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Kang YH, Zhou T, Wu SX, Li XJ, Huang XY, Xia R, Ling YH, Zhou HT, Zhang SW, Yin WY. Effects of Rosa roxburghii Tratt on Ulcerative Colitis: An Integrated Analysis of Network Pharmacology and Experimental Validation. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2023; 51:1477-1499. [PMID: 37530508 DOI: 10.1142/s0192415x23500672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Rosa roxburghii Tratt is a traditional Chinese plant that has been used to treat different inflammatory diseases. The purpose of this study was to investigate the mechanism of action of Rosa roxburghii Tratt extract (RRTE) against ulcerative colitis (UC) using network pharmacology and experimental validation. HPLC-Q/Orbitrap MS was used to rapidly identify the substances contained in RRTE after extracting the active components from the fruit. Then, network pharmacology combined with molecular docking was used to explore the critical target and potential mechanism of RRTE against UC using the active ingredients in RRTE as the research object. Data are presented in a visual manner. Finally, the pharmacological effects of RRTE in alleviating UC were further verified using a DSS-induced UC model of NCM460. The results showed that 25 components in RRTE were identified. A total of 250 targets of the active components and 5376 targets associated with UC were collected. Furthermore, a systematic analysis of the Protein-Protein Interaction (PPI) networks suggests that epidermal growth factor receptor (EGFR), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), and serine/threonine kinase 1 (AKT1) are critical targets for RRTE in the treatment of UC. A comprehensive regulatory network analysis showed that RRTE alleviated UC through the EGFR-mediated PI3K/Akt pathway, and molecular docking showed that active components could strongly bind to EGFR, PIK3R1, and AKT1. In addition, RRTE alleviated dextran sulfate sodium salt (DSS)-induced cell injury and significantly decreased the protein expression levels of EGFR, PIK3R1, and p-AKT in NCM460 cells in vitro. Furthermore, RRTE significantly regulated the expression of the apoptosis-related proteins Apoptotic protease-activating factor 1 (Apaf1), cleaved caspase-3, B-cell lymphoma-2 (Bcl2), and Bcl2 associated X protein (Bax). In conclusion, the components of RRTE are complex, and RRTE can relieve UC through the EGFR-mediated PI3K/Akt pathway.
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Affiliation(s)
- Yu-Hong Kang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - Ting Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - Shou-Xun Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - Xing-Jie Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - Xiao-Yi Huang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - Rui Xia
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - Yi-Han Ling
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - He-Ting Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - Shu-Wen Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
| | - Wen-Ya Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, P. R. China
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Batista NMG, de Moraes ATL, Balbinot KM, de Souza Neto OR, da Silva Brandão JM, da Silva Kataoka MS, de Melo Alves Júnior S, de Jesus Viana Pinheiro J. Immunohistochemical analysis of ADAMTS-1, versican and pEGFR expressions in periapical granuloma and radicular cyst. BMC Oral Health 2021; 21:102. [PMID: 33676487 PMCID: PMC7937253 DOI: 10.1186/s12903-021-01462-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/25/2021] [Indexed: 11/21/2022] Open
Abstract
Background ADAMTS expression can be associated with several inflammatory processes, and has been correlated with tumorigenesis of some neoplasms, but its participation in the development of periapical lesions has not been investigated. Therefore, our objective was to verify the expression of ADAMTS-1, versican and pEGFR in Periapical Granuloma (PG) and in the Radicular Cyst (RC) since they are the most common lesions of the periapex.
Methods 25 samples of RC and 10 of PG were used. As a control, 10 samples of inflammatory fibrous hyperplasia (IFH) and 10 of dental follicle (DF) were used. The expression of these proteins was investigated using immunohistochemistry. Results In the epithelium of RC, IFH and DF, the expression of ADAMTS-1 was greater in DF than in RC (p < .001). Versicano showed greater expression in IFH than in RC, DF than in RC (p < .001). pEGFR showed greater expression in IFH and RC than in DF (p < .01 and p < .05, respectively). In connective tissue, ADAMTS-1 expression was greater in PG and RC than in IFH and DF (p < .001). Versicano showed greater expression in PG, RC and IFH compared to DF (p < .001). In pEGFR there was a higher expression in PG when compared to RC, IFH and DF (p < .001). Greater immunostaining occurred in the RC than in the DF (p < .001). Conclusions Our results suggest that the studied proteins may participate in the pathogenesis of PG and RC, through the interaction of these proteins, in the remodeling of the ECM (versican) by ADAMTS-1, producing bioactive fragments, which could activate EGFR, contributing to the formation, growth and maintenance of injuries.
