title: Radiation arteriopathy in the transgenic arteriovenous fistula model.
abstract: OBJECTIVE
  The transgenic arteriovenous fistula model, surgically constructed with transgenic mouse aorta interposed in common carotid artery-to-external jugular vein fistulae in nude rats, has a 4-month experimental window because patency and transgenic phenotype are lost over time. We adapted this model to investigate occlusive arteriopathy in brain arteriovenous malformations after radiosurgery by radiating grafted aorta before insertion in the fistula. We hypothesized that high-dose radiation would reproduce the arteriopathy observed clinically within the experimental time window and that deletions of endoglin (ENG) and endothelial nitric oxide synthase (eNOS) genes would modify the radiation response.
  
  
  METHODS
  Radiation arteriopathy in the common carotid arteries of 171 wild-type mice was examined with doses of 25, 80, 120, or 200 Gy (Experiment 1). Radiation arteriopathy in 68 wild-type arteriovenous fistulae was examined histologically and morphometrically with preoperative radiation doses of 0, 25, or 200 Gy (Experiment 2). Radiation arteriopathy in 51 transgenic arteriovenous fistulae (36 ENG and 15 eNOS knock-out fistulae) was examined using preoperative radiation doses of 0, 25, or 200 Gy (Experiment 3).
  
  
  RESULTS
  High-dose radiation (200 Gy) of mouse common carotid arteries induced only mild arteriopathy (mean score, 0.66) without intimal hyperplasia and with high mortality (68%). Radiation arteriopathy in wild-type arteriovenous fistulae was severe (mean score, 3.5 at 200 Gy), with intimal hyperplasia and medial disruption at 3 months, decreasing luminal areas with increasing dose, and no mortality. Arteriopathy was robust in transgenic arteriovenous fistulae with ENG +/- and with eNOS +/-, with thick intimal hyperplasia in the former and distinct smooth muscle cell proliferation in the latter.
  
  
  CONCLUSIONS
  The transgenic arteriovenous fistula model can be adapted to rapidly reproduce radiation arteriopathy observed in resected brain arteriovenous malformations after radiosurgery. High radiation doses accelerate the progression of arteriopathy to fit the 4-month time limitation of the model, allowing transgenic tissues to retain their phenotypes throughout the experimental window. Modified radiation responses in ENG and eNOS knock-out fistulae indicate that arteriopathy after arteriovenous malformation radiosurgery might potentially be enhanced by altered gene expression.
authors.affiliation: Department of Neurological Surgery, Center for Cerebrovascular Research, University of California at San Francisco, San Francisco, California 94143-0112, USA. lawtonm@neurosurg.ucsf.edu
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lawton
authors.forename: Christine M
authors.initials: CM
authors.lastname: Arnold
authors.forename: Yung J
authors.initials: YJ
authors.lastname: Kim
authors.forename: Ernesto A
authors.initials: EA
authors.lastname: Bogarin
authors.forename: Campbell L
authors.initials: CL
authors.lastname: Stewart
authors.forename: Amanda A
authors.initials: AA
authors.lastname: Wulfstat
authors.forename: Nikita
authors.initials: N
authors.lastname: Derugin
authors.forename: Dennis
authors.initials: D
authors.lastname: Deen
authors.forename: William L
authors.initials: WL
authors.lastname: Young
mesh_terms: D000818:Animals; D001011:Aorta / Q000528:radiation effects / Q000637:transplantation; D001164:Arteriovenous Fistula / Q000601:surgery*; D002339:Carotid Arteries / Q000528:radiation effects* / Q000601:surgery; D004195:Disease Models, Animal; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D007601:Jugular Veins / Q000528:radiation effects* / Q000601:surgery; D051379:Mice; D008822:Mice, Transgenic; D016634:Radiosurgery; D051381:Rats; D011923:Rats, Nude