title: CD4(+) lymphocytes improve venous blood flow in experimental arteriovenous fistulae.
abstract: BACKGROUND
  The role of immune cells in arteriovenous fistulae (AVF) maturation is poorly understood and has received, until quite recently, little attention. This study examines the function of T lymphocytes in AVF vascular remodeling.
  
  
  METHODS
  Experimental fistulae were created in athymic rnu nude rats lacking mature T lymphocytes and euthymic control animals by anastomosing the left superior epigastric vein to the nearby femoral artery. Blood flow rates, wall morphology, and histologic changes were assessed in AVF 21 days after creation. The effect of CD4(+) lymphocytes on AVF maturation in athymic animals was analyzed by adoptive transfer of cells after fistula creation.
  
  
  RESULTS
  The absence of T lymphocytes compromised blood flow in experimental fistulae. Histopathologic inspection of AVF from athymic rats revealed that T-cell immunodeficiency negatively affected venous vascular remodeling, as evidenced by a reduced lumen, a thick muscular layer, and a low number of inflammatory cells compared with control animals. Adoptive transfer of CD4(+) lymphocytes from euthymic rats into athymic animals after fistula creation improved blood flow and reduced intima-media thickness.
  
  
  CONCLUSIONS
  These results point at the protective role of CD4(+) lymphocytes in the remodeling of the AVF vascular wall.
authors.affiliation: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Duque
authors.affiliation: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Laisel
authors.initials: L
authors.lastname: Martinez
authors.affiliation: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Annia
authors.initials: A
authors.lastname: Mesa
authors.affiliation: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Yuntao
authors.initials: Y
authors.lastname: Wei
authors.affiliation: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Marwan
authors.initials: M
authors.lastname: Tabbara
authors.affiliation: Section of Interventional Nephrology, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Loay H
authors.initials: LH
authors.lastname: Salman
authors.affiliation: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL. Electronic address: rvazquez@med.miami.edu.
authors.forename: Roberto I
authors.initials: RI
authors.lastname: Vazquez-Padron
mesh_terms: D000818:Animals; D001166:Arteriovenous Shunt, Surgical; D015415:Biomarkers / Q000378:metabolism; D001783:Blood Flow Velocity; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism*; D005263:Femoral Artery / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D007150:Immunohistochemistry; D008297:Male; D051381:Rats; D011923:Rats, Nude; D066253:Vascular Remodeling / Q000276:immunology*
chemical_list: D015415:Biomarkers