Expression of CHI3L1 in failed autologous arteriovenous fistula of patients with end-stage renal disease and its mechanism of action
Objective To investigate the expression of CHI3L1 in autologous arteriovenous fistula(AVF)in patients with end-stage renal disease and to analyze the potential mechanism of CHI3L1 in AVF failure.Methods Immunoreactivity of CHI3L1,matrix metalloproteinase 9(MMP-9),matrix metalloproteinase 2(MMP-2)and vascular endothelial growth factor-A(VEGF-A)were detected in vascular tissues collected from nine patients who underwent AVF surgery.Due to significant steno-sis,six of the nine patients received arteriovenous fistula reconstruction.Results The failure of AVF due to stenosis was char-acterized by intracaval thrombosis,collagen fiber rupture,fibrous connective tissue hyperplasia,vessel wall thickening and neo-vascularization,scattered inflammatory cell infiltration and increased CHI3L1 expression.The median CHI3L1 positive area rate in the initial AVF group was 0.42,and was 0.64 in the AVF reconstruction group due to vascular fistula stenosis.The difference was statistically significant(P＜0.05).The expression levels of MMP-2 and VEGF-A increased in the AVF reconstruction group.The expression of CHI3L1 was positively correlated with MMP-2,MMP-9 and VEGF-A(r=0.902 2,P＜0.05;r=0.9323,P＜0.001;r=0.8335,P＜0.05).Conclusion CHI3L1 expression in vascular tissues possibly plays an important role in AVF failure.MMP-2 and VEGF-A may participate in venous stenosis with CHI3L1.
renal replacement therapyhemodialysisautologous arteriovenous fistulachitinase-3-like protein 1
万方数据
维普
