Autologous arteriovenous fistula (AVF) is commonly placed for hemodialysis treatment. Recent studies show that increased baseline serum level of Chitinase-3-like protein 1 (CHI3L1) is independently associated with a higher risk of the early failure of forearm AVFs. However, the changes and mechanisms of CHI3LI in local vascular tissues of failed AVF have not be revealed. This study aims to conduct the expression and mechanism of CHI3L1 in vascular tissues from patients. Immunoreactivity of CHI3L1, matrix metalloproteinase 2 (MMP-2) and vascular endothelial growth factor-A (VEGF-A) were detected in vascular tissues collected from nine patients with AVF surgery. Due to the significant stenosis clinically, six of the nine patients received arteriovenous fistula reconstruction. The expression differences of CHI3L1 between the initial vascular tissues and failed AVF are significant (P < 0.05). Failed AVF due to stenosis shows intraluminal thrombus, collagen fiber rupture, fibrous connective tissue hyperplasia, tube wall thickening, neovascularization, scattered inflammatory cell infiltration in the tunica media as well as high CHI3L1 expression level, and the expression of MMP-2 (r = 0.9022, P = 0.0139) and VEGF-A (r = 0.8355, P = 0.0393) was positively correlated with CHI3L1. CHI3L1 expression in vascular tissues possibly plays an important role in AVF failure. MMP-2 and VEGF-A may participate in venous stenosis with CHI3L1.

中文翻译：

---

CHI3L1 在终末期肾病自体动静脉瘘失败中的潜在作用。

自体动静脉瘘 (AVF) 通常用于血液透析治疗。最近的研究表明，几丁质酶 3 样蛋白 1 (CHI3L1) 的基线血清水平升高与前臂 AVF 早期衰竭的较高风险独立相关。然而，CHI3LI 在 AVF 失败的局部血管组织中的变化和机制尚未揭示。本研究旨在研究CHI3L1在患者血管组织中的表达及其机制。在从 9 名 AVF 手术患者收集的血管组织中检测到 CHI3L1、基质金属蛋白酶 2 (MMP-2) 和血管内皮生长因子-A (VEGF-A) 的免疫反应性。由于临床上明显狭窄，9 例患者中有 6 例接受了动静脉瘘重建术。CHI3L1在初始维管组织和失败AVF中的表达差异有显着性(P < 0.05)。因狭窄而失败的 AVF 表现为腔内血栓、胶原纤维断裂、纤维结缔组织增生、管壁增厚、新生血管、中膜散在炎性细胞浸润以及 CHI3L1 高表达、MMP-2 表达（r = 0.9022，P = 0.0139）和 VEGF-A（r = 0.8355，P = 0.0393）与 CHI3L1 呈正相关。维管组织中 CHI3L1 的表达可能在 AVF 失败中起重要作用。MMP-2 和 VEGF-A 可能与 CHI3L1 一起参与静脉狭窄。新生血管、中膜散在炎症细胞浸润以及CHI3L1高表达，与MMP-2（r=0.9022，P=0.0139）和VEGF-A（r=0.8355，P=0.0393）的表达呈正相关与 CHI3L1。维管组织中 CHI3L1 的表达可能在 AVF 失败中起重要作用。MMP-2 和 VEGF-A 可能与 CHI3L1 一起参与静脉狭窄。新生血管、中膜散在炎症细胞浸润以及CHI3L1高表达，与MMP-2（r=0.9022，P=0.0139）和VEGF-A（r=0.8355，P=0.0393）的表达呈正相关与 CHI3L1。维管组织中 CHI3L1 的表达可能在 AVF 失败中起重要作用。MMP-2 和 VEGF-A 可能与 CHI3L1 一起参与静脉狭窄。