Expression of caspase-3-dependent apoptosis in mural thrombi leukocytes.
Failure of arteriovenous access is mostly due to graft thrombosis and multifactorial, with medical and surgical etiologies. Apoptosis of blood cells, such as macrophages, lymphocytes and eosinophils, may play an important role in thrombus formation. We also investigated caspase-3-dependent apoptosis in thrombi. We recorded clinical parameters in 43 consecutive patients with vascular access failure (13 men, 30 women; mean age+/-SD, 64.6+/-14.2 years) who underwent surgical thrombectomy. Major presentations included absent (92%) and/or near near-absent (16%) flow through the access during hemodialysis. Cardiovascular risk factors were hypertension (70%), hyperlipidemia (47%), diabetes mellitus (47%), chronic obstructive pulmonary disease (12%), heart failure (12%), coronary artery disease (21%), and stroke (16%). Laboratory data included hemoglobin level of 100+/-17 g/L, total white blood cell count of 7.65+/-2.14 x 10(9)/L, and platelet count of 205.6+/-57.9 1000/ìL. Abnormal biochemistry data included elevated blood urea nitrogen level of 63.5+/-24.4 mg/dL and creatinine level of 8.6+/-4.0 mg/dL (normal <1.4 mg/dL). Thrombi were characterized by apoptosis (32%) in a caspase-dependent pathway in all types of leukocytes. Thrombi in arteriovenous access failure demonstrate apoptosis by means of the caspase-3 pathway in white blood cells.
Chu
Pao-Hsien
PH
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, COllege of Medicine, Chang Gung University, Taipei, Taiwan. pchu@adm.cgmh.org.tw
Jung
Shih-Ming
SM
Yeh
Chi-Hsiao
CH
Wu
Hsueh-Hua
HH
Shiu
Tzu-Fang
TF
She
Hung-Chung
HC
Tseng
Ngan-Ming
NM
D000368:Aged; D017209:Apoptosis; D050197:Atherosclerosis / Q000209:etiology* / Q000473:pathology; D053148:Caspase 3 / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications; D006973:Hypertension / Q000097:blood / Q000150:complications; D007668:Kidney / Q000098:blood supply; D007962:Leukocytes / Q000201:enzymology* / Q000473:pathology*; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012079:Renal Circulation; D006435:Renal Dialysis; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000150:complications; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery
D053148:Caspase 3