Development of artificial blood vessels made from new materials for use in renal dialysis vascular access

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K08601
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53040:Nephrology-related
• Research Institution: Osaka Medical and Pharmaceutical University
• Principal Investigator: Jin Denan 大阪医科薬科大学, 医学部, 講師 (90319533)
• Co-Investigator(Kenkyū-buntansha): 高井 真司 大阪医科薬科大学, 医学研究科, 教授 (80288703)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 人工血管 / 腎透析 / キマーゼ阻害薬 / バスキュラーアクセス不全

Outline of Final Research Achievements

In recent years, ePTFE artificial blood vessels have been frequently used as access routes; however, their low patency rate has become a significant issue.
We found that after the transplantation of ePTFE artificial blood vessels, fibroblasts from the out side invade the inner lumen through the gaps in the artificial vessel wall material. There, they provide scaffolding, proliferate, and transform into myofibroblasts, forming intimal hyperplasia, which ultimately leads to vascular access failure. In this study, we coated the outer membrane of the artificial blood vessels with a chymase inhibitor and transplanted them into hamsters and dogs. As a result, it was found that the migration of fibroblasts into the vascular lumen was significantly suppressed.

Free Research Field

j腎透析のための新しい人工血管開発

Academic Significance and Societal Importance of the Research Achievements

我々はePTFE人工血管移植後、外膜側の線維芽細胞が人工血管壁素材の隙間を介して内腔側へと浸潤し、そこで足場を提供したり、浸潤した線維芽細胞自身が増殖、形質転換して筋線維芽細胞になったりして内膜肥厚を形成し、最終的にバスキュラーアクセス不全に陥ると考えている。また、このような線維芽細胞の遊走および増殖、筋線維芽細胞への形質転換には肥満細胞由来のキマーゼが非常に深く関与することも明らかにしてきた。本研究では、キマーゼ阻害薬の人工血管外膜側へのコーティングが線維芽細胞の遊走を有意に抑制することが確認でき、今後の腎透析患者のバスキュラーアクセス不全に対する治療法の開発に貢献できると思っている。