Abstract
Objective
Pentraxin-3 (PTX3) has been suggested to play a role in the development of vascular
pathology. Stenosis of arteriovenous fistula (AVF) leading to its failure is the major
cause of morbidity in hemodialysis patients. To date, little is known on the pathogenesis
of AVF stenosis. The aim of the present study was to investigate the potential role
of PTX3 in this setting.
Methods and results
A sample of venous wall was collected at the time of AVF formation in 44 patients
with end stage renal disease. Ten patients developed AVF stenosis and from these patients
a second portion of the venous wall was obtained during surgical revision of the AVF.
Confocal laser scanning microscopy demonstrated that PTX3 immunostaining, hardly detectable
in native AVF, was significantly increased in failed AVF, showing a specific co-localization
with endothelial cell markers. Circulating mononuclear cells isolated at the time
of AVF revision presented a significantly higher PTX3 mRNA expression than those collected
during AVF creation. Interestingly, a significant deposition of C5b-9 on endothelial
cells, co-localizing with PTX3, was observed in stenotic AVF.
Conclusion
The present study demonstrates for the first time a close association between PTX3
deposition and complement activation at the endothelial cell level in failed AVF and
suggests a role for PTX3 in modulating innate immunity in the pathogenesis of AVF
stenosis.
Keywords
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Article Info
Publication History
Published online: September 23, 2009
Accepted:
August 25,
2009
Received in revised form:
August 24,
2009
Received:
March 26,
2009
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
