This work was supported in part by the United States Department of Veterans Affairs Biomedical Laboratory Research and Development Program Merit Review Award I01-BX002336, the National Institute of Health grant R56-HL095498, as well as with the resources and the use of facilities at the VA Connecticut Healthcare System, West Haven, CT.

適切な制度的動物実験委員会の承認が得られます。 1.麻酔と手術前の手順<ol><li>気化した3％のイソフルラン及びアクリル誘導チャンバ内に投与0.8リットル/分の酸素と雄のC57BL / 6氷、8週齢を、麻酔。 </li><li>つま先のピンチに反応の欠如によって、十分な麻酔を確認してください。位置操作テーブル上でマウスを仰臥位と気化2配信するためにシリコーンマスクを配置 - 連続吸入により3％のイソフルランを。 </li><li>化学脱毛クリームを使用して、腹部下に首から腹の毛を削除します。 </li><li>関心のある分野で動脈および静脈の流れと血管径のベースライン特性を記録する前にAVF手術にドップラー超音波検査を行う。1,2 </li><li> 25 G針に1mlシリンジを取り付け、所望の薬物と注射器をロードします。ベンド必要性から60度の角度に針が約4ミリメートルル先端。湾曲した針ホルダと25 G針をつかみます。 </li></ol> 2.手術の手順<ol><li>局所消毒で切開部位を準備し、外科用ドレープを適用します。手術を通して無菌技術を維持するために、滅菌手袋や楽器を使用してください。 </li><li>メスはちょうど恥骨の上に下肝縁のレベルから延びるとともに腹部正中切開を行います。 </li><li>開創器を挿入し、右側に向けて腹腔からすべての腸を骨抜き。生理食塩水に浸したガーゼで腸ラップ。大動脈とIVCの完全なビューを得るために、レトロ腹膜および下部結腸を結ぶ膜を解剖。 </li><li>近位および遠位のクランプの準備を、周囲の組織からの赤外線腎大動脈とIVCを解剖。 </li><li>近位大動脈とちょうど左腎静脈下のレベルでの近位IVCの両方にまたがる単一マイクロサークリップを配置します。 Dの両方を横切って第二のマイクロサークリップを配置しますistal大動脈および遠位IVC。 </li><li>前述したように、大動脈の周囲の結合組織をつかみ、大動脈の背側表面はやや動脈穿刺のた ​​めに露出されるように内側に回転させます。1 </li><li>速やかに穿刺部位を露出させます。穿刺部位は、血管、大動脈分岐に左腎静脈からの距離の約四分の三の尾側の側面になります。右手で穿刺を可能にするために十分な曝露があるように左手で回転した位置に大動脈を維持する、大動脈の左横の余白を分析。大動脈とIVCの間で解剖しないように注意してください。 </li><li>回転位置に大動脈を維持し、薬液を含む添付1mlシリンジで25 G針を使用して、IVCへを通して大動脈を穿刺。 （ 図1A） </li><li>左手を使用して - （200μlの100）薬液を注入。針は拡張と薄いを通して見ることができます透明な薬液がIVC（ 図1B、C）のうち、静脈血を変位IVC壁。まだ残っていると15分の位置に針を維持します。 </li><li>唯一の遠位大動脈および遠位IVCをクランプを解除するために、遠位顕微クリップを削除します。 </li><li>針を外し、隣接するレトロ腹膜組織を引き上げて、大動脈の穿刺部位をカバーしています。 </li><li>近位大動脈および近位IVCを解除クランプする近位顕微クリップを削除します。非クランプ時に、動脈血の代わりに暗い静脈血流のIVCに流入観察されます。 1分間の穿刺孔を覆って保管してください。 </li><li>圧縮せずに30秒間観察による止血を確認した後、彼らの自然な位置に腸を戻って承認された動物プロトコルに従って実行されている縫合糸で腹部を閉じます。 </li></ol> 3.術後の手順<ol><li>腹部の閉鎖後、ANESTを中止hesia。施設内動物管理使用委員会が推奨する指示に従い、鎮痛および創傷ケアなどの術後ケアを適用します。鎮痛のために我々は/ kgをintrasmuscularly 24時間ごとに12時間は、手術の手順に従って0.1ミリグラムでブプレノルフィンを使用します。 </li><li>操作後の最初の日に、AVFの開通性を確認するために、ドップラー超音波検査を行います。また、直列に他の容器と流動特性を測定し、手術前のベースライン値からの変化を比較します。1,2 </li></ol><img alt="図1" src="/files/ftp_upload/53905/53905fig1.jpg" /> AVF手術中に管内送出を表示図1（A）手術写真。顕微クリップを適用することにより、近位および遠位大動脈と同様に、IVCをクランプします。取り付けられたシリンジを含む薬液25 G針を用いてIVCにを通じて大動脈を穿刺（B）HIGを注入前のパンクIVCの彼女のパワーピクチャー（4X倍率）。針の先端は暗色の静脈血によって隠されています。黄色の矢印が注入後のパンクIVCのIVC。（C）Aより高い電力ピクチャー（4X倍率）の壁から壁の直径を表します。針先（黒矢印）静脈血を変位透明な薬液として穏やかに膨張及び薄いIVC壁（黄色矢印）を介して見ることができます。

