Natural Vascular Scaffolding Treatment Promotes Outward Remodeling During Arteriovenous Fistula Development in Rats

Area of Science:

• Biomedical Engineering
• Vascular Biology
• Regenerative Medicine

Background:

• Arteriovenous fistula (AVF) maturation is crucial for hemodialysis access.
• High AVF maturation failure rates necessitate novel therapeutic strategies.
• Extracellular matrix (ECM) integrity is a key factor in AVF remodeling.

Purpose of the Study:

• To investigate the efficacy of Natural Vascular Scaffolding (NVS) Therapy in enhancing AVF maturation.
• To determine if NVS Therapy preserves vascular ECM integrity during AVF remodeling.
• To assess the safety and therapeutic potential of NVS Therapy for AVF maturation.

Main Methods:

• AVFs were surgically created in Wistar rats, followed by perivascular application of NVS compound or phosphate-buffered saline (PBS) with light activation.
• Histology, morphometry, immunohistochemistry, and multiphoton microscopy were employed to evaluate AVF structure and composition at 4 weeks.
• Inflammatory markers (IL-6, MMP-9) and collagen fiber organization were analyzed.

Main Results:

• NVS Therapy significantly increased AVF lumen area (4.2-fold) and % open lumen area (2-fold) compared to PBS controls.
• Treatment with NVS Therapy led to significant reductions in inflammatory markers IL-6 and MMP-9.
• Collagen fibers in NVS-treated AVFs showed a trend towards perpendicular alignment, suggesting altered ECM remodeling.

Conclusions:

• NVS Therapy demonstrates potential to improve AVF maturation by enhancing lumen expansion and preserving ECM integrity.
• The observed reduction in inflammation and favorable collagen organization indicate a beneficial therapeutic effect.
• NVS Therapy is safe and may offer a promising new approach to enhance AVF maturation in patients requiring hemodialysis.