Figure 8

Simulation of RVD treated with co-adjuvant renal angioplasty and VEGF administration: Simulation of RVD with simultaneous angioplasty and co-adjuvant VEGF administration demonstrated an initial increase in variables involved in deleterious processes associated with renal injury progression prior to therapy, with a subsequent reversal following the combined therapy. The end state closely mimicked the state of the healthy kidney with inactive inflammation, MV rarefaction, fibrosis, and glomerulosclerosis, and activated angiogenesis and scavenging of reactive oxygen species. The impact of the treatment simulation to either inactivate or activate every single variable in the network, which did not occur in any other simulation, is likely due to the direct restoration of blood flow to the stenotic kidney, which allowed an inactivation of mild ischemia, Ang II, and NADPH oxidase. Names of the factors are identified in the y axis and indicated in green when active and are depicted in gray when inactive (A). Variables that were inactive after co-adjuvant renal angioplasty and VEGF administration simulation compared to untreated RVD control are depicted in red, and factors that activated are depicted in blue (B). Renal angioplasty and VEGF therapy simulation began at timepoint 25. The first column in (A,B) depicts the initial steady state condition at which time the simulation has been initiated but has not yet produced changes.