Transforming growth factor-beta(1) may be involved in shunt obstruction inpatients on chronic hemodialysis

Obstructed shunt vessels were studied immunohistochemically to clarify the mechanism of shunt obstruction in hemodialysis patients. The subjects were 12 hemodialysis patients with shunt obstruction, and 8 patients newly start ed on hemodialysis were used as the controls. Cryosections of shunt tissue were prepared and stained for thrombomodulin as well as transforming growth factor-pi using the enzyme antibody method. In the obstructed shunt group, the intima was significantly thicker than in the control group. In additio n, staining of the intima for thrombomodulin was decreased in the obstructe d shunt group when compared with the controls. Staining for transforming gr owth factor-pi was related to intimal thickening and cell proliferation, Th ese results indicate that release of thrombomodulin occurs with vascular en dothelial cell damage and that transforming growth factor-pi may be involve d in intimal hypertrophic change and shunt obstruction.