Searching for the mechanisms and therapeutics in the pathogenesis of stenosis after the implantation of arteriovenous ePTFE artificial and auto blood vessel grafts.

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K09741
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Kidney internal medicine
• Research Institution: Osaka Medical College
• Principal Investigator: Jin Denan 大阪医科大学, 医学研究科, 講師 (90319533)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 血管アクセス不全 / 内膜肥厚 / 線維芽細胞遊走

Outline of Final Research Achievements

We have compared the migration patterns of outside fibroblasts after subcutaneous implantation of PTFE vascular prosthesis either coated with chymase inhibitor or solvent only at 3 months after the implantation in hamsters. We found that chymase inhibitor coating tended to reduce the migration distance in the PTFE wall more than the PTFE vascular prosthesis coated solvent only, however, it did not reach a statistical significance. On the other hand, we also investigated if there is a qualitative difference between new and old version of PTFE vascular prosthesis, former adventitial interstices are modified to more narrow (20 μm) to decrease seroma after the implantation compared to old one. Although the modification of adventitial interstices in the new version of PTFE vascular prosthesis delay the migration speed of outside fibroblasts in the wall of PTFE vascular prosthesis, however, no statistical differences were found between two groups.

Free Research Field

心血管系疾患

Academic Significance and Societal Importance of the Research Achievements

現在、腎透析によってその生命が維持されている患者さんが年々増え続けており、血液の浄化に費やされている医療費も莫大に膨れ上がっている。それに加えて、人工血管移植後のバスキュラーアクセス不全によるアクセスルートの再建術にも更なる医療費を必要とする。
また、近年、冠動脈バイパス術が年々増えており、術後の血管管腔内狭窄に対する再手術率もかなり増えている。本研究を介して、血管狭窄性疾患における動静脈中膜平滑筋細胞と外膜側の線維芽細胞のそれぞれの役割を解明し、人工血管や動静脈グラフトの血管内膜肥厚の病態生理に最も適した治療法を模索することにより基礎研究から臨床応用への橋渡しができればと考えている。