implantation, resulting in a cascade of maladaptive gene regulatory networks. Together, these results suggest that distension initiates the upregulation of pathological pathways that may ultimately contribute to bypass graft failure and presents potential early targets warranting investigation for targeted therapies. This work highlights the first applications of single-nuclei and spatial transcriptomic analyses to investigate venous pathologies, underscoring the utility of these methodologies and providing a foundation for future investigations.
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Affiliation(s)
- Marina E. Michaud
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA (M.E.M., M.B., B.E.T., S.S.B., M.K.B.)
| | - Lucas Mota
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center (L.M., J.T., M.C., C.F., L.P.-N., F.W.L., P.L.), Harvard Medical School, Boston, MA
| | - Mojtaba Bakhtiari
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA (M.E.M., M.B., B.E.T., S.S.B., M.K.B.)
| | - Beena E. Thomas
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA (M.E.M., M.B., B.E.T., S.S.B., M.K.B.)
| | - John Tomeo
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center (L.M., J.T., M.C., C.F., L.P.-N., F.W.L., P.L.), Harvard Medical School, Boston, MA
| | - William Pilcher
- Department of Biomedical Engineering, Emory University, Atlanta, GA (W.P., M.K.B.)
| | - Mauricio Contreras
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center (L.M., J.T., M.C., C.F., L.P.-N., F.W.L., P.L.), Harvard Medical School, Boston, MA
| | - Christiane Ferran
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center (L.M., J.T., M.C., C.F., L.P.-N., F.W.L., P.L.), Harvard Medical School, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Center for Vascular Biology Research and the Division of Nephrology (C.F.), Harvard Medical School, Boston, MA
| | - Swati S. Bhasin
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA (M.E.M., M.B., B.E.T., S.S.B., M.K.B.)
- Aflac Cancer and Blood Disorders Center, Children Healthcare of Atlanta, GA (S.S.B., M.K.B.)
| | - Leena Pradhan-Nabzdyk
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center (L.M., J.T., M.C., C.F., L.P.-N., F.W.L., P.L.), Harvard Medical School, Boston, MA
| | - Frank W. LoGerfo
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center (L.M., J.T., M.C., C.F., L.P.-N., F.W.L., P.L.), Harvard Medical School, Boston, MA
| | - Patric Liang
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center (L.M., J.T., M.C., C.F., L.P.-N., F.W.L., P.L.), Harvard Medical School, Boston, MA
| | - Manoj K. Bhasin
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA (M.E.M., M.B., B.E.T., S.S.B., M.K.B.)
- Aflac Cancer and Blood Disorders Center, Children Healthcare of Atlanta, GA (S.S.B., M.K.B.)
- Department of Biomedical Engineering, Emory University, Atlanta, GA (W.P., M.K.B.)
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Michaud ME, Mota L, Bakhtiari M, Thomas BE, Tomeo J, Pilcher W, Contreras M, Ferran C, Bhasin S, Pradhan-Nabzdyk L, LoGerfo FW, Liang P, Bhasin MK. Integrated single-nuclei and spatial transcriptomic analysis reveals propagation of early acute vein harvest and distension injury signaling pathways following arterial implantation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.31.564995. [PMID: 37961724 PMCID: PMC10635041 DOI: 10.1101/2023.10.31.564995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Vein graft failure (VGF) following cardiovascular bypass surgery results in significant patient morbidity and cost to the healthcare system. Vein graft injury can occur during autogenous vein harvest and preparation, as well as after implantation into the arterial system, leading to the development of intimal hyperplasia, vein graft stenosis, and, ultimately, bypass graft failure. While previous studies have identified maladaptive pathways that occur shortly after implantation, the specific signaling pathways that occur during vein graft preparation are not well defined and may result in a cumulative impact on VGF. We, therefore, aimed to elucidate the response of the vein conduit wall during harvest and following implantation, probing the key maladaptive pathways driving graft failure with the overarching goal of identifying therapeutic targets for biologic intervention to minimize these natural responses to surgical vein graft injury. Methods Employing a novel approach to investigating vascular pathologies, we harnessed both single-nuclei RNA-sequencing (snRNA-seq) and spatial transcriptomics (ST) analyses to profile the genomic effects of vein grafts after harvest and distension, then compared these findings to vein grafts obtained 24 hours after carotid-cartoid vein bypass implantation in a canine model (n=4). Results Spatial transcriptomic analysis of canine cephalic vein after initial conduit harvest and distention revealed significant enrichment of pathways (P < 0.05) involved in the activation of endothelial cells (ECs), fibroblasts (FBs), and vascular smooth muscle cells (VSMCs), namely pathways responsible for cellular proliferation and migration and platelet activation across the intimal and medial layers, cytokine signaling within the adventitial layer, and extracellular matrix (ECM) remodeling throughout the vein wall. Subsequent snRNA-seq analysis supported these findings and further unveiled distinct EC and FB subpopulations with significant upregulation (P < 0.00001) of markers related to endothelial injury response and cellular activation of ECs, FBs, and VSMCs. Similarly, in vein grafts obtained 24 hours after arterial bypass, there was an increase in myeloid cell, protomyofibroblast, injury-response EC, and mesenchymal-transitioning EC subpopulations with a concomitant decrease in homeostatic ECs and fibroblasts. Among these markers were genes previously implicated in vein graft injury, including VCAN (versican), FBN1 (fibrillin-1), and VEGFC (vascular endothelial growth factor C), in addition to novel genes of interest such as GLIS3 (GLIS family zinc finger 3) and EPHA3 (ephrin-A3). These genes were further noted to be driving the expression of genes implicated in vascular remodeling and graft failure, such as IL-6, TGFBR1, SMAD4, and ADAMTS9. By integrating the ST and snRNA-seq datasets, we highlighted the spatial architecture of the vein graft following distension, wherein activated and mesenchymal-transitioning ECs, myeloid cells, and FBs were notably enriched in the intima and media of distended veins. Lastly, intercellular communication network analysis unveiled the critical roles of activated ECs, mesenchymal transitioning ECs, protomyofibroblasts, and VSMCs in upregulating signaling pathways associated with cellular proliferation (MDK, PDGF, VEGF), transdifferentiation (Notch), migration (ephrin, semaphorin), ECM remodeling (collagen, laminin, fibronectin), and inflammation (thrombospondin), following distension. Conclusions Vein conduit harvest and distension elicit a prompt genomic response facilitated by distinct cellular subpopulations heterogeneously distributed throughout the vein wall. This response was found to be further exacerbated following vein graft implantation, resulting in a cascade of maladaptive gene regulatory networks. Together, these results suggest that distension initiates the upregulation of pathological pathways that may ultimately contribute to bypass graft failure and presents potential early targets warranting investigation for targeted therapies. This work highlights the first applications of single-nuclei and spatial transcriptomic analyses to investigate venous pathologies, underscoring the utility of these methodologies and providing a foundation for future investigations.
