Transcriptomic Evaluation of Vein Tissue to Identify Risk Factors for Stenosis in Autologous Arteriovenous Fistulas

Background: Diabetes mellitus and hypertension have been reported as risks for shunt failure, but their molecular mechanisms are unknown. We conducted an analysis of the comprehensive gene expression profile of the cephalic vein to identify the set of genes whose expression variations were induced in the venous tissue of patients who required vascular access interventional study (VAIVT) within one year following arterio-venous fistula (AVF) creation. Methods: A transcriptome analysis was conducted on 21 patients with end-stage renal failure who underwent arteriovenous fistula (AVF) creation at our hospital. The analysis utilized the Next Seq 500 platform to examine venous transections collected at the time of anastomosis. The study compared patients who required vascular access intervention within one year post-surgery (10 patients) with those who did not require such intervention (11 patients). Results: There was no difference in the prevalence of hypertension or diabetes mellitus. 282 molecules were defined as variable genes (DEGs) with fold change >1.5 or <0.67, p<0.05. Enrichment analysis showed fluctuations in the expression of inflammation-related molecules, including a group of molecules regulated by STAT2. Network analysis of DEGs identified S100A8, S100A9 and CXCR1 as hub genes. Conclusion: Inflammation-related genes expressed in anastomotic veins may modulate the molecular mechanism of shunt stenosis.