Endothelial-mesenchymal Transdifferentiation In The Stenosis Of Arteriovenous Fistula

Objective Observing the expression of endothelial mark(CD31, vWF) and mesenchymal/myofibroblast mark(a-SMA) in the venous stenosis of arteriovenous fistula(AVF), to discuss the meaning of endothelial-mesenchymal transdifferentiation in the stenosis of AVF.Methods Collecting venous stenosis region of the AVF and normal vein of patients who has uremia, detect the expression of CD31, vWF anda-SMA via immunofluorescence.Result A total of25cases were include:13stenosis AVF,12normal vein.(1)1case found the cell which co-expressing of vWF and a-SMA;(2)8cases of normal vein have a certain change like neointimal hyperplasia;(3)4cases of stenosis AVF, their hyperplasia tissue under the intima was mainly constituted with matrix.Conclusion (1) Endothelial-mesenchymal transdifferentiation participated in the stenosis of AVF;(2)Long-term uremia patients may already have neointimal hyperplasia in the vein;(3)Except the appearance of a large number of myofibroblasts, extracellular matrix maybe another critical reason which lead to the stenosis of AVF.