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Affiliation(s)
- Marina E. Michaud
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA
| | - Lucas Mota
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Mojtaba Bakhtiari
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA
| | - Beena E. Thomas
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA
| | - John Tomeo
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - William Pilcher
- Department of Biomedical Engineering, Emory University, Atlanta, GA 30322, USA
| | - Mauricio Contreras
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Christiane Ferran
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Center for Vascular Biology Research and the Division of Nephrology Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Swati Bhasin
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA
- Aflac Cancer and Blood Disorders Center, Children Healthcare of Atlanta, Atlanta, GA
| | - Leena Pradhan-Nabzdyk
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Frank W. LoGerfo
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Patric Liang
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Manoj K. Bhasin
- Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA
- Aflac Cancer and Blood Disorders Center, Children Healthcare of Atlanta, Atlanta, GA
- Department of Biomedical Engineering, Emory University, Atlanta, GA 30322, USA
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Mota L, Zhu M, Li J, Contreras M, Aridi T, Tomeo JN, Stafford A, Mooney DJ, Pradhan-Nabzdyk L, Ferran C, LoGerfo FW, Liang P. Perivascular CLICK-gelatin delivery of thrombospondin-2 small interfering RNA decreases development of intimal hyperplasia after arterial injury. FASEB J 2024; 38:e23321. [PMID: 38031974 PMCID: PMC10726962 DOI: 10.1096/fj.202301359r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/25/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023]
Abstract
Bypass graft failure occurs in 20%-50% of coronary and lower extremity bypasses within the first-year due to intimal hyperplasia (IH). TSP-2 is a key regulatory protein that has been implicated in the development of IH following vessel injury. In this study, we developed a biodegradable CLICK-chemistry gelatin-based hydrogel to achieve sustained perivascular delivery of TSP-2 siRNA to rat carotid arteries following endothelial denudation injury. At 21 days, perivascular application of TSP-2 siRNA embedded hydrogels significantly downregulated TSP-2 gene expression, cellular proliferation, as well as other associated mediators of IH including MMP-9 and VEGF-R2, ultimately resulting in a significant decrease in IH. Our data illustrates the ability of perivascular CLICK-gelatin delivery of TSP-2 siRNA to mitigate IH following arterial injury.
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Affiliation(s)
- Lucas Mota
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
| | - Max Zhu
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
| | - Jennifer Li
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
| | - Mauricio Contreras
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
| | - Tarek Aridi
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
| | - John N. Tomeo
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
| | - Alexander Stafford
- John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge, MA
| | - David J. Mooney
- John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge, MA
| | - Leena Pradhan-Nabzdyk
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
| | - Christiane Ferran
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
- The Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Boston MA
- Division of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston MA
| | - Frank W. LoGerfo
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
| | - Patric Liang
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston MA
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Nakahara T, Yamada M, Yokoyama Y, Yamada Y, Narita K, Imanishi N, Yamazaki M, Shimizu H, Narula J, Jinzaki M. Saphenous vein valve assessment utilizing upright CT to potentially improve graft assessment for bypass surgery. Sci Rep 2021; 11:11602. [PMID: 34078949 PMCID: PMC8172633 DOI: 10.1038/s41598-021-90998-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/04/2021] [Indexed: 11/09/2022] Open
Abstract
Saphenous veins (SVs) are frequently employed as bypass grafts. The SV graft failure is predominantly seen at the valve site. Avoiding valves during vein harvest would help reduce graft failure. We endeavored to detect SV valves, tributaries, and vessel size employing upright computed tomography (CT) for the raw cadaver venous samples and in healthy volunteers. Five cadaver legs were scanned. Anatomical analysis showed 3.0 (IQR: 2.0-3.0) valves and 13.50 (IQR: 10.00-16.25) tributaries. The upright CT completely detected, compared to 2.0 (IQR: 1.5-2.5, p = 0.06) valves and 9.5 (IQR: 7.5-13.0, p = 0.13) tributaries by supine CT. From a total of 190 volunteers, 138 (men:75, women:63) were included. The number of valves from the SF junction to 35 cm were significantly higher in upright CT than in supine CT bilaterally [upright vs. supine, Right: 4 (IQR: 3-5) vs. 2 (IQR:1-2), p < 0.0001, Left: 4 (IQR: 3-5) vs. 2 (IQR: 1-2), p < 0.0001]. The number of tributaries and vessel areas per leg were also higher for upright compared with supine CT. Upright CT enables non-invasive detection of SV valves, tributaries, and vessel size. Although not tested here, it is expected that upright CT may potentially improve graft assessment for bypass surgery.
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Affiliation(s)
- Takehiro Nakahara
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Minoru Yamada
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Yoichi Yokoyama
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Keiichi Narita
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Nobuaki Imanishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masataka Yamazaki
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Shimizu
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Jagat Narula
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan.
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Wang W, Li Y, Wang Q, Cao Y, Wang F, Li W. Identification and Analysis of Differentially Expressed Genes in Human Saphenous Vein Endothelial Cells Overexpressing Domain-Containing mTOR-Interacting Protein (DEPTOR) by RNA-Seq. Med Sci Monit 2019; 25:6965-6971. [PMID: 31525175 PMCID: PMC6761854 DOI: 10.12659/msm.915442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Autologous saphenous vein is the most common choice for coronary artery bypass grafting. This study was conducted to identify and characterize differentially expressed genes (DEGs) induced by overexpressing DEPTOR in human saphenous vein endothelial cells (hsVECs) that might play roles in restenosis. Material/Methods hsVECs isolated from the saphenous veins were transfected with DEPTOR overexpression vector and analyzed for mTOR expression. RNA was prepared from the cells and sequenced using high-throughput sequencing technology (RNA-Seq). The DEGs were analyzed based on enrichment scores in GO terms and KEGG pathways. Results The cells had typical hsVEC morphology and characteristics based on the HE staining and immunohistochemical and immunofluorescence assays. The expression of mTOR increased, and 102 genes were upregulated, and 409 genes were downregulated after DEPTOR overexpression. KEGG analysis showed that the DEGs were mainly enriched in 20 signal pathways, such as Focal adhesion and ECM-receptor interaction pathways. The DEGs were enriched in GO terms such as integrin binding and glycosaminoglycan binding. For cellular components, GO analysis revealed that the DEGs were enriched in main axon, plasma membrane part, cell junction, and proteinaceous extracellular matrix. DEGs included many cytokines, such as bone morphogenetic protein-7, interleukin-8, interleukin-1β, and inhibin, which have important effects on vascular growth and inflammation. Conclusions The overexpression of DEPTOR in hsVECs results in DEGs that are involved in cell proliferation and differentiation, intercellular junction, and extracellular matrix receptor. These findings may provide valuable molecular information for improving venous permeability through manipulation of DEPTOR and related mTOR pathways.
