Document Detail


Decrease of apoptosis rate in patients with renal transplantation treated with mycophenolate mofetil.
MedLine Citation:
PMID:  10395995     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Mycophenolate mofetil (MMF) is a powerful immunosuppressant that inhibits the proliferation of lymphocytes by blocking the enzyme inosine monophosphate dehydrogenase. MMF prevents acute graft rejection in organ transplants. The aim of this investigation is to study whether MMF has any influence on apoptosis and proliferation rates of cells other than lymphocytes. METHODS: We conducted a retrospective study of renal allograft biopsies taken during the 1st week after transplantation in 25 patients receiving triple therapy with prednisone, ciclosporin and azathioprine 75 mg/day and in 25 patients treated with MMF at a dose of 2 g/day instead of azathioprine, in order to investigate the differences in the proliferation and apoptosis rates of the glomerular, tubular, interstitial and endothelial cells of the kidney. Twelve normal kidneys were used as controls. Conventional histopathological techniques were applied as usual for pathological diagnosis. Proliferative activity was assessed by use of MIB-1 antibody. Sections of formalin-fixed, paraffin-embedded tissue blocks were stained for the presence of apoptotic cells by TUNEL assay. Evaluation of proliferative or apoptotic rates was made by counting the number of positive cells in 10 glomeruli and in 10 transversely cut tubuli in each biopsy. The positive cells in the interstitium were counted in ten high-power fields. Positive cells in the endothelium were scored semiquantitatively from 0 to 3: 0 = none, 1 = isolated cells, 2 = small groups of cells, 3 = most endothelial cells. Mann-Whitney U and chi-square tests were used for intergroup comparisons. RESULTS: All biopsies were normal or had borderline (Banff classification) acute rejection. MIB-1 rates were similar in both groups, without statistical differences (p > 0.05) between them. Significantly lower apoptotic rates were found in the group treated with MMF in tubular epithelium (23.41 +/- 8.86 vs. 57.4 +/- 13.42; p = 0.021), in glomerular (1.25 +/- 0.78 vs. 5.3 +/- 1.66; p = 0.027), and interstitial cells (1.58 +/- 0.6 vs. 5.8 +/- 1.54; p = 0.043). Apoptosis in endothelial cells (p > 0.05) was similar in both groups. CONCLUSION: We conclude that treatment with MMF of kidney transplant patients does not affect the proliferative rate of cells of the allograft, but decreases the number of apoptotic cells in tubular epithelium.
Authors:
F J Pardo-Mindán; P Errasti; A Panizo; I Sola; E de Alava; M D Lozano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nephron     Volume:  82     ISSN:  0028-2766     ISO Abbreviation:  Nephron     Publication Date:  1999  
Date Detail:
Created Date:  1999-08-06     Completed Date:  1999-08-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0331777     Medline TA:  Nephron     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  232-7     Citation Subset:  IM    
Affiliation:
Department of Pathology, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain. jpardo@unav.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Apoptosis / drug effects,  immunology*
Azathioprine / pharmacology,  therapeutic use
Cell Division / drug effects
Humans
Immunohistochemistry
Immunosuppressive Agents / therapeutic use*
In Situ Nick-End Labeling
Kidney Glomerulus / drug effects
Kidney Transplantation / immunology*
Kidney Tubules / drug effects
Middle Aged
Mycophenolic Acid / analogs & derivatives*,  therapeutic use
Retrospective Studies
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 128794-94-5/mycophenolate mofetil; 24280-93-1/Mycophenolic Acid; 446-86-6/Azathioprine

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