<ol>
	<li>Yamamoto, K., Li, X., Shu, C., Miyata, T., Dardik, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technical+Aspects+of+the+Mouse+Aortocaval+Fistula.">Technical Aspects of the Mouse Aortocaval Fistula.</a> J. Vis. Exp. (77), e50449 (2013).</li><li>Yamamoto, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+mouse+aortocaval+fistula+recapitulates+human+arteriovenous+fistula+maturation.">The mouse aortocaval fistula recapitulates human arteriovenous fistula maturation.</a> Am. J. Physiol.: Heart Circ. Physiol. 305 (12), H1718-H1725 (2013).</li><li>Escobar-Ch&#225;vez, J. J., L&#242;pez-Cervantes, M., Na&#239;k, A., Kalia, Y. N., Quintanar-Guerrero, D., Ganem-Quintanar, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Applications+of+thermo-reversible+pluronic+F-127+gels+in+pharmaceutical+formulations.">Applications of thermo-reversible pluronic F-127 gels in pharmaceutical formulations.</a> J. Pharm. Pharm. Sci. 9 (3), 339-358 (2006).</li><li>Almeida, H., Amaral, M. H., Lob&#227;o, P., Lobo, J. M. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pluronic&#174;+F-127+and+Pluronic+Lecithin+Organogel+(PLO):+main+features+and+their+applications+in+topical+and+transdermal+administration+of+drugs.">Pluronic&#174; F-127 and Pluronic Lecithin Organogel (PLO): main features and their applications in topical and transdermal administration of drugs.</a> J. Pharm. Pharm. Sci. 15 (4), 592-605 (2012).</li><li>Karper, J. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Toll-like+receptor+4+is+involved+in+human+and+mouse+vein+graft+remodeling,+and+local+gene+silencing+reduces+vein+graft+disease+in+hypercholesterolemic+APOE*3Leiden+mice.">Toll-like receptor 4 is involved in human and mouse vein graft remodeling, and local gene silencing reduces vein graft disease in hypercholesterolemic APOE*3Leiden mice.</a> Arterioscler., Thromb., Vasc. Biol. 31 (5), 1033-1040 (2011).</li><li>Redmond, E. M., Hamm, K., Cullen, J. P., Hatch, E., Cahill, P. A., Morrow, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inhibition+of+patched-1+prevents+injury-induced+neointimal+hyperplasia.">Inhibition of patched-1 prevents injury-induced neointimal hyperplasia.</a> Arterioscler., Thromb., Vasc. Biol. 33 (8), 1960-1964 (2013).</li><li>Wong, D. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ephrin+type-B+receptor+4+activation+reduces+neointimal+hyperplasia+in+human+saphenous+vein+in+vitro.">Ephrin type-B receptor 4 activation reduces neointimal hyperplasia in human saphenous vein in vitro.</a> J. Vasc. Surg. , (2014).</li><li>Matsumoto, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hemagglutinating+virus+of+Japan-liposome-mediated+gene+transfer+of+endothelial+cell+nitric+oxide+synthase+inhibits+intimal+hyperplasia+of+canine+vein+grafts+under+conditions+of+poor+runoff.">Hemagglutinating virus of Japan-liposome-mediated gene transfer of endothelial cell nitric oxide synthase inhibits intimal hyperplasia of canine vein grafts under conditions of poor runoff.</a> J. Vasc. Surg. 27 (1), 135-144 (1998).</li><li>Petrofski, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gene+delivery+to+aortocoronary+saphenous+vein+grafts+in+a+large+animal+model+of+intimal+hyperplasia.">Gene delivery to aortocoronary saphenous vein grafts in a large animal model of intimal hyperplasia.</a> J. Thorac. Cardiovasc. Surg. 127 (1), 27-33 (2004).</li><li>Hata, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulation+of+phosphatidylinositol+3-kinase+signaling+reduces+intimal+hyperplasia+in+aortocoronary+saphenous+vein+grafts.">Modulation of phosphatidylinositol 3-kinase signaling reduces intimal hyperplasia in aortocoronary saphenous vein grafts.</a> J. Thorac. Cardiovasc. Surg. 129 (6), 1405-1413 (2005).</li><li>Ohta, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraluminal+gene+transfer+of+endothelial+cell-nitric+oxide+synthase+suppresses+intimal+hyperplasia+of+vein+grafts+in+cholesterol-fed+rabbit:+a+limited+biological+effect+as+a+result+of+the+loss+of+medial+smooth+muscle+cells.">Intraluminal gene transfer of endothelial cell-nitric oxide synthase suppresses intimal hyperplasia of vein grafts in cholesterol-fed rabbit: a limited biological effect as a result of the loss of medial smooth muscle cells.