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2017 ; 93
(1
): 11-17
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The effects of indoxyl sulfate-induced endothelial microparticles on neointimal
hyperplasia formation in an ex vivo model
#MMPMID28706886
Ryu JH
; Park H
; Kim SJ
Ann Surg Treat Res
2017[Jul]; 93
(1
): 11-17
PMID28706886
show ga
PURPOSE: Neointimal hyperplasia (NH) is considered to be one of the main causes
of vascular access occlusion in patients receiving hemodialysis. Endothelial
injury and TGF-?-mediated proliferation of vascular smooth muscle cells (VSMCs)
induce NH. Endothelial microparticles (EMPs) are also increased by endothelial
injury. We aimed to investigate the effects of EMPs and TGF-? expression on VSMC
proliferation and their contributions to NH formation in an ex vivo model.
METHODS: EMPs were collected from the culture media of human umbilical vein
endothelial cells treated with indoxyl sulfate (IS, 250 µg/mL) after
ultracentrifugation at 100,000 × g. Porcine internal jugular veins were isolated
and treated with EMPs (2 × 10(6) /mL) or left untreated for 12 days and
subsequently compared with TGF-? (10 ng/mL)-treated venous tissue. Intima-media
thickness and NH area were assessed using a digital program. Masson's trichrome
staining and immunohistochemistry (IHC) analysis for ?-smooth muscle actin,
phosphorylated Akt, ERK1/2, p38 mitogen-activated protein kinase (MAPK), and
Smad3 were performed on each vein sample. RESULTS: NH and VSMC proliferation
developed to a significantly greater degree in EMP-treated veins compared to
controls, with similar patterns seen in TGF-?-stimulated samples. IHC analysis
demonstrated that EMPs markedly increased phosphorylation of Akt, ERK1/2, p38
MAPK, and Smad3 in areas of venous NH formation. CONCLUSION: Our results showed
that IS-induced EMPs provoked massive VSMC proliferation and NH formation via
activation of the TGF-? signaling pathways. Further investigation is needed to
elucidate the precise mechanism of EMP activity on vascular access stenosis in
vivo.