1. Stimulation of Caveolin-1 Signaling Improves Arteriovenous Fistula Patency.
- Author
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Hashimoto T, Isaji T, Hu H, Yamamoto K, Bai H, Santana JM, Kuo A, Kuwahara G, Foster TR, Hanisch JJ, Yatsula BA, Sessa WC, Hoshina K, and Dardik A
- Subjects
- Animals, Aorta, Abdominal surgery, Caveolae metabolism, Caveolin 1 biosynthesis, Caveolin 1 deficiency, Caveolin 1 genetics, Caveolin 1 pharmacology, Cells, Cultured, Drug Evaluation, Preclinical, Hemorheology, Humans, Lung cytology, Male, Mice, Mice, Inbred C57BL, Mice, Knockout, Nitric Oxide metabolism, Nitric Oxide Synthase Type III antagonists & inhibitors, Nitric Oxide Synthase Type III physiology, Peptide Fragments pharmacology, Vascular Remodeling physiology, Vena Cava, Inferior surgery, Arteriovenous Shunt, Surgical, Caveolin 1 physiology, Receptor, EphB4 physiology, Signal Transduction physiology, Vena Cava, Inferior physiology
- Abstract
Objective- Arteriovenous fistulae (AVF) are the most common access created for hemodialysis; however, many AVF fail to mature and require repeated intervention, suggesting a need to improve AVF maturation. Eph-B4 (ephrin type-B receptor 4) is the embryonic venous determinant that is functional in adult veins and can regulate AVF maturation. Cav-1 (caveolin-1) is the major scaffolding protein of caveolae-a distinct microdomain that serves as a mechanosensor at the endothelial cell membrane. We hypothesized that Cav-1 function is critical for Eph-B4-mediated AVF maturation. Approach and Results- In a mouse aortocaval fistula model, both Cav-1 mRNA and protein were increased in the AVF compared with control veins. Cav-1 KO (knockout) mice showed increased fistula wall thickening ( P=0.0005) and outward remodeling ( P<0.0001), with increased eNOS (endothelial NO synthase) activity compared with WT (wild type) mice. Ephrin-B2/Fc inhibited AVF outward remodeling in WT mice but not in Cav-1 KO mice and was maintained in Cav-1 RC (Cav-1 endothelial reconstituted) mice (WT, P=0.0001; Cav-1 KO, P=0.7552; Cav-1 RC, P=0.0002). Cavtratin-a Cav-1 scaffolding domain peptide-decreased AVF wall thickness in WT mice and in Eph-B4 het mice compared with vehicle alone (WT, P=0.0235; Eph-B4 het, P=0.0431); cavtratin also increased AVF patency (day 42) in WT mice ( P=0.0275). Conclusions- Endothelial Cav-1 mediates Eph-B4-mediated AVF maturation. The Eph-B4-Cav-1 axis regulates adaptive remodeling during venous adaptation to the fistula environment. Manipulation of Cav-1 function may be a translational strategy to enhance AVF patency.
- Published
- 2019
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