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Affiliation(s)
- Wenjun Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Yiying Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Qun Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Yuanping Cao
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Fudong Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Wan Li
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
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Huynh C, Shih TY, Mammoo A, Samant A, Pathan S, Nelson DW, Ferran C, Mooney D, LoGerfo F, Pradhan-Nabzdyk L. Delivery of targeted gene therapies using a hybrid cryogel-coated prosthetic vascular graft. PeerJ 2019; 7:e7377. [PMID: 31497383 PMCID: PMC6707340 DOI: 10.7717/peerj.7377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/28/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The success of prosthetic vascular grafts in the management of peripheral arterial disease is frequently limited by the development of anastomotic neointimal hyperplasia (ANIH), with the host response to prosthetic grafts beginning soon after implantation. To address this, we combine a platform of polyethylene terephthalate (PET) fabric with an applied cryogel layer containing biologic agents to create a bioactive prosthetic graft system, with the ability to deliver therapeutics targeting modulators of the ANIH-associated transcriptome response, along with antithrombotic agents. METHODS Hybrid graft materials were synthesized by cryopolymerization of methacrylated alginate and heparin onto electrospun (ePET), knitted PET (kPET), or woven PET (wPET). Arg-Gly-Asp (RGD) peptides were added to increase cell adhesion. Scanning electron microscopy (SEM) was used to study the microstructure at 1 day, and 2, 4, and 8 weeks. Physical properties such as swelling ratio, pore connectivity, shape recovery, and stiffness were evaluated. Human aortic endothelial cell (HAoEC) adherence was visualized using confocal microscopy after 24 hours and proliferation was evaluated with a resazurin-based assay for 7 days. Confocal microscopy was used to assess delivery of adeno-associated virus (AAV-GFP) after incubation of hybrid grafts with HAoECs. Heparin activity of the materials was measured using an anti-Xa assay. RESULTS SEM demonstrated large interconnected pores throughout the entire structure for all graft types, with minimal degradation of the cryogel after 8 weeks. Hybrid materials showed a trend towards increased shape recovery, increased stiffness, decreased swelling ratio, and no difference in pore connectivity. HAoECs incorporated, adhered, and proliferated over 7 days on all materials. HAoECs were successfully transduced with AAV-GFP from the hybrid graft materials. Anti-Xa assay confirmed continued activity of heparin from all materials for over 7 days. CONCLUSIONS We have developed a bioactive prosthetic graft system with a cryogel coating capable of delivering biologic agents with antithrombotic activity. By applying the cryogel and selected agents onto PET prior to graft implantation, this study sets the stage for the system to be individualized and tailored to the patient, with bioengineering and targeted gene therapy strategies dovetailing to create an improved prosthetic graft adaptable to emerging knowledge and technologies.
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Affiliation(s)
- Cindy Huynh
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Surgery, State University of New York (SUNY), Syracuse, NY, United States of America
| | - Ting-Yu Shih
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States of America
| | - Alexander Mammoo
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
- Division of Pharmacology, Department of Pharmaceutical Biosciences, Uppsala Universitet, Uppsala, Sweden
| | - Amruta Samant
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Saif Pathan
- BioSurfaces, Inc, Ashland, MA, United States of America
| | | | - Christiane Ferran
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - David Mooney
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States of America
| | - Frank LoGerfo
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Leena Pradhan-Nabzdyk
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
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8
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Rehfuss JP, DeSart KM, Rozowsky JM, O'Malley KA, Moldawer LL, Baker HV, Wang Y, Wu R, Nelson PR, Berceli SA. Hyperacute Monocyte Gene Response Patterns Are Associated With Lower Extremity Vein Bypass Graft Failure. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2019. [PMID: 29530886 DOI: 10.1161/circgen.117.001970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Despite being the definitive treatment for lower extremity peripheral arterial disease, vein bypass grafts fail in half of all cases. Early repair mechanisms after implantation, governed largely by the immune environment, contribute significantly to long-term outcomes. The current study investigates the early response patterns of circulating monocytes as a determinant of graft outcome. METHODS In 48 patients undergoing infrainguinal vein bypass grafting, the transcriptomes of circulating monocytes were analyzed preoperatively and at 1, 7, and 28 days post-operation. RESULTS Dynamic clustering algorithms identified 50 independent gene response patterns. Three clusters (64 genes) were differentially expressed, with a hyperacute response pattern defining those patients with failed versus patent grafts 12 months post-operation. A second independent data set, comprised of 96 patients subjected to major trauma, confirmed the value of these 64 genes in predicting an uncomplicated versus complicated recovery. Causal network analysis identified 8 upstream elements that regulate these mediator genes, and Bayesian analysis with a priori knowledge of the biological interactions was integrated to create a functional network describing the relationships among the regulatory elements and downstream mediator genes. Linear models predicted the removal of either STAT3 (signal transducer and activator of transcription 3) or MYD88 (myeloid differentiation primary response 88) to shift mediator gene expression levels toward those seen in successful grafts. CONCLUSIONS A novel combination of dynamic gene clustering, linear models, and Bayesian network analysis has identified a core set of regulatory genes whose manipulations could migrate vein grafts toward a more favorable remodeling phenotype.
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Affiliation(s)
- Jonathan P Rehfuss
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Kenneth M DeSart
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Jared M Rozowsky
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Kerri A O'Malley
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Lyle L Moldawer
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Henry V Baker
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Yaqun Wang
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Rongling Wu
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Peter R Nelson
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.)
| | - Scott A Berceli
- From the Malcom Randall Veterans Affairs Medical Center, Gainesville, FL (J.P.R., K.M.D., J.M.R., K.A.O., S.A.B.); Department of Surgery (J.P.R., K.M.D., J.M.R., K.A.O., L.L.M., S.A.B.) and Department of Molecular Genetics and Microbiology (H.V.B.), University of Florida, Gainesville; Department of Biostatistics, Rutgers University, New Brunswick, NJ (Y.W.); Center for Statistical Genetics, Pennsylvania State University, Hershey (R.W.); and Department of Surgery, University of South Florida, Tampa (P.R.N.).
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9
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Lee KW, Gade PS, Dong L, Zhang Z, Aral AM, Gao J, Ding X, Stowell CE, Nisar MU, Kim K, Reinhardt DP, Solari MG, Gorantla VS, Robertson AM, Wang Y. A biodegradable synthetic graft for small arteries matches the performance of autologous vein in rat carotid arteries. Biomaterials 2018; 181:67-80. [DOI: 10.1016/j.biomaterials.2018.07.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 12/17/2022]
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10
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Liu Q, Yin X, Li M, Wan L, Liu L, Zhong X, Liu Z, Wang Q. Identification of potential crucial genes and pathways associated with vein graft restenosis based on gene expression analysis in experimental rabbits. PeerJ 2018; 6:e4704. [PMID: 29785339 PMCID: PMC5960261 DOI: 10.7717/peerj.4704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/15/2018] [Indexed: 11/27/2022] Open
Abstract
Occlusive artery disease (CAD) is the leading cause of death worldwide. Bypass graft surgery remains the most prevalently performed treatment for occlusive arterial disease, and veins are the most frequently used conduits for surgical revascularization. However, the clinical efficacy of bypass graft surgery is highly affected by the long-term potency rates of vein grafts, and no optimal treatments are available for the prevention of vein graft restenosis (VGR) at present. Hence, there is an urgent need to improve our understanding of the molecular mechanisms involved in mediating VGR. The past decade has seen the rapid development of genomic technologies, such as genome sequencing and microarray technologies, which will provide novel insights into potential molecular mechanisms involved in the VGR program. Ironically, high throughput data associated with VGR are extremely scarce. The main goal of the current study was to explore potential crucial genes and pathways associated with VGR and to provide valid biological information for further investigation of VGR. A comprehensive bioinformatics analysis was performed using high throughput gene expression data. Differentially expressed genes (DEGs) were identified using the R and Bioconductor packages. After functional enrichment analysis of the DEGs, protein–protein interaction (PPI) network and sub-PPI network analyses were performed. Finally, nine potential hub genes and fourteen pathways were identified. These hub genes may interact with each other and regulate the VGR program by modulating the cell cycle pathway. Future studies focusing on revealing the specific cellular and molecular mechanisms of these key genes and pathways involved in regulating the VGR program may provide novel therapeutic targets for VGR inhibition.
