Document Detail


Expression of fibrosis-associated molecules in IgA nephropathy treated with cyclosporine.
MedLine Citation:
PMID:  19066978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cyclosporine (CsA) treatment in immunoglobulin A nephropathy (IgAN) is controversial and has not been widely studied. The aim of this study was to investigate the effects of CsA on renal histology and the expression of interstitial fibrosis-associated molecules in childhood IgAN. The subjects were 18 children (age 4.2-13.9 years; male:female 13:5) who had been treated with CsA for 8 or 12 months and who had renal biopsies before and after treatment. Renal biopsies were assessed by routine histology and immunohistochemistry against osteopontin (OPN), transforming growth factor-beta (TGF-beta), CD68, and CD34. The degree of proteinuria and mesangial IgA deposits decreased or disappeared after treatment in all cases, and the percentage of patients with diffuse mesangial proliferation decreased from 44.4 to 22.2%. However, interstitial fibrosis developed or was aggravated in nine patients (50%) after treatment and was associated with an increased degree of interstitial inflammation in five patients. Tubular OPN expression (45.3 +/- 23.4 vs. 37.6 +/- 19.3%) and the degree of CD68-positive macrophage infiltration (136.1 +/- 88.2 vs. 132 +/- 86.0/mm(2)) were not increased after CsA treatment, but TGF-beta expression was significantly increased (6.4 +/- 4.2 vs. 13.3 +/- 9.9%; p = 0.025). Microvascular density was increased and peritubular capillaries were of small caliber in inflamed areas. We conclude that increased levels of TGF-beta and the development of interstitial fibrosis limit the long-term use of CsA in IgAN patients. Osteopontin and macrophages may be indirectly involved in renal fibrosis by prolonging interstitial inflammation rather than by directly increasing TGF-beta expression.
Authors:
Beom Jin Lim; Ji Hong Kim; Soon Won Hong; Hyeon Joo Jeong
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Publication Detail:
Type:  Journal Article     Date:  2008-12-09
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  24     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-02-03     Completed Date:  2009-06-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  513-9     Citation Subset:  IM    
Affiliation:
Department of Pathology and Cancer Research Institute, Chungnam National University College of Medicine, Daejeon, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Capillaries / drug effects,  pathology
Child
Child, Preschool
Cyclosporine / adverse effects*
Female
Fibrosis
Glomerulonephritis, IGA / drug therapy*
Humans
Immunohistochemistry
Immunosuppressive Agents / adverse effects*
Kidney / blood supply,  chemistry,  drug effects*,  pathology
Male
Osteopontin / analysis
Transforming Growth Factor beta / analysis
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Transforming Growth Factor beta; 106441-73-0/Osteopontin; 59865-13-3/Cyclosporine

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