Regulatory mechanism of HIF-1α/HO-1/VEGF-A signaling pathway in immaturity of autogenous arteriovenous fistula
Objective To observe the differences in the expression levels of the hypoxia-induc-ible factor-1α/heme oxygenase-1/vascular endothelial growth factor A(HIF-1α/HO-1/VEGF-A)signaling pathway under different maturation outcomes of arteriovenous fistula(AVF)in patients with stage 5 chronic kidney disease,and explore the regulatory mechanism of the HIF-1α/HO-1/VEGF-A signaling pathway in the maturation process of AVF.Methods A total of 45 patients with AVF sur-gery for stage 5 chronic kidney disease were selected as research objects,vascular specimens were col-lected during the AVF surgery,and the patients were divided into AVF maturation group(n=35)and AVF poor maturation group(n=10)based on the AVF maturation outcomes within 8 weeks after surgery.Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the gene ex-pression levels of HIF-1α,HO-1 and VEGF-A in the HIF-1α/HO-1/VEGF-A signaling pathway;the Western blotting was used to detect the protein expression levels of HIF-1α,HO-1 and VEGF-A;the enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of downstream inflammatory factors such as interleukin-1β(IL-1β),interleukin-8(IL-8),and transforming growth factor-β(TGF-β).Results The expression levels of HIF-1α mRNA,HO-1 mRNA,and VEGF-A mRNA in the AVF maturation group were significantly higher than those in the AVF poor maturation group(P＜0.01);the protein expression levels of HIF-1α,HO-1 and VEGF-A in the AVF maturation group were significantly higher than those in the AVF poor maturation group(P＜0.01);the ex-pression levels of IL-1β,IL-8 and TGF-β in the AVF maturation group were significantly lower than those in the AVF poor maturation group(P＜0.01).Conclusion The upregulation of the HIF-1α/HO-1/VEGF-A signaling pathway is conducive to the early maturation of AVF.The measurement of the expression levels of the HIF-1α/HO-1/VEGF-A signaling pathway has a certain predictive sig-nificance for the early maturation outcome of AVF.
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