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Affiliation(s)
- Qiang Liu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Xiujie Yin
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Mingzhu Li
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Li Wan
- Department of Cardiovascular Surgery, Cardiovascular Research Institute Laboratory, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Liqiao Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi Province, China
| | - Xiang Zhong
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Zhuoqi Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi Province, China
| | - Qun Wang
- Department of Cardiovascular Surgery, Cardiovascular Research Institute Laboratory, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
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11
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Malik S, Sadhu S, Elesela S, Pandey RP, Chawla AS, Sharma D, Panda L, Rathore D, Ghosh B, Ahuja V, Awasthi A. Transcription factor Foxo1 is essential for IL-9 induction in T helper cells. Nat Commun 2017; 8:815. [PMID: 28993609 PMCID: PMC5634439 DOI: 10.1038/s41467-017-00674-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 07/16/2017] [Indexed: 11/09/2022] Open
Abstract
Interleukin 9 (IL-9)-producing helper T (Th9) cells have a crucial function in allergic inflammation, autoimmunity, immunity to extracellular pathogens and anti-tumor immune responses. In addition to Th9, Th2, Th17 and Foxp3+ regulatory T (Treg) cells produce IL-9. A transcription factor that is critical for IL-9 induction in Th2, Th9 and Th17 cells has not been identified. Here we show that the forkhead family transcription factor Foxo1 is required for IL-9 induction in Th9 and Th17 cells. We further show that inhibition of AKT enhances IL-9 induction in Th9 cells while it reciprocally regulates IL-9 and IL-17 in Th17 cells via Foxo1. Mechanistically, Foxo1 binds and transactivates IL-9 and IRF4 promoters in Th9, Th17 and iTreg cells. Furthermore, loss of Foxo1 attenuates IL-9 in mouse and human Th9 and Th17 cells, and ameliorates allergic inflammation in asthma. Our findings thus identify that Foxo1 is essential for IL-9 induction in Th9 and Th17 cells.The transcription factor Foxo1 can control regulatory T cell and Th1 function. Here the authors show that Foxo1 is also critical for IL-9 production by Th9 cells and other IL-9-producing cells.
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Affiliation(s)
- Sakshi Malik
- Center for Human Microbial Ecology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone Gurgaon-Faridabad Expressway, Faridabad, Haryana, 121 001, India
| | - Srikanth Sadhu
- Center for Human Microbial Ecology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone Gurgaon-Faridabad Expressway, Faridabad, Haryana, 121 001, India
| | - Srikanth Elesela
- Center for Human Microbial Ecology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone Gurgaon-Faridabad Expressway, Faridabad, Haryana, 121 001, India
| | - Ramendra Pati Pandey
- Center for Human Microbial Ecology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone Gurgaon-Faridabad Expressway, Faridabad, Haryana, 121 001, India
| | | | - Deepak Sharma
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, India
| | - Lipsa Panda
- Institute of Genomics and Integrative Biology (IGIB), Mall Road, New Delhi, 110007, India
| | - Deepak Rathore
- Center for Human Microbial Ecology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone Gurgaon-Faridabad Expressway, Faridabad, Haryana, 121 001, India
| | - Balram Ghosh
- Institute of Genomics and Integrative Biology (IGIB), Mall Road, New Delhi, 110007, India
| | - Vineet Ahuja
- Department of Gastroenterology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India
| | - Amit Awasthi
- Center for Human Microbial Ecology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, 3rd Milestone Gurgaon-Faridabad Expressway, Faridabad, Haryana, 121 001, India.
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12
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Nabzdyk CS, Pradhan-Nabzdyk L, LoGerfo FW. RNAi therapy to the wall of arteries and veins: anatomical, physiologic, and pharmacological considerations. J Transl Med 2017; 15:164. [PMID: 28754174 PMCID: PMC5534068 DOI: 10.1186/s12967-017-1270-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/20/2017] [Indexed: 12/02/2022] Open
Abstract
Background Cardiovascular disease remains a major health care challenge. The knowledge about the underlying mechanisms of the respective vascular disease etiologies has greatly expanded over the last decades. This includes the contribution of microRNAs, endogenous non-coding RNA molecules, known to vastly influence gene expression. In addition, short interference RNA has been established as a mechanism to temporarily affect gene expression. This review discusses challenges relating to the design of a RNA interference therapy strategy for the modulation of vascular disease. Despite advances in medical and surgical therapies, atherosclerosis (ATH), aortic aneurysms (AA) are still associated with high morbidity and mortality. In addition, intimal hyperplasia (IH) remains a leading cause of late vein and prosthetic bypass graft failure. Pathomechanisms of all three entities include activation of endothelial cells (EC) and dedifferentiation of vascular smooth muscle cells (VSMC). RNA interference represents a promising technology that may be utilized to silence genes contributing to ATH, AA or IH. Successful RNAi delivery to the vessel wall faces multiple obstacles. These include the challenge of cell specific, targeted delivery of RNAi, anatomical barriers such as basal membrane, elastic laminae in arterial walls, multiple layers of VSMC, as well as adventitial tissues. Another major decision point is the route of delivery and potential methods of transfection. A plethora of transfection reagents and adjuncts have been described with varying efficacies and side effects. Timing and duration of RNAi therapy as well as target gene choice are further relevant aspects that need to be addressed in a temporo-spatial fashion. Conclusions While multiple preclinical studies reported encouraging results of RNAi delivery to the vascular wall, it remains to be seen if a single target can be sufficient to the achieve clinically desirable changes in the injured vascular wall in humans. It might be necessary to achieve simultaneous and/or sequential silencing of multiple, synergistically acting target genes. Some advances in cell specific RNAi delivery have been made, but a reliable vascular cell specific transfection strategy is still missing. Also, off-target effects of RNAi and unwanted effects of transfection agents on gene expression are challenges to be addressed. Close collaborative efforts between clinicians, geneticists, biologists, and chemical and medical engineers will be needed to provide tailored therapeutics for the various types of vascular diseases.