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Affiliation(s)
| | - Antonia Taiane Lopes de Moraes
- Department of Oral Pathology, School of Dentistry, Federal University of Pará, Avenue Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil
| | - Karolyny Martins Balbinot
- Department of Oral Pathology, School of Dentistry, Federal University of Pará, Avenue Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil
| | | | - Juliana Melo da Silva Brandão
- Department of Oral Pathology, School of Dentistry, Federal University of Pará, Avenue Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil
| | - Maria Sueli da Silva Kataoka
- Department of Oral Pathology, School of Dentistry, Federal University of Pará, Avenue Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil
| | - Sérgio de Melo Alves Júnior
- Department of Oral Pathology, School of Dentistry, Federal University of Pará, Avenue Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil
| | - João de Jesus Viana Pinheiro
- Federal University of Pará Brazil, Avenue Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil. .,Department of Oral Pathology, School of Dentistry, Federal University of Pará, Avenue Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil. .,Cell Culture Laboratory, Faculty of Dentistry, Federal University of Pará, Rua Augusto Corrêa, 01, Guamá, Belém, PA, 66075110, Brazil.
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Mackiewicz T, Sowa A, Fichna J. Biomarkers for Early Detection of Colitis-associated Colorectal Cancer - Current Concepts, Future Trends. Curr Drug Targets 2021; 22:137-145. [PMID: 32077822 DOI: 10.2174/1389450121666200220123844] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/20/2019] [Accepted: 01/29/2020] [Indexed: 02/08/2023]
Abstract
Colitis-associated colorectal cancer (CAC) remains a critical complication of ulcerative colitis (UC) with a mortality of approximately 15%, which makes early CAC diagnosis crucial. The current standard of surveillance, with repetitive colonoscopies and histological testing of biopsied mucosa samples, is burdensome and expensive, and therefore less invasive methods and reliable biomarkers are needed. Significant progress has been made, thanks to continuous extensive research in this field, however, no clinically relevant biomarker has been established so far. This review of the current literature presents the genetic and molecular differences between CAC and sporadic colorectal cancer and covers progress made in the early detection of CAC carcinogenesis. It focuses on biomarkers under development, which can easily be tested in samples of body fluids or breath and, once made clinically available, will help to differentiate between progressors (UC patients who will develop dysplasia) from non-progressors and enable early intervention to decrease the risk of cancer development.
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Affiliation(s)
- Tomasz Mackiewicz
- Department Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | | | - Jakub Fichna
- Department Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
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Abstract
Background::Human tumor cells lines and tumor samples overexpress the neurokinin-1 receptor (NK-1R). Substance P (SP), after binding to NK-1Rs, induces tumor cell proliferation, an antiapoptotic effect and promotes angiogenesis and the migration of cancer cells for invasion and metastasis.Methods: :In contrast, NK-1R antagonists block the previous pathophysiological actions mediated by SP. These antagonists promote the death of tumor cells by apoptosis. Peptide and non-peptide NK-1R antagonists have been reported.Results: :Peptide NK-1R antagonists show chemical modifications of the SP molecule (L-amino acids being replaced by D-amino acids), whereas non-peptide NK-1R antagonists include numerous compounds with different chemical compositions while showing similar stereochemical features (affinity for the NK- 1R). Currently, there are more than 300 NK-1R antagonists.Conclusion::In combination therapy with classic cytostatics, NK-1R antagonists have additive or synergic effects and minimize the side-effects of cytostatics. The effect of NK-1R antagonists as broad-spectrum anticancer drugs is reviewed and the use of these antagonists for the treatment of cancer is suggested.