</a> Surg. 131 (6), 644-653 (2002).</li><li>Baldwin, Z. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulation+of+vascular+remodeling+induced+by+a+brief+intraluminal+exposure+to+the+recombinant+R7020+strain+of+Herpes+simplex-1.">Modulation of vascular remodeling induced by a brief intraluminal exposure to the recombinant R7020 strain of Herpes simplex-1.</a> J. Vasc. Surg. 41 (1), 115-121 (2005).</li><li>Eslami, M. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gene+delivery+to+in+situ+veins:+differential+effects+of+adenovirus+and+adeno-associated+viral+vectors.">Gene delivery to in situ veins: differential effects of adenovirus and adeno-associated viral vectors.</a> J. Vasc. Surg. 31 (6), 1149-1159 (2000).</li><li>Globerman, A. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficient+transgene+expression+from+naked+DNA+delivered+into+an+arterio-venous+fistula+model+for+kidney+dialysis.">Efficient transgene expression from naked DNA delivered into an arterio-venous fistula model for kidney dialysis.</a> J. Gene Med. 13 (11), 611-621 (2011).</li><li>Yang, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adventitial+transduction+of+lentivirus-shRNA-VEGF-A+in+arteriovenous+fistula+reduces+venous+stenosis+formation.">Adventitial transduction of lentivirus-shRNA-VEGF-A in arteriovenous fistula reduces venous stenosis formation.</a> Kidney Int. 85 (2), 289-306 (2014).</li><li>Brahmbhatt, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+Iex-1+in+the+pathogenesis+of+venous+neointimal+hyperplasia+associated+with+hemodialysis+arteriovenous+fistula.">The role of Iex-1 in the pathogenesis of venous neointimal hyperplasia associated with hemodialysis arteriovenous fistula.</a> PLoS ONE. 9 (7), e102542 (2014).</li><li>Karram, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Induction+of+cardiac+hypertrophy+by+a+controlled+reproducible+sutureless+aortocaval+shunt+in+the+mouse.">Induction of cardiac hypertrophy by a controlled reproducible sutureless aortocaval shunt in the mouse.</a> J. Investig. Surg. 18 (6), 325-334 (2005).</li><li>Perry, G. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genetic+variation+in+angiotensin-converting+enzyme+does+not+prevent+development+of+cardiac+hypertrophy+or+upregulation+of+angiotensin+II+in+response+to+aortocaval+fistula.">Genetic variation in angiotensin-converting enzyme does not prevent development of cardiac hypertrophy or upregulation of angiotensin II in response to aortocaval fistula.</a> Circ. 103 (7), 1012-1016 (2001).</li><li>Guzman, R. J., Krystkowiak, A., Zarins, C. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Early+and+sustained+medial+cell+activation+after+aortocaval+fistula+creation+in+mice.">Early and sustained medial cell activation after aortocaval fistula creation in mice.</a> J. Surg. Res. 108 (1), 112-121 (2002).</li><li>Alexander, J. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+and+safety+of+edifoligide,+an+E2F+transcription+factor+decoy,+for+prevention+of+vein+graft+failure+following+coronary+artery+bypass+graft+surgery:+PREVENT+IV:+a+randomized+controlled+trial.">Efficacy and safety of edifoligide, an E2F transcription factor decoy, for prevention of vein graft failure following coronary artery bypass graft surgery: PREVENT IV: a randomized controlled trial.</a> JAMA. 294 (19), 2446-2454 (2005).</li><li>Khaleel, M. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=High-pressure+distention+of+the+saphenous+vein+during+preparation+results+in+increased+markers+of+inflammation:+a+potential+mechanism+for+graft+failure.">High-pressure distention of the saphenous vein during preparation results in increased markers of inflammation: a potential mechanism for graft failure.</a> Ann. thorac. surg. 93 (2), 552-558 (2012).</li></ol>

