Acute arterial haemodynamics activation of endothelial to mesenchymal transition in long saphenous veins. Impact on vein graft disease

Introduction

The long saphenous vein (LSV) is frequently used in cardiac surgery; however, its use is complicated by late stenosis or occlusion due to the development of intimal hyperplasia (IH). TGF-β has been implicated in the process of IH however the impact of acute haemodynamic changes on the activation of TGF-β endothelial-to mesenchymal transition (EndMT) has not been assessed and it's the focus of this study.

Purpose

To assess the role of acute haemodynamics changes in veins implanted into arterial circulation on EndMT.

Methods

Surplus LSV were exposed to acute arterial haemodynamics using a perfusion bioreactor. Changes in EndMT markers at the RNA and protein level evaluated by quantitative real time PCR, RNAScope and immunofluorescence.

Results

The acute exposure of veins to arterial haemodynamics ex-vivo induced significant increase in inflammatory marker IL-8 expression and transcription factor TWIST1 in LSV (both p≤0.01, Figure 1A) endothelium. Furthermore, immunostaining demonstrated the activation of pSMAD (p≤0.01, Figure 1B) acutely in endothelium after 45 minutes of exposure to arterial haemodynamics. This was followed by significant increase of SMC related markers (Vimentin and α-SMA; Figure 1C, both p≤0.001) and the suppression of endothelial cell related marker CD31 after 4 hours of LSV exposure to acute arterial haemodynamics. RNAScope and IHC results showed localisation of TWIST1 RNA and protein in CD31+ (p≤0.001) and VECAD+ (p≤0.001) cells respectively following exposure to acute arterial haemodynamics (Figure 1D). Furthermore, TGF-β pathway phosphorylation array identified the activation of Smad1 (p≤0.05) but not TAK1 in LSV endothelial cells indicating that acute arterial haemodynamics activates the TGF-β–SMAD pathway specifically (Figure 1E).

Conclusion

The exposure of LSV to acute arterial haemodynamics is associated with the activation of TGF-β–SMAD pathway leading to EndMT changes in the endothelium of vein grafts ex-vivo. This contributes to our understanding of the changes that occur in veins after implantation into arterial circulation and that the acute changes in the endothelium and suggests that strategies to modulate TGF-β–SMAD can be utilised to modulate IH in vein grafts.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Van Geest Foundation Heart and Cardiovascular Diseases Research Fund

Sacral nerve stimulation for urinary dysfunction: the first year of the Scottish national service

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Quality Enhancement Research Initiative (QUERI): A collaboration between research and clinical practice

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The nature of ophthalmic services, and the education and qualifications of nurses: a national survey

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A survey of the qualifications of ophthalmology nurses

A study was conducted to ascertain the numbers of nurses working in ophthalmology with appropriate qualifications. A questionnaire was sent to 168 ophthalmic nurse managers in the UK which revealed that a much greater proportion of nurses employed at grades I, H, G and F hold an ophthalmic qualification compared with those employed at grades E, D and C. Those nurses working at higher grades were far fewer in number, however. The results also indicated that the smaller the unit is, the less likely it is to employ nurses holding the specialist qualification. More funding and access to courses is recommended.

Drug-induced perturbations in the in vivo distribution of oncological radiotracers--II. 5-[125I]iodo-2'-deoxyuridine influenced by nitrobenzylthioinosine-5'-phosphate (NBMPR-P) and acyclothymidine (ACT)

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Route of passage of cypermethrin across the surface of sheep skin

14C cypermethrin applied topically to the dorsal surface of sheep moved radially across the skin within the stratum corneum of the epidermis at a rate which exceeded 11 cm h-1. This spread was accompanied by some dermal infiltration which was most marked at the site of application.

Passage of lanthanum through the intercellular spaces of the sebaceous gland

Lanthanum introduced intradermally into cattle, sheep, goats, ponies and rats penetrated into the sebum through the intercellular spaces of the sebaceous gland. It is concluded that the sebaceous gland is permeable to the passage of small molecules outwards and probably in some circumstances inwards. Since the constituents of sebum are not all produced by necrosis it is likely that the sebaceous gland is not a simple holocrine gland.

Comparative studies of the effect of thermal stimulation on the permeability of the luminal cell junctions of the sweat gland to lanthanum

Lanthanum injected intradermally in vivo into the skin of cattle, sheep, goats and ponies penetrated the intercellular spaces of the sweat glands. It was not, however, detected in the glandular lumen either visually or by electron probe microanalysis even at elevated ambient temperatures when the animals were sweating. It is concluded that the luminal intercellular connections between epithelial cells in these glands are tight junctions, which remain so during sweating despite the occurrence of cell death and extrusion into the lumen.

Kinetic studies of the murine foetal thymus using vincristine sulphate

The turnover time of the foetal thymus has been evaluated in CD1 mice using the metaphase arrest drug vincristine sulphate and also by direct cell counting and found to be 18 h (range 12--26) and 11.9 h (range 10.9--13.1) respectively. Vincristine sulphate can be used for cell kinetic studies on foetal thymus provided an appropriate dose (5 mgm per kgm body weight given intravenously) and time scale (less than 1 hour after injection) are used for these measurements. These conditions are different from those used for adult tissues. Using 125I-iododeoxyuridine uptake measurements, it was found that vincristine sulphate suppressed DNA synthesis in the foetal thymus but not in the maternal thymus at this dose. Only the G2 cohort of cells in the thymus entered mitosis.