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Affiliation(s)
- Miguel Muñoz
- Research Laboratory on Neuropeptides, Virgen del Rocío University Hospital (IBIS), Sevilla, Spain
| | - Rafael Coveñas
- Laboratory of Neuroanatomy of the Peptidergic Systems, Institute of Neurosciences of Castilla y León (INCYL) University of Salamanca, Salamanca, Spain
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Sato T, Otsuka Y, Kikkawa Y, Iwasaki Y, Fukagawa M. Semiquantitative analysis of virtual histology derived from intravascular ultrasound images at vascular access stenosis. J Vasc Access 2019; 20:55-59. [PMID: 31032725 DOI: 10.1177/1129729818769030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Vascular access failure, such as recurrent stenosis and thrombosis, is a major concern in patients with end-stage kidney disease. Neointimal hyperplasia development at the anastomosis site of outflow vessels is a primal cause for recurrent vascular access failure. We previously shed some lights into a role of vitamin D, which exerts a protective effect against neointimal hyperplasia formation. Virtual histology, derived from intravascular ultrasound technology, provides novel insights into plaque composition analysis in atherosclerotic diseases. However, there is so far a lack of evidence on the relation between virtual histology and pathophysiological findings. To elucidate this missing link, we comprehensively reviewed 10 chronic hemodialysis patients who underwent repeated intravascular ultrasound-guided balloon angioplasty. Their age, dialysis vintage, and follow-up period were 75.0 ± 4.24, 20.5 ± 2.12, and 11.5 ± 0.71 (mean ± standard deviation) years, respectively. Pathological cross-sectional analyses were performed using specimens from vascular access surgeries during the follow-up period. Interestingly, positive relation is found between virtual histology-constructed fibrous tissue and pathological neointimal hyperplasia. Strikingly, immunohistological analysis revealed that vitamin D receptor-positive myofibroblasts were abundantly distributed in the equivalent area to virtual histology fibrous tissue. Our 10-year follow-up data of resistant vascular access stenosis indicates strong correlation between vitamin D receptor-rich neointimal vessel hypertrophy and intravascular ultrasound-assisted virtual histological analysis. Intravascular ultrasound technology is one of the minimally invasive diagnostic tools to provide histologically relevant tissue structure information and help determine target vessel stenosis on vascular access.
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Affiliation(s)
- Tetsuhiko Sato
- 1 Division of Diabetes and Endocrinology, Nagoya Daini Red Cross Hospital and Masuko Memorial Hospital, Nagoya, Japan
| | - Yasuhiro Otsuka
- 2 Division of Nephrology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Yamato Kikkawa
- 3 Laboratory of Clinical Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Science, Tokyo, Japan
| | - Yoshiko Iwasaki
- 4 Department of Health Sciences, Oita University of Nursing and Health Sciences, Oita, Japan
| | - Masafumi Fukagawa
- 5 Division of Nephrology, Endocrinology and Metabolism, School of Medicine, Tokai University, Isehara, Japan
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Vitamin D receptor FokI polymorphism and the risks of colorectal cancer, inflammatory bowel disease, and colorectal adenoma. Sci Rep 2018; 8:12899. [PMID: 30150667 PMCID: PMC6110797 DOI: 10.1038/s41598-018-31244-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 08/10/2018] [Indexed: 02/08/2023] Open
Abstract
Based on an inverse association between vitamin D levels and the risks of colorectal diseases, a functional start codon polymorphism in the vitamin D receptor (VDR) gene is speculated to affect the risks for these diseases. To validate this hypothesis, we first conducted a case-control study of 695 colorectal cancer patients and 1,397 controls. The association of VDR FokI polymorphism with colorectal cancer risk was analyzed using a logistic regression model. In the present case-control study, compared to the F allele, the f allele seemed to be associated with lower risks of colon cancer and advanced colorectal cancer. Additionally, a meta-analysis of 27 studies was conducted to combine findings from previous studies investigating the association of FokI polymorphism with colorectal disease using a random effects model. In the present meta-analysis, the f allele was positively associated with the risk of inflammatory bowel disease, including Crohn’s disease and ulcerative colitis. However, this allele was inversely associated with colon cancer and was not associated with the risk of rectal cancer or colorectal adenoma. In conclusion, the findings from this study imply that the role of VDR FokI polymorphism may differ based on the type and severity of colorectal disease.