The authors have nothing to disclose.

ネズミAVFモデルのこの変更は、AVFの作成時に静脈内皮への管腔内薬物送達を内蔵しています。 AVFは25 G針で赤外線腎動脈を穿刺し、同じ針を介して薬液の注入に続いてIVCへの反対大動脈壁を通って穿刺を拡張することによって作成されました。解決策は、イントラ大静脈維持されている、すなわち 。、AVFの静脈手足に、デクランプまで。何17-19他のネズミAVFモデルからこのモデ...

大動脈と下大静脈（IVC）の間ネズミaortovenous瘻（AVF）穿刺モデルが確立された技術である。このモデルでは1、赤外線腎大動脈の両方の壁がに出た、25 G針で穿刺されています赤外線腎大静脈に隣接します。前方大動脈エントランスホールは、単純な圧縮で修復され、縫合糸の修理を必要としません。高解像度のドップラー超音波および組織学的分析によりシリアルフォローアップ検査は、AVFは人間のAVFの既知の病態生理を反復する、成熟期、その後、失敗の位相を持つように示している。2 AVFの成熟を調節する機構を調査するために、成熟AVF内皮への治療剤の送達のための改良された方法が必要とされています。血管への治療薬の送達は、内腔への血管内送達を介して、または外膜の外部の送達を介してのいずれかであることができます。外部配信の一例は、comのですmonlyプルロニックゲルの外膜のアプリケーションを使用していました。この共重合体は、熱可逆性であり、体温に暖めたとき、固体ゲルを液体から変換されました。以前の研究は、プルロニックゲルで混合し、薬剤がインビボで局所的に適用されたときに持続的薬物送達が達成される。プルロニックゲルを有するウイルスベクターまたはsiRNAの3,4-外膜アプリケーションは血管周囲送達システムとして有効であることが報告されている示されている。5,6我々また、ペプチドによる外膜の刺激による外植人間の伏在静脈の治療は、内皮受容体タンパク質のリン酸化をもたらしたことを報告している。7 一方、研究者らはまた、静脈グラフトの8月10日 、イヌおよびウサギ11,12モデルにおけるウイルスおよび非ウイルスベクターの両方の管腔内配信を使用しています。これらの報告では、遺伝子導入は、静脈収穫後ex vivoで実施しました。 Eslami らは、血管内のウイルス遺伝子が提供する報告しましたyはバイパスを作成せずにその場で静脈を頸動脈にする。13 Glovermanら。ラット大腿動脈、浅腹壁静脈瘻における裸のDNAの管腔内および外膜の配信を報告した。14メイヨー・グループは、マウス頸動脈-頚静脈瘻における外膜の薬物送達を報告した。15,16しかし、これらの以前に報告されたモデルが作成する縫合吻合を必要とAVF。この報告書では、マウスでの同時AVFの作成と管腔内薬物送達は、AVF作成の縫合レスモデルを用いて、記載されています。この修​​正されたマウスAVFモデルを用いて瘻孔の静脈血肢に管腔内薬物送達のための簡単​​な方法を行うことができます。

<table border="0" cellpadding="0" cellspacing="0" width="948">
	<tbody>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">Pluronic F-127</td>
			<td style="width:259px;">Sigma-Aldrich</td>
			<td style="width:119px;">P2443-250G</td>
			<td style="width:231px;">Used as 30% solution in d-water</td>
		</tr>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">GFP antibody</td>
			<td style="width:259px;">NOVUS BIOLOGICALS INC</td>
			<td style="width:119px;">NB100-1770</td>
			<td></td>
		</tr>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">Ad-CMV-GFP</td>
			<td style="width:259px;">VECTOR BIOLABS</td>
			<td style="width:119px;">1060</td>
			<td></td>
		</tr>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">0.9% Sodium Chloride Irrigation, USP</td>
			<td style="width:259px;">Baxter</td>
			<td style="width:119px;">2F7122</td>
			<td></td>
		</tr>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">BD PrecisionGlide Needle 25G x 5/8</td>
			<td style="width:259px;">BD</td>
			<td style="width:119px;">305122</td>
			<td></td>
		</tr>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">BD 1ml Syringe Tuberculin Slip Tip</td>
			<td style="width:259px;">BD</td>
			<td style="width:119px;">309659</td>
			<td></td>
		</tr>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">Scarpel</td>
			<td style="width:259px;">Surgical Design Inc</td>
			<td style="width:119px;">22079707</td>
			<td></td>
		</tr>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">6-0 ETHILON P-1 11mm 3/8c Reverse Cutting</td>
			<td style="width:259px;">ETHICON INC</td>
			<td style="width:119px;">697G</td>
			<td></td>
		</tr>
		<tr height="69">
			<td height="69" style="height:69px;width:343px;">Vevo 770 ultrasound machine&#160;</td>
			<td style="width:259px;">Visualsonics&#160;</td>
			<td style="width:119px;">20-60 Mhz scan head; RMV-704</td>
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		</tr>
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			<td height="23" style="height:23px;width:343px;">Vascular clamp&#160;</td>
			<td style="width:259px;">Roboz Surgical Instrument Co.</td>
			<td style="width:119px;">RS-5424</td>
			<td></td>
		</tr>
		<tr height="23">
			<td height="23" style="height:23px;width:343px;">Clamp applying forceps&#160;</td>
			<td style="width:259px;">Roboz Surgical Instrument Co.</td>
			<td style="width:119px;">RS-5410</td>
			<td></td>
		</tr>
	</tbody>
</table>

