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Food Safety and Natural Toxins
Open AccessArticle

Oral Charcoal Adsorbents Attenuate Neointima Formation of Arteriovenous Fistulas

1
Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan
2
Institute of Clinical Medicine, National Yang-Ming University, Taipei 11221, Taiwan
3
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu 30059, Taiwan
4
College of Medicine, National Taiwan University, Taipei 10051, Taiwan
5
Institute of Biomedical Engineering, National Tsing-Hua University, Hsinchu 30013, Taiwan
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Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan 35053, Taiwan
7
Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
8
Department of Critical Care Medicine, Taipei Veteran Hospital, Taipei 11217, Taiwan
9
Institute of Physiology, National Yang-Ming University, Taipei 11221, Taiwan
10
Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
*
Authors to whom correspondence should be addressed.
Toxins 2020, 12(4), 237; https://doi.org/10.3390/toxins12040237
Received: 9 February 2020 / Revised: 31 March 2020 / Accepted: 5 April 2020 / Published: 8 April 2020
Chronic kidney disease (CKD) accelerates the development of neointima formation at the anastomosis site of arteriovenous (AV) fistulas. Accumulation of certain uremic toxins has a deleterious effect on the cardiovascular system. The oral charcoal adsorbent, AST-120, reduces circulating and tissue uremic toxins, but its effect on neointima formation at an AV fistula is unknown. To understand the effect of CKD and AST-120 on neointima formation, we created AV fistulas (common carotid artery to the external jugular vein in an end-to-side anastomosis) in mice with and without CKD. AST-120 was administered in chow before and after AV fistula creation. Administration of AST-120 significantly decreased serum indoxyl sulfate levels in CKD mice. CKD mice had a larger neointima area than non-CKD mice, and administration of AST-120 in CKD mice attenuated neointima formation. Both smooth muscle cell and fibrin components were increased in CKD mice, and AST-120 decreased both. RNA expression of MMP-2, MMP-9, TNFα, and TGFβ was increased in neointima tissue of CKD mice, and AST-120 administration neutralized the expression. Our results provided in vivo evidence to support the role of uremic toxin-binding therapy on the prevention of neointima formation. Peri-operative AST-120 administration deserves further investigation as a potential therapy to improve AV fistula patency. View Full-Text
Keywords: arteriovenous fistula; charcoal adsorbent; indoxyl sulfate; neointima; uremic toxin arteriovenous fistula; charcoal adsorbent; indoxyl sulfate; neointima; uremic toxin
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Shih, Y.-C.; Wu, C.-C.; Wang, S.-C.; Liou, J.-Y.; Huang, P.-H.; Tarng, D.-C. Oral Charcoal Adsorbents Attenuate Neointima Formation of Arteriovenous Fistulas. Toxins 2020, 12, 237.

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