scholarly journals Long-term effects of erythropoietin therapy on fistula stenosis and plasma concentrations of PDGF and MCP-1 in hemodialysis patients.

1997 ◽  
Vol 8 (7) ◽  
pp. 1147-1156 ◽  
Author(s):  
S De Marchi ◽  
E Cecchin ◽  
E Falleti ◽  
R Giacomello ◽  
G Stel ◽  
...  
Keyword(s):  
Growth Factor ◽  
Vascular Access ◽  
Plasma Concentrations ◽  
Hemodialysis Patients ◽  
Platelet Derived Growth Factor ◽  
Long Term Effects ◽  
Monocyte Chemoattractant Protein 1 ◽  
Monocyte Chemoattractant ◽  
Monocyte Chemoattractant Protein

Among the adverse effects possibly associated with the use of erythropoietin (EPO) in hemodialysis patients is an increased incidence of thrombosis of the vascular access. However, little is known about the effect of EPO on the stenotic lesion in the venous outflow system, which is the leading cause of fistula thrombosis. This study was designed to explore the long-term effects of EPO treatment on progressive fistula stenosis and the plasma concentrations of some potential mediators of neointimal hyperplasia. A cross-sectional and 3-yr prospective, placebo-controlled, pilot study was performed in 30 hemodialysis patients with native arteriovenous fistula. Sixteen patients received EPO and 14 received a placebo. Venous dialysis pressure, urea recirculation, color Doppler sonography, and angiography were used to monitor vascular access patency. Compared with 60 healthy subjects, the hemodialysis patients had elevated plasma levels of platelet-derived growth factor, monocyte chemoattractant protein-1, and interleukin 6, three proteins that might be involved in the neointima formation regulating the proliferation of vascular smooth muscle cells. In addition, these patients had numerous endothelial and hemostatic abnormalities that indicated a thrombophilic state. Eleven patients, six (37.5%) receiving EPO and five (35.7%) taking placebo, developed a progressive stenosis in the venous circuit of the fistula. There was no significant difference in the vascular access, event-free survival over 36 mo between patients receiving EPO therapy and placebo. EPO induced a significant decrease in the plasma values of platelet-derived growth factor and vascular cell adhesion molecule-1 and an increase of monocyte chemoattractant protein-1 concentration. After EPO withdrawal, these parameters returned to pretreatment levels. In conclusion, long-term EPO therapy does not increase the risk of progressive stenosis of native arteriovenous fistula. The use of erythropoietin does not induce any prothrombotic change in hemostatic parameters, and further studies are required to elucidate the theoretically beneficial effects on the plasma concentration of some potential mediators of neointimal formation.

Abstract W MP32: Localized Increase of Chemokines in the Lumen of Human Cerebral Aneurysms

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Nohra Chalouhi ◽  
Lauren Points ◽  
Gary L Pierce ◽  
Zuhair Ballas ◽  
Pascal Jabbour ◽  
...  
Keyword(s):  
Growth Factor ◽  
Plasma Concentrations ◽  
Cerebral Aneurysms ◽  
Monocyte Chemoattractant Protein 1 ◽  
Monocyte Chemoattractant ◽  
Femoral Arteries ◽  
Monocyte Chemoattractant Protein ◽  
Inflammatory Protein ◽  
Inflammatory Molecules ◽  
Macrophage Inflammatory Protein

Introduction: Inflammation may play an important role in the formation and rupture of cerebral aneurysms. Chemokines act as chemoattractants for leukocytes directing them toward sites of tissue inflammation. The purpose of this study was to determine whether chemokines and chemoattractant cytokines were increased in the lumen of human cerebral aneurysms. Methods: The concentrations of chemokines and other inflammatory molecules in blood samples drawn from the lumen of human cerebral aneurysms of 16 consecutive patients (harboring 18 aneurysms) were compared with blood samples from femoral arteries of the same patients. Specifically, the concentrations of the following molecules were determined: RANTES, monokine-induced-by-gamma-interferon (MIG), interferon-gamma-induced protein-10 (IP-10), eotaxin, interleukin (IL) 1-beta, IL 1 Receptor Antagonist, IL2, IL2 Receptor, IL4, IL5, IL6, I7, IL8, IL10, IL12, IL13, IL15, IL17, vascular endothelial growth factor, granulocyte colony stimulating factor, epidermal growth factor, basic fibroblast growth factor, granulocyte monocyte colony stimulating factor, tumor necrosis factor-alpha, interferon-alpha, interferon-gamma, macrophage inflammatory protein 1 alpha, macrophage inflammatory protein-1-beta, and monocyte chemoattractant protein-1 (MCP-1). Results: The mean plasma concentration of RANTES, MIG, IP-10, eotaxin, IL 8, and IL17 was significantly higher in samples taken from cerebral aneurysms compared with femoral arteries. In contrast, plasma concentrations of all remaining inflammatory molecules (except IL6) that were tested did not differ between cerebral aneurysms and femoral arteries. For unruptured aneurysms, there was a significantly higher mean plasma concentration of monocyte chemoattractant protein-1,RANTES, MIG, IP-10, eotaxin, IL8, and IL17 in samples obtained from cerebral aneurysms. Conclusions: High plasma concentrations of chemokines (monocyte chemoattractant protein-1, RANTES, MIG, IP-10, and eotaxin) and chemoattractant cytokines (IL8 and IL17) were found in the lumen of human cerebral aneurysms. These findings suggest that there may be an active recruitment of inflammatory cells into the aneurysm wall that may be exploited therapeutically.

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