intraluminal drug delivery to the mouse arteriovenous fistula endothelium

動静脈瘻を強化する治療薬の送達（AVF）成熟のいずれか腔内または外部の経路を介して投与することができます。簡単なマウスAVFモデルは、瘻の作成と同時に静脈内皮への薬液の管腔内投与と組み合わせました。このモデルの技術的な側面が議論されています。全身麻酔下で、腹部切開が行われ、大動脈と下大静脈（IVC）が露出しています。赤外線腎大動脈とIVCをクランプするために解剖されています。近位および遠位のクランプ後、穿刺部位が露出され、25 G針を大動脈およびIVCに両方の壁を穿刺するために使用されます。すぐに穿刺した後、レポーター遺伝子を発現するウイルスベクターは、インキュベーションの15分間、続いて、同じ針を介しIVCに注入しました。腔内投与方法は、外部の経路による投与に比べて静脈内皮へのより強固なウイルス遺伝子送達を可能にしました。このノーブ配信lの方法は、AVFの成熟における内皮の役割を探求し、手術時の管腔内薬物送達を可能にする研究を促進します。

33匹のマウスのシリーズでは、最初の術後日目の生存率は97.0％でした。 AVFの開通性は、超音波によって決定されるように、84.9％でした。 従来の外部ルートと、この血管内送達経路の遺伝子導入効率を比較しました。管腔内配信（ILD）の場合は、すぐに穿刺した後、アデノウイルス-GFP（AD-GFP）ベクター溶液（1×10 9</su...

Watch this Scientific Journal Video about Intraluminal Drug Delivery to the Mouse Arteriovenous Fistula Endothelium at JoVE.com

Intraluminal Drug Delivery to the Mouse Arteriovenous Fistula Endothelium

After puncturing the aorta through the inferior vena cava (IVC) to create an aorto-caval fistula in the mouse, solution containing a drug is infused into the IVC via the same needle, followed by incubation. This method enables more robust drug delivery to the venous endothelium compared to the external route.

マウスの動静脈瘻内皮への管腔内薬物送達

Delivery of therapeutic agents to enhance arteriovenous fistula (AVF) maturation can be administered either via intraluminal or external routes. The ...

intraluminal-drug-delivery-to-mouse-arteriovenous-fistula

Research

JoVE Journal

Medicine

9.3K ビュー.  Yale University. After puncturing the aorta through the inferior vena cava (IVC) to create an aorto-caval fistula in the mouse, solution containing a drug is infused into the IVC via the same needle, followed by incubation. This method enables more robust drug delivery to the venous endothelium compared to the external route.

ビデオ: Intraluminal Drug Delivery to the Mouse Arteriovenous Fistula Endothelium

Osmotic Drug Delivery to Ischemic Hindlimbs and Perfusion of Vasculature with Microfil for Micro-Computed Tomography Imaging

Preclinical research in animal models of peripheral arterial disease plays a vital role in testing the efficacy of therapeutic agents designed to stimulate microcirculation. The choice of delivery method for these agents is important because the route of administration profoundly affects the bioactivity and efficacy of these agents1,2. In this article, we demonstrate how to locally administer a substance in ischemic hindlimbs by using a catheterized osmotic pump. This pump can deliver a fixed volume of aqueous solution continuously for an allotted period of time. We also present our mouse model of unilateral hindlimb ischemia induced by ligation of the common femoral artery proximal to the origin of profunda femoris and epigastrica arteries in the left hindlimb. Lastly, we describe the in vivo cannulation and ligation of the infrarenal abdominal aorta and perfusion of the hindlimb vasculature with Microfil, a silicone radiopaque casting agent. Microfil can perfuse and fill the entire vascular bed (arterial and venous), and because we have ligated the major vascular conduit for exit, the agent can be retained in the vasculature for future ex vivo imaging with the use of small specimen micro-CT3.

We show here the in vivo insertion of an osmotic pump for constant local drug delivery and the creation of hindlimb ischemia in a mouse model. Moreover, the hindlimb vasculature is perfused with Microfil, a silicone radiopaque agent, to prepare for micro-computed tomography (micro-CT) imaging.

マイクロコンピュータ断層撮影イメージング用Microfilで虚血後肢と血管系の灌流に浸透ドラッグデリバリー

Preclinical research in animal models of peripheral arterial disease plays a vital role in testing the efficacy of therapeutic agents designed to ...

医学

Technical Aspects of the Mouse Aortocaval Fistula

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta and inferior vena cava (IVC) are exposed. The proximal infrarenal aorta and the distal aorta are dissected for clamp placement and needle puncture, respectively. Special attention is paid to avoid dissection between the aorta and the IVC. After clamping the aorta, a 25 G needle is used to puncture both walls of the aorta into the IVC. The surrounding connective tissue is used for hemostatic compression. Successful creation of the AVF will show pulsatile arterial blood flow in the IVC. Further confirmation of successful AVF can be achieved by post-operative Doppler ultrasound.

