2025 Wylie Scholar

Dr. Sara Gaines, MD, Assistant Professor of Surgery, Section of Vascular Surgery and Associate Program Director, General Surgery at the University of Chicago Pritzker School of Medicine, has been selected as the 2025 Wylie Scholar award recipient for her proposed project, The role of microbial uremic toxins on endothelial and smooth muscle cell regulation of neointimal formation in arteriovenous fistulas. This project addresses a significant health problem related to chronic kidney disease (CKD), which affects millions of individuals worldwide. CKD leads to high blood urea levels that disrupt both gut health and vascular function. Patients with CKD often experience gut microbiome imbalances that produce harmful toxins called uremic toxins. These toxins accumulate in the bloodstream, causing inflammation and damage to blood vessels, which impacts patients undergoing dialysis. Specifically, dialysis patients commonly experience arteriovenous fistula (AVF) failures—an essential surgical connection used for blood filtration during dialysis—due to complications like dysfunctional vessel remodeling.

This project aims to understand how gut microbiome-derived toxins damage blood vessels and hinder AVF function. To achieve this, Dr. Gaines will conduct experiments using animal models and 3D lab-grown vascular tissue systems to study the interactions between gut microbiome toxins, endothelial cells (lining blood vessels), and smooth muscle cells (in vessel walls). By mimicking the complex processes in CKD patients, this study will identify how these microbial toxins contribute to AVF failures. Additionally, Dr. Gaines will explore signaling pathways and molecular changes triggered by toxins, such as endothelial-to-mesenchymal transition, which leads to vessel narrowing.

The anticipated impact on patients includes providing insights that could lead to new microbiome-based interventions, improving AVF outcomes, and dialysis efficiency. Enhanced AVF functionality and longevity will directly enhance patients' quality of life and reduce complications faced during dialysis treatments. This work holds promise to revolutionize vascular health strategies for CKD patients through innovative microbiome therapies.

This research could help people with CKD who rely on dialysis by making the process smoother, safer, and more comfortable. By discovering how gut bacteria and their toxins damage blood vessels, we could develop new treatments—like probiotics, diet changes, or medications—to protect and improve the function of the arteriovenous fistulas (AVFs) that make dialysis possible. This would mean fewer fistula failures, less need for repeat surgeries, and a reduction in complications like inflammation and blood vessel narrowing. Ultimately, patients could see better dialysis outcomes, spend less time facing medical issues or hospital visits, and enjoy a higher quality of life. Plus, the knowledge gained could allow doctors to personalize care, offering each patient more effective, targeted therapies based on their unique microbiome and health needs.