UVA Health researchers are developing epiNanopaint, which could help dialysis and heart disease patients avoid the need for repeated surgeries.
UVA Health researchers received $2.8 million to advance the development of epiNanopaint, a high-tech method that saves heart and dialysis patients from the need for multiple surgeries.
Researchers Lian-Wang Guo, Ph.D., and K. Craig Kent, M.D., Ph.D., are developing a quick and gentle technique to “paint” tiny nanoparticles onto transplanted veins to prevent them from clogging in the future. This type of blockage often requires repeated surgeries in cardiovascular and dialysis patients. Approximately half of all heart bypass vein grafts fail and require another graft.
Dialysis patients, on the other hand, often require multiple surgeries to continue life-saving treatment. Some people may require repeated surgeries on both arms, then on the legs and collarbone.
If UVA’s EpiNanoPaint approach is successful, it will be the first solution for these patients and an innovative application of nanomedicine, a form of medicine that takes place on a surprisingly small scale.
“Our approach is like putting a little guard in place to prevent damage to the blood vessels, so we don’t have to open the body multiple times to repair them,” said Dr. Guo said. Robert M. Byrne Cardiovascular Research Center. “You’ll save a lot of pain and money by avoiding repeat surgeries.”
“Drawing” to improve health
Vascular surgeons commonly perform “revascularization” to treat cardiovascular disease. This restores blood flow to areas that have been lost or have an inadequate blood supply. For example, this may be done in the form of a vein graft. It relocates veins from one part of the body to another, such as from the legs of a heart failure patient to the heart.
Meanwhile, people who require dialysis due to decreased kidney function undergo surgery to provide access to dialysis, usually by grafting an artery and vein into their arm. This removes their blood from their body, removes toxins, and returns it. These dialysis connection points are called “arteriovenous fistulas” (AVFs), and the management of arteriovenous fistulas in patients with end-stage renal disease is estimated to cost $5 billion annually in the United States alone.
Revascularization procedures tend to fail over time. That’s because the procedure itself promotes the same problem it’s trying to address: blood flow issues. The surgery itself causes a buildup of cells within the blood vessels, eventually cutting off the blood supply again.
Unfortunately, doctors don’t have a good alternative. There is no “standard treatment” for AVF. Because despite many efforts, nothing is effective at keeping the AVF open. Some of his AVFs don’t get enough blood flow at all to function properly. Therefore, the only option for patients is to install a new one if the old one fails, which frequently does.
“Coronary artery bypass grafting, known as CABG, involves cutting open a patient’s chest for heart surgery. It has already caused a major disruption to the patient’s normal life and the risk of having to repeat the surgery if the graft fails. “Imagine that,” said Kent, a vascular surgeon, UVA Health’s chief executive officer, and UVA’s executive vice president of health affairs. “Surgeons need an easy-to-use technology that can maintain graft function by simply applying protective nanoparticles to the graft, eliminating the need for repeat surgeries.”
Possibilities of epinano paint
Kent, Guo, and their team of UVA collaborators want to take a new approach. Their EpiNanoPaint method allows surgeons to brush adhesive nanoparticles onto blood vessels during the initial surgery. These nanoparticles contain agents that prevent the harmful proliferation of invading cells.
The sticky nature of nanoparticles allows them to stay where they are placed, delivering drugs exactly where they are needed over time. (This kind of precision is one of nanomedicine’s great strengths and is a priority research area for the UVA School of Medicine and his Paul and Diane Manning Biotechnology Institute, which UVA is building.)
Guo and Kent will use $2.8 million from the National Institutes of Health to study whether a specific enzyme, DOT1L, can be targeted with drugs to prevent blood vessel narrowing. They also plan to work with Dr. Shaoqin Gong at the University of Wisconsin-Madison to determine the best way to use the painting approach to administer the drug. “We still have much work to do to ensure this technology is safe and effective for patients,” Guo said.
If the research is successful, EpiNanoPaint could be transformative for vast numbers of patients around the world. More than 400,000 open vascular reconstructions are performed each year in the United States alone, and the number of Americans on dialysis nearly doubled between 2000 and 2018 to more than 500,000. increased to.
“Our goal is to develop the first treatment that can reduce graft failure rates in patients undergoing revascularization surgery,” Kent said. “This will be of tremendous benefit to patients around the world.”
More information about the study is available here. The research team includes Takuro Shirasu, Nisakorn Yodsanit, Jin Li, Yitao Huang, Xiijie Xie, Runze Tang, Qingwei Wang, Mengxue Zhang, Go Urabe, Amy Webb, Yuyuan Wang, Xiuxiu Wang, Ruosen Xie, Bowen Wang, Kent , consisting of Shaoqin. Gon and Guo.
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