The goal is to produce an arteriovenous fistula that is simple and reproducible. This method does not use sutures or glue adhesive. Therefore the samples can be used with the least amount of foreign materials for analysis.

マウスAortocaval瘻の技術的な側面

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta ...

Heterotopic Mucosal Engrafting Procedure for Direct Drug Delivery to the Brain in Mice

Delivery of therapeutics into the brain is impeded by the presence of the blood-brain barrier (BBB) which restricts the passage of polar and high molecular weight compounds from the bloodstream and into brain tissue. Some direct delivery success in humans has been achieved via implantation of transcranial catheters; however this method is highly invasive and associated with numerous complications. A less invasive alternative would be to dose the brain through a surgically implanted, semipermeable membrane such as the nasal mucosa that is used to repair skull base defects following endoscopic transnasal tumor removal surgery in humans. Drug transfer though this membrane would effectively bypass the BBB and diffuse directly into the brain and cerebrospinal fluid. Inspired by this approach, a surgical approach in mice was developed that uses a donor septal mucosal membrane engrafted over an extracranial surgical BBB defect. This model has been shown to effectively allow the passage of high molecular weight compounds into the brain. Since numerous drug candidates are incapable of crossing the BBB, this model is valuable for performing preclinical testing of novel therapies for neurological and psychiatric diseases.

A mouse model of human endoscopic skull base reconstruction has been developed that creates a semipermeable interface between the brain and nose using nasal mucosal grafts. This method allows researchers to study delivery to the central nervous system of high molecular weight therapeutics which are otherwise excluded by the blood-brain barrier when administered systemically.

マウスの脳に直接薬剤送達のための異粘膜移植手順

Delivery of therapeutics into the brain is impeded by the presence of the blood-brain barrier (BBB) which restricts the passage of polar and high ...

Slow-release Drug Delivery through Elvax 40W to the Rat Retina: Implications for the Treatment of Chronic Conditions

Diseases of the retina are difficult to treat as the retina lies deep within the eye. Invasive methods of drug delivery are often needed to treat these diseases. Chronic retinal diseases such as retinal oedema or neovascularization usually require multiple intraocular injections to effectively treat the condition. However, the risks associated with these injections increase with repeated delivery of the drug. Therefore, alternative delivery methods need to be established in order to minimize the risks of reinjection. Several other investigations have developed methods to deliver drugs over extended time, through materials capable of releasing chemicals slowly into the eye. In this investigation, we outline the use of Elvax 40W, a copolymer resin, to act as a vehicle for drug delivery to the adult rat retina. The resin is made and loaded with the drug. The drug-resin complex is then implanted into the vitreous cavity, where it will slowly release the drug over time. This method was tested using 2-amino-4-phosphonobutyrate (APB), a glutamate analogue that blocks the light response of the retina. It was demonstrated that the APB was slowly released from the resin, and was able to block the retinal response by 7 days after implantation. This indicates that slow-release drug delivery using this copolymer resin is effective for treating the retina, and could be used therapeutically with further testing.

This paper details how Elvax 40W can be used as a slow-release method for drug delivery to the adult rat retina. The protocol for preparing, loading, and delivering the drug-resin complex to the eye is described.

ラット網膜へのエルバックス40Wを通じて徐放性ドラッグデリバリー：慢性症状の治療のための含意

Diseases of the retina are difficult to treat as the retina lies deep within the eye. Invasive methods of drug delivery are often needed to treat these ...

A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

The arteriovenous fistula (AVF) still suffers from a high number of failures caused by insufficient remodeling and intimal hyperplasia from which the exact pathophysiology remains unknown. In order to unravel the pathophysiology a murine model of AVF-failure was developed in which the configuration of the anastomosis resembles the preferred situation in the clinical setting. A model was described in which an AVF is created by connecting the venous end of the branch of the external jugular vein to the side of the common carotid artery using interrupted sutures. At a histological level, we observed progressive stenotic intimal lesions in the venous outflow tract that is also seen in failed human AVFs. Although this procedure can be technically challenging due to the small dimensions of the animal, we were able to achieve a surgical success rate of 97% after sufficient training. The key advantage of a murine model is the availability of transgenic animals. In view of the different proposed mechanisms that are responsible for AVF failure, disabling genes that might play a role in vascular remodeling can help us to unravel the complex pathophysiology of AVF failure.

Here we present a murine model of arteriovenous fistula (AVF) failure in which a clinically relevant anastomotic configuration is incorporated. This model can be used to study the pathophysiology and to test possible therapeutic interventions.