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Affiliation(s)
- Christoph S Nabzdyk
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Frank W. LoGerfo Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA, 02215, USA
| | - Leena Pradhan-Nabzdyk
- Frank W. LoGerfo Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA, 02215, USA.
| | - Frank W LoGerfo
- Frank W. LoGerfo Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA, 02215, USA
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13
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Jiao Y, Li G, Korneva A, Caulk AW, Qin L, Bersi MR, Li Q, Li W, Mecham RP, Humphrey JD, Tellides G. Deficient Circumferential Growth Is the Primary Determinant of Aortic Obstruction Attributable to Partial Elastin Deficiency. Arterioscler Thromb Vasc Biol 2017; 37:930-941. [PMID: 28254817 DOI: 10.1161/atvbaha.117.309079] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/17/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Williams syndrome is characterized by obstructive aortopathy attributable to heterozygous loss of ELN, the gene encoding elastin. Lesions are thought to result primarily from excessive smooth muscle cell (SMC) proliferation and consequent medial expansion, although an initially smaller caliber and increased stiffness of the aorta may contribute to luminal narrowing. The relative contributions of such abnormalities to the obstructive phenotype had not been defined. APPROACH AND RESULTS We quantified determinants of luminal stenosis in thoracic aortas of Eln-/- mice incompletely rescued by human ELN. Moderate obstruction was largely because of deficient circumferential growth, most prominently of ascending segments, despite increased axial growth. Medial thickening was evident in these smaller diameter elastin-deficient aortas, with medial area similar to that of larger diameter control aortas. There was no difference in cross-sectional SMC number between mutant and wild-type genotypes at multiple stages of postnatal development. Decreased elastin content was associated with medial fibrosis and reduced aortic distensibility because of increased structural stiffness but preserved material stiffness. Elastin-deficient SMCs exhibited greater contractile-to-proliferative phenotypic modulation in vitro than in vivo. We confirmed increased medial collagen without evidence of increased medial area or SMC number in a small ascending aorta with thickened media of a Williams syndrome subject. CONCLUSIONS Deficient circumferential growth is the predominant mechanism for moderate obstructive aortic disease resulting from partial elastin deficiency. Our findings suggest that diverse aortic manifestations in Williams syndrome result from graded elastin content, and SMC hyperplasia causing medial expansion requires additional elastin loss superimposed on ELN haploinsufficiency.
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Affiliation(s)
- Yang Jiao
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Guangxin Li
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Arina Korneva
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Alexander W Caulk
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Lingfeng Qin
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Matthew R Bersi
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Qingle Li
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Wei Li
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Robert P Mecham
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - Jay D Humphrey
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.)
| | - George Tellides
- From the Department of Surgery, Yale University School of Medicine, New Haven, CT (Y.J., G.L., L.Q., Q.L., W.L., G.T.); Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China (Y.J., Q.L., W.L.); Department of Vascular Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China (G.L.); Department of Biomedical Engineering, Yale University, New Haven, CT (A.K., A.W.C., M.R.B., J.D.H.); Department of Cell Biology, Washington University School of Medicine, St Louis, MO (R.P.M.); Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine (J.D.H., G.T.); and Veterans Affairs Connecticut Healthcare System, West Haven (G.T.).
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14
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Extracellular Vesicles Derived from Adipose Mesenchymal Stem Cells Regulate the Phenotype of Smooth Muscle Cells to Limit Intimal Hyperplasia. Cardiovasc Drugs Ther 2017; 30:111-8. [PMID: 26650931 DOI: 10.1007/s10557-015-6630-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) play important roles in the reduction of inflammation in multiple disease models. However, their role in vein graft (VG) remodeling is undefined. We aimed to investigate the effect of EVs from adipose MSCs (ADMSC-EVs) on VG intimal hyperplasia and to explore the possible mechanisms. METHODS After generation and characterization of control-EVs and ADMSC-EVs in vitro, we investigated their effect on the proliferation and migration of vascular smooth muscle cells (VSMCs) in vitro. Next, we established a mouse model of VG transplantation. Mice underwent surgery and received control-EVs or ADMSC-EVs by intraperitoneal injection every other day for 20 days. VG remodeling was evaluated after 4 weeks. We also assessed the effect of ADMSC-EVs on macrophage migration and inflammatory cytokine expression. RESULTS Significant inhibitory effects of ADMSC-EVs on in vitro VSMC proliferation (p < 0.05) and migration (p < 0.05) were observed compared with control-EVs. The extent of intimal hyperplasia was significantly decreased in ADMSC-EV-treated mice compared with control-EV-treated mice (26 ± 8.4 vs. 45 ± 9.0 μm, p < 0.05). A reduced presence of macrophages was observed in ADMSC-EV-treated mice (p < 0.05). Significantly decreased expression of inflammatory cytokines interleukin (IL)-6 and monocyte chemoattractant protein-1 (MCP-1) was also found in the ADMSC-EV-treated group (both p < 0.05). In addition, phosphorylation of Akt, Erk1/2, and p38 in VGs was decreased in the ADMSC-EV-treated group. CONCLUSIONS We demonstrated that ADMSC-EVs exert an inhibitory effect on VG neointima formation by regulating VSMC proliferation and migration, macrophage migration, inflammatory cytokine expression, and the related signaling pathways.
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15
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Boire TC, Balikov DA, Lee Y, Guth CM, Cheung-Flynn J, Sung HJ. Biomaterial-Based Approaches to Address Vein Graft and Hemodialysis Access Failures. Macromol Rapid Commun 2016; 37:1860-1880. [PMID: 27673474 PMCID: PMC5156561 DOI: 10.1002/marc.201600412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/15/2016] [Indexed: 12/19/2022]
Abstract
Veins used as grafts in heart bypass or as access points in hemodialysis exhibit high failure rates, thereby causing significant morbidity and mortality for patients. Interventional or revisional surgeries required to correct these failures have been met with limited success and exorbitant costs, particularly for the US Centers for Medicare & Medicaid Services. Vein stenosis or occlusion leading to failure is primarily the result of neointimal hyperplasia. Systemic therapies have achieved little long-term success, indicating the need for more localized, sustained, biomaterial-based solutions. Numerous studies have demonstrated the ability of external stents to reduce neointimal hyperplasia. However, successful results from animal models have failed to translate to the clinic thus far, and no external stent is currently approved for use in the US to prevent vein graft or hemodialysis access failures. This review discusses current progress in the field, design considerations, and future perspectives for biomaterial-based external stents. More comparative studies iteratively modulating biomaterial and biomaterial-drug approaches are critical in addressing mechanistic knowledge gaps associated with external stent application to the arteriovenous environment. Addressing these gaps will ultimately lead to more viable solutions that prevent vein graft and hemodialysis access failures.