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Zhen Y, Luo C, Zhang H. Early detection of ulcerative colitis-associated colorectal cancer. Gastroenterol Rep (Oxf) 2018; 6:83-92. [PMID: 29780595 PMCID: PMC5952942 DOI: 10.1093/gastro/goy010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 02/17/2018] [Accepted: 03/26/2018] [Indexed: 02/05/2023] Open
Abstract
Colitis-associated colorectal cancer (CACC) is one of the most serious complications of inflammatory bowel disease (IBD), particularly in ulcerative colitis (UC); it accounts for approximately 15% of all-causes mortality among IBD patients. Because CACC shows a worse prognosis and higher mortality than sporadic colorectal cancer, early detection is critical. Colonoscopy is primarily recommended for surveillance and several advanced endoscopic imaging techniques are emerging. In addition, recent studies have reported on attempts to develop clinically relevant biomarkers for surveillance using various biosamples, which may become high-performance screening tools in the future, so the best approach and technique for cancer surveillance in long-standing UC patients remain under debate. This review gives a comprehensive description and summary about what progress has been made in terms of early CACC detection.
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Affiliation(s)
- Yu Zhen
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chengxin Luo
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hu Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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Identification of Candidate Genes Related to Inflammatory Bowel Disease Using Minimum Redundancy Maximum Relevance, Incremental Feature Selection, and the Shortest-Path Approach. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5741948. [PMID: 28293637 PMCID: PMC5331171 DOI: 10.1155/2017/5741948] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 01/11/2017] [Indexed: 02/08/2023]
Abstract
Identification of disease genes is a hot topic in biomedicine and genomics. However, it is a challenging problem because of the complexity of diseases. Inflammatory bowel disease (IBD) is an idiopathic disease caused by a dysregulated immune response to host intestinal microflora. It has been proven to be associated with the development of intestinal malignancies. Although the specific pathological characteristics and genetic background of IBD have been partially revealed, it is still an overdetermined disease and the blueprint of all genetic variants still needs to be improved. In this study, a novel computational method was built to identify genes related to IBD. Samples from two subtypes of IBD (ulcerative colitis and Crohn's disease) and normal samples were employed. By analyzing the gene expression profiles of these samples using minimum redundancy maximum relevance and incremental feature selection, 21 genes were obtained that could effectively distinguish samples from the two subtypes of IBD and the normal samples. Then, the shortest-path approach was used to search for an additional 20 genes in a large network constructed using protein-protein interactions based on the above-mentioned 21 genes. Analyses of the 41 genes obtained indicate that they are closely associated with this disease.
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Abreu-Delgado Y, Isidro RA, Torres EA, González A, Cruz ML, Isidro AA, González-Keelan CI, Medero P, Appleyard CB. Serum vitamin D and colonic vitamin D receptor in inflammatory bowel disease. World J Gastroenterol 2016; 22:3581-3591. [PMID: 27053850 PMCID: PMC4814644 DOI: 10.3748/wjg.v22.i13.3581] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 12/05/2015] [Accepted: 01/18/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine serum vitamin D levels and colonic vitamin D receptor (VDR) expression in inflammatory bowel disease (IBD) and non-IBD patients and correlate these with histopathology.
METHODS: Puerto Rican IBD (n = 10) and non-IBD (n = 10) patients ≥ 21 years old scheduled for colonoscopy were recruited. Each patient completed a questionnaire and provided a serum sample and a colonic biopsy of normal-appearing mucosa. For IBD patients, an additional biopsy was collected from visually diseased mucosa. Serum vitamin D levels were measured by ultra-performance liquid chromatography and mass spectrometry. Hematoxylin and eosin stained tissue sections from colonic biopsies were classified histologically as normal or colitis (active/inactive), and scored for the degree of inflammation present (0-3, inactive/absent to severe). Tissue sections from colonic biopsies were also stained by immunohistochemistry for VDR, for which representative diagnostic areas were photographed and scored for staining intensity using a 4-point scale.
RESULTS: The IBD cohort was significantly younger (40.40 ± 5.27, P < 0.05) than the non-IBD cohort (56.70 ± 1.64) with a higher prevalence of vitamin D deficiency (40% vs 20%, respectively) and insufficiency (70% vs 50%, respectively). Histologic inflammation was significantly higher in visually diseased mucosa from IBD patients (1.95 ± 0.25) than in normal-appearing mucosa from control patients (0.25 ± 0.08, P < 0.01) and from IBD patients (0.65 ± 0.36, P < 0.05) and correlated inversely with VDR expression in visually diseased colonic tissue from IBD patients (r = -0.44, P < 0.05) and from IBD patients with Crohn’s disease (r = -0.69, P < 0.05), but not in normal-appearing colonic tissue from control patients or IBD patients. Control and IBD patient serum vitamin D levels correlated positively with VDR expression in normal colon from control and IBD patients (r = 0.38, P < 0.05) and with patient age (r = 0.54, P < 0.01).