動静脈瘻の障害の新規マウスモデル：詳細の外科的手順

The arteriovenous fistula (AVF) still suffers from a high number of failures caused by insufficient remodeling and intimal hyperplasia from which the ...

Pancreatic Duct Infusion: An Effective and Selective Method of Drug and Viral Delivery

The pancreas is a bifunctional organ with both endocrine and exocrine components. A number of pathologies can afflict the pancreas, including diabetes, pancreatitis, and pancreatic cancer. All three of these diseases mark active areas of study, not only to develop immediate therapy, but also to better understand their pathophysiology. There are few tools to further these areas of study. Pancreatic duct infusion is an important technique that can allow for lineage tracing, gene introduction, and cell line-specific targeting. The technique requires the intricate dissection of the second portion of the duodenum and ampulla, followed by the occlusion of the bile duct and the cannulation of the pancreatic duct. Although the technique is technically challenging at first, the applications are myriad. Ambiguity in the specifics of the procedure between groups highlighted the need for a standard protocol. This work describes the expression of a green fluorescent protein (GFP) within the pancreas after the pancreatic duct infusion of a viral vector expressing GFP versus a sham surgery. The infusion and therefore expression is specific to the pancreas, without expression present in any other tissue type.

Pancreatic duct infusion is an important technique that can allow for lineage tracing, gene introduction, and cell line-specific targeting. A pancreatic duct infusion technique for drug and viral delivery to pancreatic cells is presented here.

膵管注入:薬物およびウイルス送達の有効かつ選択的な方法

The pancreas is a bifunctional organ with both endocrine and exocrine components. A number of pathologies can afflict the pancreas, including diabetes, ...

Optimized LC-MS/MS Method for the High-throughput Analysis of Clinical Samples of Ivacaftor, Its Major Metabolites, and Lumacaftor in Biological Fluids of Cystic Fibrosis Patients

Defects in the cystic fibrosis trans-membrane conductance regulator (CFTR) are the cause of cystic fibrosis (CF), a disease with life-threatening pulmonary manifestations. Ivacaftor (IVA) and ivacaftor-lumacaftor (LUMA) combination are two new breakthrough CF drugs that directly modulate the activity and trafficking of the defective CFTR-protein. However, there is still a dearth of understanding on pharmacokinetic/pharmacodynamic parameters and the pharmacology of ivacaftor and lumacaftor. The HPLC-MS technique for the simultaneous analysis of the concentrations of ivacaftor, hydroxymethyl-ivacaftor, ivacaftor-carboxylate, and lumacaftor in biological fluids in patients receiving standard ivacaftor or ivacaftor-lumacaftor combination therapy has previously been developed by our group and partially validated to FDA standards. However, to allow the high-throughput analysis of a larger number of patient samples, our group has optimized the reported method through the use of a smaller pore size reverse-phase chromatography column (2.6 &#181;m, C8 100 &#197;; 50 x 2.1 mm) and a gradient solvent system (0-1 min: 40% B; 1-2 min: 40-70% B; 2-2.7 min: held at 70% B; 2.7-2.8 min: 70-90% B; 2.8-4.0 min: 90% B washing; 4.0-4.1 min: 90-40% B; 4.1-6.0 min: held at 40% B) instead of an isocratic elution. The goal of this study was to reduce the HPLC-MS analysis time per sample dramatically from ~15 min to only 6 min per sample, which is essential for the analysis of a large amount of patient samples. This expedient method will be of considerable utility for studies into the exposure-response relationships of these breakthrough CF drugs.

Ivacaftor and ivacaftor-lumacaftor combination are two new CF drugs. However, there is still a dearth of understanding on their PK/PD and pharmacology. We present an optimized HPLC-MS technique for the simultaneous analysis of ivacaftor and its major metabolites, and lumacaftor.

Ivacaftor、主要な代謝産物および嚢胞性線維症患者の体液中の Lumacaftor の臨床サンプルの高スループット分析のための最適化された LC-MS/MS 法

Defects in the cystic fibrosis trans-membrane conductance regulator (CFTR) are the cause of cystic fibrosis (CF), a disease with life-threatening ...