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Affiliation(s)
- Timothy C Boire
- Department of Biomedical Engineering, Vanderbilt University, 37235, Nashville, TN, USA
| | - Daniel A Balikov
- Department of Biomedical Engineering, Vanderbilt University, 37235, Nashville, TN, USA
| | - Yunki Lee
- Department of Biomedical Engineering, Vanderbilt University, 37235, Nashville, TN, USA
| | - Christy M Guth
- Division of Vascular Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | - Joyce Cheung-Flynn
- Division of Vascular Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | - Hak-Joon Sung
- Department of Biomedical Engineering, Vanderbilt University, 37235, Nashville, TN, USA
- Severance Biomedical Science Institute, College of Medicine, Yonsei University, Seoul, 120-752, Republic of Korea
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16
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Bodewes TCF, Johnson JM, Auster M, Huynh C, Muralidharan S, Contreras M, LoGerfo FW, Pradhan-Nabzdyk L. Intraluminal delivery of thrombospondin-2 small interfering RNA inhibits the vascular response to injury in a rat carotid balloon angioplasty model. FASEB J 2016; 31:109-119. [PMID: 27671229 DOI: 10.1096/fj.201600501r] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 09/16/2016] [Indexed: 01/06/2023]
Abstract
In an effort to inhibit the response to vascular injury that leads to intimal hyperplasia, this study investigated the in vivo efficacy of intraluminal delivery of thrombospondin-2 (TSP-2) small interfering RNA (siRNA). Common carotid artery (CCA) balloon angioplasty injury was performed in rats. Immediately after denudation, CCA was transfected intraluminally (15 min) with one of the following: polyethylenimine (PEI)+TSP-2 siRNA, saline, PEI only, or PEI+control siRNA. CCA was analyzed at 24 h or 21 d by using quantitative real-time PCR and immunohistochemistry. TSP-2 gene and protein expression were significantly up-regulated after endothelial denudation at 24 h and 21 d compared with contralateral untreated, nondenuded CCA. Treatment with PEI+TSP-2 siRNA significantly suppressed TSP-2 gene expression (3.1-fold) at 24 h and TSP-2 protein expression, cell proliferation, and collagen deposition up to 21 d. These changes could be attributed to changes in TGF-β and matrix metalloproteinase-9, the downstream effectors of TSP-2. TSP-2 knockdown induced anti-inflammatory M2 macrophage polarization at 21 d; however, it did not significantly affect intima/media ratios. In summary, these data demonstrate effective siRNA transfection of the injured arterial wall and provide a clinically effective and translationally applicable therapeutic strategy that involves nonviral siRNA delivery to ameliorate the response to vascular injury.-Bodewes, T. C. F., Johnson, J. M., Auster, M., Huynh, C., Muralidharan, S., Contreras, M., LoGerfo, F. W., Pradhan-Nabzdyk, L. Intraluminal delivery of thrombospondin-2 small interfering RNA inhibits the vascular response to injury in a rat carotid balloon angioplasty model.
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Affiliation(s)
- Thomas C F Bodewes
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Department of Vascular Surgery, University Medical Center, Utrecht, The Netherlands; and
| | - Joel M Johnson
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Auster
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Cindy Huynh
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Department of Surgery, State University of New York (SUNY) Upstate Medical University, Syracuse, New York, USA
| | - Sriya Muralidharan
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Mauricio Contreras
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Frank W LoGerfo
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Leena Pradhan-Nabzdyk
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA;
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17
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Wise ES, Hocking KM, Luo W, Feldman DL, Song J, Komalavilas P, Cheung-Flynn J, Brophy CM. Traditional graft preparation decreases physiologic responses, diminishes viscoelasticity, and reduces cellular viability of the conduit: A porcine saphenous vein model. Vasc Med 2016; 21:413-421. [PMID: 27216870 DOI: 10.1177/1358863x16649040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Traditional methods of intraoperative human saphenous vein preparation for use as bypass grafts can be deleterious to the conduit. The purpose of this study was to characterize acute graft preparation injury, and to mitigate this harm via an improved preparation technique. Porcine saphenous veins were surgically harvested (unprepared controls, UnP) and prepared using traditional (TraP) and improved preparations (ImP). The TraP used unregulated radial distension, marking with a surgical skin marker and preservation in heparinized normal saline. ImP used pressure-regulated distension, brilliant blue FCF-based pen marking and preservation in heparinized Plasma-Lyte A. Rings from each preparation were suspended in a muscle bath for characterization of physiologic responses to vasoactive agents and viscoelasticity. Cellular viability was assessed using the methyl thiazolyl tetrazolium (MTT) assay and the terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay for apoptosis. Contractile responses to potassium chloride (110 mM) and phenylephrine (10 µM), and endothelial-dependent and independent vasodilatory responses to carbachol (0.5 µM) and sodium nitroprusside (1 µM), respectively, were decreased in TraP tissues compared to both UnP and ImP tissues (p ⩽ 0.05). TraP tissues demonstrated diminished viscoelasticity relative to UnP and ImP tissues (p ⩽ 0.05), and reduced cellular viability relative to UnP control (p ⩽ 0.01) by the MTT assay. On the TUNEL assay, TraP tissues demonstrated a greater degree of apoptosis relative to UnP and ImP tissues (p ⩽ 0.01). In conclusion, an improved preparation technique prevents vascular graft smooth muscle and endothelial injury observed in tissues prepared using a traditional approach.
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Affiliation(s)
- Eric S Wise
- Department of Surgery, Vanderbilt University, Nashville, TN, USA
| | - Kyle M Hocking
- Department of Surgery, Vanderbilt University, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Weifeng Luo
- Department of Surgery, Vanderbilt University, Nashville, TN, USA
| | - Daniel L Feldman
- Department of Surgery, Vanderbilt University, Nashville, TN, USA
| | - Jun Song
- Department of Surgery, Vanderbilt University, Nashville, TN, USA
| | - Padmini Komalavilas
- Department of Surgery, Vanderbilt University, Nashville, TN, USA.,VA Tennessee Valley Healthcare System, Nashville, TN, USA
| | | | - Colleen M Brophy
- Department of Surgery, Vanderbilt University, Nashville, TN, USA.,VA Tennessee Valley Healthcare System, Nashville, TN, USA
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18
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Perry CJ, Blake P, Buettner C, Papavassiliou E, Schain AJ, Bhasin MK, Burstein R. Upregulation of inflammatory gene transcripts in periosteum of chronic migraineurs: Implications for extracranial origin of headache. Ann Neurol 2016; 79:1000-13. [PMID: 27091721 DOI: 10.1002/ana.24665] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/29/2016] [Accepted: 04/07/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Chronic migraine (CM) is often associated with chronic tenderness of pericranial muscles. A distinct increase in muscle tenderness prior to onset of occipital headache that eventually progresses into a full-blown migraine attack is common. This experience raises the possibility that some CM attacks originate outside the cranium. The objective of this study was to determine whether there are extracranial pathophysiologies in these headaches. METHODS We biopsied and measured the expression of gene transcripts (mRNA) encoding proteins that play roles in immune and inflammatory responses in affected (ie, where the head hurts) calvarial periosteum of (1) patients whose CMs are associated with muscle tenderness and (2) patients with no history of headache. RESULTS Expression of proinflammatory genes (eg, CCL8, TLR2) in the calvarial periosteum significantly increased in CM patients attesting to muscle tenderness, whereas expression of genes that suppress inflammation and immune cell differentiation (eg, IL10RA, CSF1R) decreased. INTERPRETATION Because the upregulated genes were linked to activation of white blood cells, production of cytokines, and inhibition of NF-κB, and the downregulated genes were linked to prevention of macrophage activation and cell lysis, we suggest that the molecular environment surrounding periosteal pain fibers is inflamed and in turn activates trigeminovascular nociceptors that reach the affected periosteum through suture branches of intracranial meningeal nociceptors and/or somatic branches of the occipital nerve. This study provides the first set of evidence for localized extracranial pathophysiology in CM. Ann Neurol 2016;79:1000-1013.
