Abstract

Jumonji domain–containing protein-3 (JMJD3), a histone H3 lysine 27 (H3K27) demethylase, promotes endothelial regeneration, but its function in neointimal hyperplasia (NIH) of arteriovenous fistulas (AVFs) has not been explored. In this study, we examined the contribution of endothelial JMJD3 to NIH of AVFs and the mechanisms underlying JMJD3 expression during kidney failure. We found that endothelial JMJD3 expression was negatively associated with NIH of AVFs in patients with kidney failure. JMJD3 expression in endothelial cells (ECs) was also downregulated in the vasculature of chronic kidney disease (CKD) mice. In addition, specific knockout of endothelial JMJD3 delayed EC regeneration, enhanced endothelial mesenchymal transition, impaired endothelial barrier function as determined by increased Evans blue staining and inflammatory cell infiltration, and accelerated neointima formation in AVFs created by venous end to arterial side anastomosis in CKD mice. Mechanistically, JMJD3 expression was downregulated via binding of transforming growth factor beta 1–mediated Hes family transcription factor Hes1 to its gene promoter. Knockdown of JMJD3 enhanced H3K27 methylation, thereby inhibiting transcriptional activity at promoters of EC markers and reducing migration and proliferation of ECs. Furthermore, knockdown of endothelial JMJD3 decreased endothelial nitric oxide synthase expression and nitric oxide production, leading to the proliferation of vascular smooth muscle cells. In conclusion, we demonstrate that decreased expression of endothelial JMJD3 impairs EC regeneration and function and accelerates neointima formation in AVFs. We propose increasing the expression of endothelial JMJD3 could represent a new strategy for preventing endothelial dysfunction, attenuating NIH, and improving AVF patency in patients with kidney disease.

Highlights

  • We confirmed that all necessary permission/patient releases have been obtained

  • We found that Jumonji domain–containing protein-3 (JMJD3) was expressed in the nuclei of endothelial cell (EC), and the expression of JMJD3 in the endothelium of venous anastomosis of Arteriovenous fistula (AVF) was reversely correlated with the size of neointima area of AVFs (p < 0.05, Fig. 1, A–D)

  • Positive staining of α-smooth muscle actin (α-SMA) and fibrinogen can be found in the endothelium of venous anastomosis of AVF with varying degrees (Fig. 1, E and F), which indicate endothelial–mesenchymal transition (EndMT) and endothelium injury

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Summary

Introduction

We confirmed that all necessary permission/patient releases have been obtained. All experiments involving animals were approved by the Institutional Animal Care and Use Committee of Baylor College of Medicine. The role of JMJD3 in ECs during NIH development in AVFs and the mechanism of its expression regulation in CKD remain unknown. Decreased expression of endothelial JMJD3 is associated with NIH of AVFs from kidney failure patients

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