Apoptoza u stijenci nativne vene u neuspjehu arteriovenskih fistula za hemodijalizu [Apoptosis in native vein wall in failure of hemodialysis arteriovenous fistulas ]

Leci-Tahiri, Laura (2016) Apoptoza u stijenci nativne vene u neuspjehu arteriovenskih fistula za hemodijalizu [Apoptosis in native vein wall in failure of hemodialysis arteriovenous fistulas ]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

In line with the growing interest for studying apoptosis in blood vessels, this study is one of the first to assess the apoptosis in native veins used for arteriovenous fistulas (AVF) done for hemodialysis. The aim of this study was to evaluate apoptosis in previously punctured native veins (study groupy) compared with not punctured native veins (controls) in patients who undergo a surgical procedure for AVF as dialysis access. Cephalic vein specimens were obtained from 60 patients before the placement of AVF. Half of the specimens were from the previously punctured and half from non-punctured veins. A 1-cm long segment was excised from distal part of the cephalic vein, divided into two portions along longitudinal axis and prepared for immunohistochemical analysis. Immunohistochemical assessment and quantification of signals was used to evaluate the expression of Bax, p53, caspase 3 and Bcl-2. Vein specimens from the study group with previously punctured veins showed significantly increased caspase 3 and Bax expression, compared with the control group (p<0.01). Bcl-2 expression in the study group was significantly decreased compared with the control group (p<0.01). p53 showed no significant differences between the two groups (p=0.791). There were statistically significant differences in fistula failure between the study group and control group (26.7% versus 6.7%, p=0.038). The association we have found between previously punctured veins and apoptosis indicates the role that venipuncture may play in the development of apoptosis. Patients with increased apoptosis showed an increased fistula failure, which is of importance for the improvement of the AVF procedure itself.

Abstract in Croatian

U skladu sa rastućim interesom za proučavanje apoptoze u krvnim žilama, ovo istraživanje je jedno od prvih koje procjenjuje apoptozu u nativnim venama namijenjenim za arteriovenske fistule (AVF) u hemodijalizi. Cilj ovog istraživanja bio je procijeniti apoptozu u prethodno probušenim nativnim venama (istraživana skupina) u usporedbi s neprobušenim nativnim venama (kontrolna skupina) u bolesnika koji su podvrgnuti kirurškom postupku za AVF kao pristupu za dijalizu. Uzorci cefalične vene dobiveni su od 60 bolesnika prije postavljanja AVF. Polovica uzoraka bila je iz prethodno probušenih, a polovica iz neprobušenih vena. Iz distalnog dijela cefalične vene izrezan je dio duljine 1-cm, podijeljen u dva dijela duž uzdužne osi i pripremljen za imunohistokemijsku analizu. Imunohistokemijska metoda i kvantifikacija signala se koristila za procjenu proteinske ekspresije Bax, p53, kaspaze 3 i Bcl-2. Uzorci vena iz istraživane skupine s prethodno probušenim venama pokazali su značajno povećani izražaj kaspaze 3 i Bax u usporedbi s kontrolnom skupinom (p <0.01). Izražaj Bcl-2 u istraživanoj skupini bio je značajno smanjen u odnosu na kontrolnu skupinu (p <0,01). Izražaj p53 nije pokazao značajnu razliku između dviju skupina (p = 0,791). Otkrivena je statistički značajna razlika u neuspjehu fistule između istraživane i kontrolne skupine (26,7% u odnosu na 6,7%, p = 0,038). Veza koju smo otkrili između prethodno probušene vene i apoptoze ukazuje na ulogu venepunkcije u razvoju apoptoze. Bolesnici s povećanom apoptozom u cefaličnoj veni pokazali su povećan neuspjeh fistule, pa je to saznanje od značaja za poboljšanje postupka izvedbe AVF.

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