Improved Method for the Establishment of an In Vitro Blood-Brain Barrier Model Based on Porcine Brain Endothelial Cells

The aim of this protocol presents an optimized procedure for the purification and cultivation of pBECs and to establish in vitro blood-brain barrier (BBB) models based on pBECs in mono-culture (MC), MC with astrocyte-conditioned medium (ACM), and non-contact co-culture (NCC) with astrocytes of porcine or rat origin. pBECs were isolated and cultured from fragments of capillaries from the brain cortices of domestic pigs 5-6 months old. These fragments were purified by careful removal of meninges, isolation and homogenization of grey matter, filtration, enzymatic digestion, and centrifugation. To further eliminate contaminating cells, the capillary fragments were cultured with puromycin-containing medium. When 60-95% confluent, pBECs growing from the capillary fragments were passaged to permeable membrane filter inserts and established in the models. To increase barrier tightness and BBB characteristic phenotype of pBECs, the cells were treated with the following differentiation factors: membrane permeant 8-CPT-cAMP (here abbreviated cAMP), hydrocortisone, and a phosphodiesterase inhibitor, RO-20-1724 (RO). The procedure was carried out over a period of 9-11 days, and when establishing the NCC model, the astrocytes were cultured 2-8 weeks in advance. Adherence to the described procedures in the protocol has allowed the establishment of endothelial layers with highly restricted paracellular permeability, with the NCC model showing an average transendothelial electrical resistance (TEER) of 1249 &#177; 80 &#937; cm2, and paracellular permeability (Papp) for Lucifer Yellow of 0.90 10-6 &#177; 0.13 10-6 cm sec-1 (mean &#177; SEM, n=55). Further evaluation of this pBEC phenotype showed good expression of the tight junctional proteins claudin 5, ZO-1, occludin and adherens junction protein p120 catenin. The model presented can be used for a range of studies of the BBB in health and disease and, with the highly restrictive paracellular permeability, this model is suitable for studies of transport and intracellular trafficking.

Improved Method for the Establishment of an In Vitro Blood-Brain Barrier Model Based on Porcine Brain Endothelial Cells

The aim of the protocol is to present an optimized procedure for the establishment of an in vitro blood-brain barrier (BBB) model based on primary porcine brain endothelial cells (pBECs). The model shows high reproducibility, high tightness, and is suitable for studies of transport and intracellular trafficking in drug discovery.

体外血液脳関門ブタ脳血管内皮細胞に基づくモデルの確立のための改良法

The aim of this protocol presents an optimized procedure for the purification and cultivation of pBECs and to establish in vitro blood-brain barrier (BBB) ...

Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity

The systemic administration of protective agents to treat drug-induced ototoxicity is limited by the possibility that these protective agents could interfere with the chemotherapeutic efficacy of the primary drugs. This is especially true for the drug cisplatin, whose anticancer actions are attenuated by antioxidants which provide adequate protection against hearing loss. Other current or potential otoprotective agents could pose a similar problem, if administered systemically. The application of various biologicals or protective agents directly to the cochlea would allow for high levels of these agents locally with limited systemic side effects. In this report, we demonstrate a trans-tympanic method of delivery of various drugs or biological reagents to the cochlea, which should enhance basic science research on the cochlea and provide a simple way of directing the use of otoprotective agents in the clinics. This report details a method of trans-tympanic drug delivery and provides examples of how this technique has been used successfully in experimental animals to treat cisplatin ototoxicity.

We present a technique for localized administration of drugs through the trans-tympanic route into the cochlea. Drug delivery through this route would not interfere with the anti-cancer efficacy of the chemotherapeutic drugs such as cisplatin.

難聴の治療のためのトランス鼓膜ドラッグデリバリー

The systemic administration of protective agents to treat drug-induced ototoxicity is limited by the possibility that these protective agents could ...

In Vivo Gene Transfer to the Rabbit Common Carotid Artery Endothelium

The goal of this method is to introduce a transgene into the endothelium of isolated segments of both rabbit common carotid arteries. The method achieves focal endothelial-selective transgenesis, thereby allowing an investigator to determine the biological roles of endothelial-expressed transgenes and to quantify the in vivo transcriptional activity of DNA sequences in large artery endothelial cells. The method uses surgical isolation of rabbit common carotid arteries and an arteriotomy to deliver a transgene-expressing viral vector into the arterial lumen. A short incubation period of the vector in the lumen, with subsequent aspiration of the lumen contents, is sufficient to achieve efficient and durable expression of the transgene in the endothelium, with no detectable transduction or expression outside of the isolated arterial segment. The method allows assessment of the biological activities of transgene products both in normal arteries and in models of human vascular disease, while avoiding systemic effects that could be caused either by targeting gene delivery to other sites (e.g. the liver) or by the alternative approach of delivering genetic constructs to the endothelium by germ line transgenesis. Application of the method is limited by the need for a skilled surgeon and anesthetist, a well-equipped operating room, the costs of purchasing and housing rabbits, and the need for expertise in gene-transfer vector construction and use. Results obtained with this method include: transgene-related alterations in arterial structure, cellularity, extracellular matrix, or vasomotor function; increases or reductions in arterial inflammation; alterations in vascular cell apoptosis; and progression, retardation, or regression of diseases such as intimal hyperplasia or atherosclerosis. The method also allows measurement of the ability of native and synthetic DNA regulatory sequences to alter transgene expression in endothelial cells, providing results that include: levels of transgene mRNA, levels of transgene protein, and levels of transgene enzymatic activity.