Research

The main research focus of Dr. Misra's lab is to identify the biological mechanisms of hemodialysis access graft failure so that novel therapies can be developed to improve outcomes for people with end-stage renal disease (ESRD). Our lab also studies acute kidney injury caused by radiocontrast agents. Because of the shortage of kidneys available for transplantation, most people with ESRD need hemodialysis as the major mode of renal replacement therapy.

The hemodialysis access graft, known as an arteriovenous fistula (AVF), is the lifeline for people on dialysis because its optimal function is needed to purify the blood and maintain electrolyte balance. These grafts are not durable, however. Only about 62% of the grafts are functioning at one year and only 25% at two years. In addition, healthcare costs related to hemodialysis access dysfunction pose an enormous burden. Our lab hopes to find solutions for these obstacles.

Research projects

Our current research projects on arteriovenous fistulas, AVF grafts and kidney injury include:

Role of senolytic-treated MSCs in improving hemodialysis AVF maturation

Our lab previously demonstrated that mesenchymal stem cells (MSCs) can be used to reduce venous stenosis formation in hemodialysis AVFs. We're now studying the role of senescence in mesenchymal stem cells.

Use of nanoparticles encapsulated with bindarit in reducing venous stenosis after angioplasty

Our lab created a new animal model in which angioplasty can be performed to treat venous stenosis. We're now investigating whether bindarit encapsulated in nanoparticles can be used to prevent stenosis formation after angioplasty.

Oxygen nanoscaffold

Because of altered blood flow and sheer stress at the graft, it's common for AVFs to develop hypoxia. Hypoxic conditions can lead to a monocyte-macrophage response and graft failure. To test if we can prevent hypoxia within the graft, we created an oxygen-loaded scaffold to support the graft. This scaffold slowly elutes oxygen. We applied the scaffold to a murine AVF model to test whether the scaffold prevents hypoxia at the graft.

Role of neuropilin 1 in vascular injury contributing to AVM formation

Our lab showed that neuropilin 1 deletion and smooth muscle cells in part are associated with development of arteriovenous malformations (AVMs) in people with hemorrhagic telangiectasia. We're investigating the molecular mechanisms responsible for this new observation.

Funding

Here are our most recent extramural grants:

Investigator & Role Grant Title Funding Source Duration
Sanjay Misra, M.D., principal investigator The role of hypoxia in venous neointimal hyperplasia in hemodialysis grafts (R01HL 98967) National Heart, Lung, and Blood Institute 5/1/2024-4/30/2028
Sanjay Misra, M.D., principal investigator Monocyte chemoattractant proteins and vascular injury DK135407 NIDDK National Institute of Diabetes and Digestive and Kidney Diseases 7/1/2023-4/30/2027

Collaborators

Research collaboration helps drive scientific success. Dr. Misra welcomes collaboration with other researchers to help find solutions to hemodialysis access graft failure and acute kidney injury.

Mayo Clinic collaborators

Our current Mayo Clinic collaborators are:

External collaborators

Our current external collaborators are:

  • Elazer R. Edelman, M.D., Ph.D.
    • Harvard-MIT Health Sciences and Technology
    • Institute for Medical Engineering and Science
    • Cambridge, Massachusetts
  • Timmy C. Lee, M.D., M.P.H.
    • University of Alabama at Birmingham
    • Department of Medicine
    • Birmingham, Alabama
  • Roberto I. Vazquez-Padron, Ph.D., FAHA
    • University of Miami Leonard M. Miller School of Medicine
    • Division of Vascular & Endovascular Surgery
    • Miami, Florida

Lab alumni

Dr. Misra has trained numerous research fellows, graduate students, undergraduate students and other research trainees, helping them gain a better understanding of research methods.

Our recent trainees and alumni include:

  • Sreenivasulu Kilari, Ph.D., research associate, 2016-2024
  • Nathan Anderson, M.D., research fellow, 2023
  • Francisco Zepeda, B.S., research fellow, 2022
  • Cole E. Rokke, M.S., research fellow, 2022
  • Avishek K. Singh, Ph.D., research fellow, 2018-2022
  • Chenglei Zhao, M.D., research fellow, 2017-2020
  • Chuanqi Cai, M.D., research fellow, 2017-2020
  • Amit Sharma, Ph.D., research fellow, 2017-2020
  • Liam Armstrong, undergraduate student research associate, 2018
  • Julie Getz, Ph.D., research fellow, 2017-2018
  • Binxia Yang, research fellow, 2010-2018
  • Tsun Ki Jerrick, undergraduate student research associate, 2016
  • Brian Thielen, undergraduate student research associate, 2016
  • Sean Engel, undergraduate student research associate, 2016
  • Jennifer Knight M.D., 2016
  • Ameet Piryani, M.D., research fellow, 2015-2016
  • Akshaar Brahmbhatt, Howard Hughes Medical Institute fellowship awardee, 2013-2016
  • Evelyn Torres-Nieves Ph.D., research fellow, 2013-2015