1. Induction of extracranial arteriogenesis by an arteriovenous fistula in a pig model
- Author
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Ivo Buschmann, Joachim Klisch, Katherine H. Smith, Philipp Hillmeister, Eva Buschmann, Nikolaos Pagonas, Peter Bramlage, Eun-Ji Lee, Dorit Jacobi, Susann Ulusans, Anne-Katrin Woischnig, and Martin Schumacher
- Subjects
Male ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Swine ,Collateral Circulation ,Neovascularization, Physiologic ,Arteriovenous fistula ,030204 cardiovascular system & hematology ,Monocytes ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Chemokine CCL2 ,Cell Proliferation ,Inflammation ,Tissue Inhibitor of Metalloproteinase-1 ,Neovascularization, Pathologic ,medicine.diagnostic_test ,biology ,Vascular disease ,business.industry ,Macrophages ,Monocyte ,CD44 ,Angiography ,Arteries ,Blood flow ,medicine.disease ,Immunohistochemistry ,Up-Regulation ,Disease Models, Animal ,Hyaluronan Receptors ,030104 developmental biology ,medicine.anatomical_structure ,Gene Expression Regulation ,Arteriovenous Fistula ,Leukocytes, Mononuclear ,biology.protein ,Swine, Miniature ,Female ,Arteriogenesis ,Cardiology and Cardiovascular Medicine ,business ,Rete mirabile - Abstract
Background and aims Arteriogenesis, the positive outward remodeling and growth of pre-existent collateral vessels, holds potential as a novel treatment for ischemic vascular disease. An extracranial arteriogenesis model in a pig will allow us to study molecular changes in a complex arteriolar network in a more clinically relevant large-animal model. To increase fluid shear stress in the brain, an experimental carotid arteriovenous fistula (AVF model) in minipigs was established, providing high flow through the extracranial rete mirabile. The aim of the study was to examine whether creation of a carotid AVF can induce extracranial arteriogenesis in the pig. Methods Angiography was performed to demonstrate blood flow diversion. Animals were sacrificed after 0, 3 and 14 days post-surgery and both retia mirabilia were removed. Immunohistochemical analysis was performed to analyze cell proliferation and accumulation of mononuclear cells in the vessel wall. Results After 3 days of high-flow conditions, increases in vascular cell proliferation (approximately 1.5-fold; p = 0.143) and monocyte invasion (approximately 6-fold; p = 0.057) were observed when compared to animals sacrificed immediately after AVF formation. Quantitative PCR (RT-qPCR) analysis from rete mirabile tissue samples 3 days post-surgery revealed that monocyte chemoattractant protein (MCP)-1 and tissue inhibitor of metalloproteinases (TIMP)-1 were highly upregulated. Expression of the pro-arteriogenic marker, CD44, reached maximum expression level 14 days post-surgery. Conclusions In response to high levels of shear stress produced in the pig AVF model, the onset of the arteriogenic process can be induced. This was demonstrated by enhanced cell proliferation, monocyte invasion and vascular remodeling.
- Published
- 2018
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