TGF-beta1 expression and chronic allograft nephropathy in protocol kidney graft biopsy.
Chronic allograft nephropathy (CAN) represents a frequent and irreversible cause of long-term renal graft loss. TGF-beta1 is a key profibrogenic cytokine associated with CAN pathogenesis. Because of clinical diagnostic inaccuracy, protocol biopsy has been suggested to be a beneficial method for early CAN detection. Protocol core biopsy was carried out in 67 consecutive cyclosporine-based immunosuppression-treated kidney transplant recipients with stable renal function 12 months after renal transplantation. Biopsy specimens were analyzed morphologically according to Banff-97' criteria and immunohistologically for TGF-beta1 staining. The data obtained were correlated with plasma TGF-beta1 levels and clinical data. CAN (grade I-III) was found in 51 patients (76 %). CAN grade I was found to be the most frequent one (44 %). A normal finding within the graft was made in only 12 patients (18 %). Clinically silent acute rejection Banff IA was present in 4 patients (6 %). In 8 patients (12 %) with CAN, borderline changes were present. We found a significant correlation between CAN grade and creatinine clearance, as measured by the Cockroft-Gault formula (p<0.01) as well as body mass index (p<0.01). There was a significant correlation between chronic vasculopathy (Banff cv) and creatinine clearance, and between the degree of TGF-beta1 staining and chronic vasculopathy (p<0.01). There were no relations between morphological findings and TGF-beta1 plasma levels, cyclosporine levels, plasma lipids, HLA-mismatches, panel reactive antibodies (PRA), proteinuria, and the donor's age. In conclusion, CAN is a frequent finding in protocol kidney graft biopsies 12 months after transplantation. TGF-beta1 tissue expression is linked with chronic vasculopathy.
Viklický
O
O
Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. ivo.matl@medicon.cz
Matl
I
I
Voska
L
L
Böhmová
R
R
Jaresová
M
M
Lácha
J
J
Lodererová
A
A
Stríz
I
I
Teplan
V
V
Vítko
S
S
D000328:Adult; D000704:Analysis of Variance; D001707:Biopsy, Needle / Q000379:methods; D015992:Body Mass Index; D003401:Creatine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000737:chemistry* / Q000473:pathology; D007678:Kidney Glomerulus / Q000737:chemistry / Q000473:pathology; D016030:Kidney Transplantation / Q000473:pathology*; D007684:Kidney Tubules / Q000737:chemistry / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D016212:Transforming Growth Factor beta / Q000032:analysis* / Q000097:blood; D053773:Transforming Growth Factor beta1
D007166:Immunosuppressive Agents; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D003401:Creatine