CONCLUSION: Levels of serum vitamin D correlate positively with colonic VDR expression in visually normal mucosa whereas inflammation correlates negatively with colonic VDR expression in visually diseased mucosa in Puerto Rican patients.
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Muñoz M, Coveñas R. Neurokinin-1 receptor antagonists as antitumor drugs in gastrointestinal cancer: A new approach. Saudi J Gastroenterol 2016; 22:260-8. [PMID: 27488320 PMCID: PMC4991196 DOI: 10.4103/1319-3767.187601] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Gastrointestinal (GI) cancer is the term for a group of cancers affecting the digestive system. After binding to the neurokinin-1 (NK-1) receptor, the undecapeptide substance P (SP) regulates GI cancer cell proliferation and migration for invasion and metastasis, and controls endothelial cell proliferation for angiogenesis. SP also exerts an antiapoptotic effect. Both SP and the NK-1 receptor are located in GI tumor cells, the NK-1 receptor being overexpressed. By contrast, after binding to the NK-1 receptor, NK-1 receptor antagonists elicit the inhibition (epidermal growth factor receptor inhibition) of the proliferation of GI cancer cells in a concentration-dependent manner, induce the death of GI cancer cells by apoptosis, counteract the Warburg effect, inhibit cancer cell migration (counteracting invasion and metastasis), and inhibit angiogenesis (vascular endothelial growth factor inhibition). NK-1 receptor antagonists are safe and well tolerated. Thus, the NK-1 receptor could be considered as a new target in GI cancer and NK-1 receptor antagonists (eg, aprepitant) could be a new promising approach for the treatment of GI cancer.
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Affiliation(s)
- Miguel Muñoz
- Rafael Coveñas, Institute of Neurosciences of Castilla and León (INCYL), Laboratory of Neuroanatomy of the Peptidergic Systems, University of Salamanca, Salamanca, Spain,Address for correspondence: Dr. Miguel Muñoz, Research Laboratory on Neuropeptides (IBIS), Hospital Infantil Virgen del Rocio, Seville - 41013, Spain. E-mail:
| | - Rafael Coveñas
- Rafael Coveñas, Institute of Neurosciences of Castilla and León (INCYL), Laboratory of Neuroanatomy of the Peptidergic Systems, University of Salamanca, Salamanca, Spain
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An efficacy of intensive vitamin D delivery to neointimal hyperplasia in recurrent vascular access stenosis. J Vasc Access 2015; 17:72-7. [PMID: 26429127 DOI: 10.5301/jva.5000469] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2015] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Neointimal hyperplasia (NH) causes vascular access (VA) stenosis, which results in serious under-dialytic morbidity in hemodialysis patients. We sought to assess whether a vitamin D intervention to NH lesions leads to better VA patency and examined clinical and in vitro studies. METHODS A pilot clinical study of six hemodialysis patients was conducted to elucidate whether 0.5 μg calcitriol injection to stenotic lesion after balloon angioplasty (PTA) maintains better vessel patency until the next follow-up angiography. Localized vitamin D exposure was utilized by delivering and fixing calcitriol intensively at the stenotic lesion through a side-hole catheter with balloon clamping. We also performed vascular smooth muscle cell (VSMC) culture to detect both apoptosis (cell death detection assay) and cell viability (5-Bromo-2'-deoxy-uridine incorporation), and explored the efficacy of vitamin D to inhibit VSMC proliferation. Additionally, immunohistochemistry (IHC) was conducted to examine vitamin D receptor (VDR) expression at NH lesion, obtained from VA surgery. RESULTS Percent patency, the proportion between stenotic and non-stenotic vessel diameters, increased significantly (p = 0.03) after directly catheter-delivered 0.5 μg calcitriol administration. In vitro VSMC studies, 0.1 nM calcitriol significantly (p<0.05) enhanced apoptosis and cell-cycle inhibition for two different calcitriol exposure times (15 minutes and 24 hours). IHC staining revealed that VDR-positive hyperplastic cells were observed at NH lesion. CONCLUSIONS Intensive vitamin D exposure at NH lesion has an ability to inhibit further VSMC proliferation, and presumably leads to greater patency rate for recurrent VA stenosis. Further studies are needed to clarify whether its unique property is exhibited through VDR-mediated mechanism.
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