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Affiliation(s)
| | - Pamela Blake
- Headache Center of Greater Heights, Memorial Hermann Greater Heights Hospital, Houston, TX
| | - Catherine Buettner
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | - Efstathios Papavassiliou
- Harvard Medical School, Boston, MA.,Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Aaron J Schain
- Harvard Medical School, Boston, MA.,Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA
| | - Manoj K Bhasin
- Harvard Medical School, Boston, MA.,Division of Genomics, Proteomics, Bioinformatics, and Systems Biology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Rami Burstein
- Harvard Medical School, Boston, MA.,Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA
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19
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Wong DJ, Lu DY, Protack CD, Kuwahara G, Bai H, Sadaghianloo N, Tellides G, Dardik A. Ephrin type-B receptor 4 activation reduces neointimal hyperplasia in human saphenous vein in vitro. J Vasc Surg 2016; 63:795-804. [PMID: 25446283 PMCID: PMC4409444 DOI: 10.1016/j.jvs.2014.09.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/24/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Vein bypass is an essential therapy for patients with advanced peripheral and coronary artery disease despite development of neointimal hyperplasia. We have shown that stimulation of the receptor tyrosine kinase ephrin type-B receptor 4 (Eph-B4) with its ligand ephrin-B2 prevents neointimal hyperplasia in murine vein grafts. This study determines whether Eph-B4 in adult human veins is capable of phosphorylation and activation of downstream signaling pathways, as well as functional to release nitric oxide (NO) and prevent neointimal hyperplasia in vitro. METHODS Discarded human saphenous veins were taken from the operating room and placed in organ culture without or with ephrin-B2/Fc (2 μg/mL) for 14 days, and the neointima/media ratio was measured in matched veins. Primary human umbilical vein endothelial cells were treated with ephrin-B2/Fc (2 μg/mL) and examined with quantitative polymerase chain reaction, Western blot, immunoassays, and for release of NO. Ephrin-B2/Fc (2 μg/mL) was placed on the adventitia of saphenous veins treated with arterial shear stress for 24 hours in a bioreactor and activated Eph-B4 examined with immunofluorescence. RESULTS The baseline intima/media ratio in saphenous vein rings was 0.456 ± 0.097, which increased to 0.726 ± 0.142 in untreated veins after 14 days in organ culture but only to 0.630 ± 0.132 in veins treated with ephrin-B2/Fc (n = 19, P = .017). Ephrin-B2/Fc stimulated Akt, endothelial NO synthase and caveolin-1 phosphorylation, and NO release (P = .007) from human umbilical vein endothelial cells (n = 6). Ephrin-B2/Fc delivered to the adventitia stimulated endothelial Eph-B4 phosphorylation after 24 hours of arterial stress in a bioreactor (n = 3). CONCLUSIONS Eph-B4 is present and functional in adult human saphenous veins, with intact downstream signaling pathways capable of NO release and prevention of neointimal hyperplasia in vitro. Adventitial delivery of ephrin-B2/Fc activates endothelial Eph-B4 in saphenous veins treated with arterial shear stress in vitro. These results suggest that stimulation of Eph-B4 function may be a candidate strategy for translation to human clinical trials designed to inhibit venous neointimal hyperplasia.
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Affiliation(s)
- Daniel J Wong
- Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Daniel Y Lu
- Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Clinton D Protack
- Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Go Kuwahara
- Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Hualong Bai
- Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Nirvana Sadaghianloo
- Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - George Tellides
- Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn; Department of Surgery, VA Connecticut Healthcare System, West Haven, Conn
| | - Alan Dardik
- Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn; Department of Surgery, VA Connecticut Healthcare System, West Haven, Conn.
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20
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Yu D, Makkar G, Strickland DK, Blanpied TA, Stumpo DJ, Blackshear PJ, Sarkar R, Monahan TS. Myristoylated Alanine-Rich Protein Kinase Substrate (MARCKS) Regulates Small GTPase Rac1 and Cdc42 Activity and Is a Critical Mediator of Vascular Smooth Muscle Cell Migration in Intimal Hyperplasia Formation. J Am Heart Assoc 2015; 4:e002255. [PMID: 26450120 PMCID: PMC4845127 DOI: 10.1161/jaha.115.002255] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Transcription of the myristoylated alanine-rich C kinase substrate (MARCKS) is upregulated in animal models of intimal hyperplasia. MARCKS knockdown inhibits vascular smooth muscle cell (VSMC) migration in vitro; however, the mechanism is as yet unknown. We sought to elucidate the mechanism of MARCKS-mediated motility and determine whether MARCKS knockdown reduces intimal hyperplasia formation in vivo. METHODS AND RESULTS MARCKS knockdown blocked platelet-derived growth factor (PDGF)-induced translocation of cortactin to the cell cortex, impaired both lamellipodia and filopodia formation, and attenuated motility of human coronary artery smooth muscle cells (CASMCs). Activation of the small GTPases, Rac1 and Cdc42, was prevented by MARCKS knockdown. Phosphorylation of MARCKS resulted in a transient shift of MARCKS from the plasma membrane to the cytosol. MARCKS knockdown significantly decreased membrane-associated phosphatidylinositol 4,5-bisphosphate (PIP2) levels. Cotransfection with an intact, unphosphorylated MARCKS, which has a high binding affinity for PIP2, restored membrane-associated PIP2 levels and was indispensable for activation of Rac1 and Cdc42 and, ultimately, VSMC migration. Overexpression of MARCKS in differentiated VSMCs increased membrane PIP2 abundance, Rac1 and Cdc42 activity, and cell motility. MARCKS protein was upregulated early in the development of intimal hyperplasia in the murine carotid ligation model. Decreased MARKCS expression, but not total knockdown, attenuated intimal hyperplasia formation. CONCLUSIONS MARCKS upregulation increases VSMC motility by activation of Rac1 and Cdc42. These effects are mediated by MARCKS sequestering PIP2 at the plasma membrane. This study delineates a novel mechanism for MARCKS-mediated VSMC migration and supports the rational for MARCKS knockdown to prevent intimal hyperplasia.
