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.