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This Article Full Text Full Text (PDF) All Versions of this Article: 293/1/H482    most recent 01372.2006v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Jiang, Z. Articles by Berceli, S. A. Search for Related Content PubMed PubMed Citation Articles by Jiang, Z. Articles by Berceli, S. A.

TGF-- and CTGF-mediated fibroblast recruitment influences early outward vein graft remodeling

¹University of Florida College of Medicine and the Malcom Randall Veterans Affairs Medical Center, and ²Department of Obstetrics and Gynecology University of Florida College of Medicine, Gainesville, Florida

Submitted 15 December 2006 ; accepted in final form 16 March 2007

Luminal shearing forces have been shown to impact both geometric remodeling and the development of intimal hyperplasia. Less well studied is the influence of intramural wall stresses on vessel growth and adaptation. Using a vein graft-fistula configuration to isolate the impact of circumferential wall stress, we identify the reorganization of adventitial myofibroblasts as the dominant histological event that limits early outward remodeling of vein grafts in response to elevated wall stress. We hypothesize that increased production of transforming growth factor- (TGF-) and connective tissue growth factor (CTGF) induces recruitment of myofibroblasts, promotes adventitial reorganization, and limits early outward remodeling in response to increased intramural wall stress. Vein grafts with a distal arteriovenous fistula in the neck of rabbits were constructed, resulting in a fourfold differential in circumferential wall stress. Using this model, we demonstrate 1) elevated wall stress augments the production of TGF- and CTGF, 2) increased TGF- expression and CTGF expression are correlated with the enhanced differentiation from fibroblasts to myofibroblasts, as evidenced by the significant increase in the -actin-positive cells in adventitia, and 3) the levels of TGF-, CTGF, and -actin are inversely correlated with the magnitude of outward remodeling of the graft wall. Increased wall stress after vein graft implantation appears to induce a TGF-- and CTGF-mediated recruitment of adventitial fibroblasts and a conversion to a myofibroblast phenotype. Although important in the maintenance of wall stability in the face of an increased mechanical load, this adventitial adaptation limits early outward remodeling of the vein conduit and may prove deleterious in maintaining long-term vein graft patency.

connective tissue growth factor; transforming growth factor-; vascular remodeling; hemodynamics; wall stress

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