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Affiliation(s)
- Dan Yu
- Department of Surgery, Veterans Affairs Medical Center, Baltimore, MD (D.Y., T.S.M.) Department of Surgery, University of Maryland School of Medicine, Baltimore, MD (D.Y., G.M., D.K.S., R.S., T.S.M.) Center for Vascular and Inflammatory Disease, University of Maryland School of Medicine, Baltimore, MD (D.Y., D.K.S., R.S., T.S.M.)
| | - George Makkar
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD (D.Y., G.M., D.K.S., R.S., T.S.M.)
| | - Dudley K Strickland
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD (D.Y., G.M., D.K.S., R.S., T.S.M.) Department of Physiology, University of Maryland School of Medicine, Baltimore, MD (D.K.S., T.A.B., R.S.) Center for Vascular and Inflammatory Disease, University of Maryland School of Medicine, Baltimore, MD (D.Y., D.K.S., R.S., T.S.M.)
| | - Thomas A Blanpied
- Department of Physiology, University of Maryland School of Medicine, Baltimore, MD (D.K.S., T.A.B., R.S.)
| | - Deborah J Stumpo
- The Signal Transduction Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC (D.J.S., P.J.B.)
| | - Perry J Blackshear
- The Signal Transduction Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC (D.J.S., P.J.B.)
| | - Rajabrata Sarkar
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD (D.Y., G.M., D.K.S., R.S., T.S.M.) Department of Physiology, University of Maryland School of Medicine, Baltimore, MD (D.K.S., T.A.B., R.S.) Center for Vascular and Inflammatory Disease, University of Maryland School of Medicine, Baltimore, MD (D.Y., D.K.S., R.S., T.S.M.)
| | - Thomas S Monahan
- Department of Surgery, Veterans Affairs Medical Center, Baltimore, MD (D.Y., T.S.M.) Department of Surgery, University of Maryland School of Medicine, Baltimore, MD (D.Y., G.M., D.K.S., R.S., T.S.M.) Center for Vascular and Inflammatory Disease, University of Maryland School of Medicine, Baltimore, MD (D.Y., D.K.S., R.S., T.S.M.)
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21
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Pradhan-Nabzdyk L, Huang C, LoGerfo FW, Nabzdyk CS. Current siRNA targets in the prevention and treatment of intimal hyperplasia. DISCOVERY MEDICINE 2014; 18:125-132. [PMID: 25227753 PMCID: PMC4265021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Intimal hyperplasia (IH) is the leading cause of late vein and prosthetic bypass graft failure. Injury at the time of graft implantation leading to the activation of endothelial cells and dedifferentiation of vascular smooth muscle cells to a synthetic phenotype are known causes of IH. Prior attempts to develop therapy to mitigate these cellular changes to prevent IH and graft failure have failed. Small interfering RNA (siRNA) mediated targeted gene silencing is a promising tool to prevent IH. Several studies have been performed in this direction to target genes that are involved in IH. In this review we discuss siRNA targets that are being investigated for prevention and treatment of IH.
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Affiliation(s)
- Leena Pradhan-Nabzdyk
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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22
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Pradhan-Nabzdyk L, Huang C, LoGerfo FW, Nabzdyk CS. Current siRNA targets in atherosclerosis and aortic aneurysm. DISCOVERY MEDICINE 2014; 17:233-246. [PMID: 24882715 PMCID: PMC4295203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Atherosclerosis (ATH) and aortic aneurysms (AA) remain challenging chronic diseases that confer high morbidity and mortality despite advances in medical, interventional, and surgical care. RNA interference represents a promising technology that may be utilized to silence genes contributing to ATH and AA. Despite positive results in preclinical and some clinical feasibility studies, challenges such as target/sequence validation, tissue specificity, transfection efficiency, and mitigation of unwanted off-target effects remain to be addressed. In this review the most current targets and some novel approaches in siRNA delivery are being discussed. Due to the plethora of investigated targets, only studies published between 2010 and 2014 were included.
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Affiliation(s)
- Leena Pradhan-Nabzdyk
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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23
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Pelham CJ, Agrawal DK. Emerging roles for triggering receptor expressed on myeloid cells receptor family signaling in inflammatory diseases. Expert Rev Clin Immunol 2013; 10:243-56. [PMID: 24325404 DOI: 10.1586/1744666x.2014.866519] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Innate immune receptors represent important therapeutic targets for inflammatory disorders. In particular, the Toll-like receptor (TLR) family has emerged as a promoter of chronic inflammation that contributes to obesity, insulin resistance and atherosclerosis. Importantly, triggering receptor expressed on myeloid cells-1 (TREM-1) has been characterized as an 'amplifier' of TLR2 and TLR4 signaling. TREM-1- and TREM-2-dependent signaling, as opposed to TREM-like transcript-1 (TLT-1 or TREML1), are mediated through association with the transmembrane adaptor DNAX activation protein of 12 kDa (DAP12). Recessive inheritance of rare mutations in DAP12 or TREM-2 results in a disorder called polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy, and surprisingly these subjects are not immunocompromised. Recent progress into the roles of TREM/DAP12 signaling is critically reviewed here with a focus on metabolic, cardiovascular and inflammatory diseases. The expanding repertoire of putative ligands for TREM receptors is also discussed.
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Affiliation(s)
- Christopher J Pelham
- Department of Biomedical Sciences and Center for Clinical & Translational Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA
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24
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Owens CD, Gasper WJ, Rahman AS, Conte MS. Vein graft failure. J Vasc Surg 2013; 61:203-16. [PMID: 24095042 DOI: 10.1016/j.jvs.2013.08.019] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 08/12/2013] [Accepted: 08/14/2013] [Indexed: 02/06/2023]
Abstract
After the creation of an autogenous lower extremity bypass graft, the vein must undergo a series of dynamic structural changes to stabilize the arterial hemodynamic forces. These changes, which are commonly referred to as remodeling, include an inflammatory response, the development of a neointima, matrix turnover, and cellular proliferation and apoptosis. The sum total of these processes results in dramatic alterations in the physical and biomechanical attributes of the arterialized vein. The most clinically obvious and easily measured of these is lumen remodeling of the graft. However, although somewhat less precise, wall thickness, matrix composition, and endothelial changes can be measured in vivo within the healing vein graft. Recent translational work has demonstrated the clinical relevance of remodeling as it relates to vein graft patency and the systemic factors influencing it. By correlating histologic and molecular changes in the vein, insights into potential therapeutic strategies to prevent bypass failure and areas for future investigation are explored.
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Affiliation(s)
- Christopher D Owens
- Division of Vascular and Endovascular Surgery, University of California San Francisco Medical Center, San Francisco, Calif.
| | - Warren J Gasper
- Division of Vascular and Endovascular Surgery, University of California San Francisco Medical Center, San Francisco, Calif
| | - Amreen S Rahman
- Division of Vascular and Endovascular Surgery, University of California San Francisco Medical Center, San Francisco, Calif
| | - Michael S Conte
- Division of Vascular and Endovascular Surgery, University of California San Francisco Medical Center, San Francisco, Calif
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