Markers of fibrosis in early biopsies of renal transplants.
Many factors are involved in the development of chronic allograft nephropathy (CAN). Extracellular matrix turnover depends on the balance between fibrogenic and antifibrogenic cytokines. The aim of our study was to analyze the presence of transforming growth factor beta-1 (TGF-beta1), matrix metalloproteinase-2 (MMP-2), and mast cells in 53 early transplant biopsies using immunochemistry with specific monoclonal antibodies. We divided the patients into two groups depending on graft evolution (lost due to CAN versus functioning), renal function, presence of proteinuria, and graft survival. There were no differences in the demographic or immunological data. Renal function was worse and proteinuria greater among the group with CAN. The presence of mast cells was similar in both groups, but TGF-beta1 was expressed more and MMP-2 less in the CAN group. We observed a negative correlation between donor age and mast cells, and a positive correlation between TGF-beta1 and MMP-2. Grafts from younger donors showed better renal function, less proteinuria, greater graft survival, and less frequent development of CAN. According to our experience, cytokines involved in matrix turnover are expressed in early stages, correlating with donor age. The expressions of TGF-beta1 and MMP-2 seem to be important for the development of fibrosis in CAN.
Palomar
R
R
Nephrology Department, Marqués de Valdecilla Hospital, University of Cantabria, Santander, Spain. mpalomarf@wanadoo.es
Mayorga
M
M
Ruiz
J C
JC
Cuevas
J
J
Rodrigo
E
E
Cotorruelo
J G
JG
Val-Bernal
J F
JF
Arias
M
M
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005260:Female; D005355:Fibrosis; D006650:Histocompatibility Testing; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology; D016030:Kidney Transplantation / Q000473:pathology*; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D008407:Mast Cells / Q000473:pathology; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D008875:Middle Aged; D012079:Renal Circulation; D016212:Transforming Growth Factor beta / Q000378:metabolism; D053773:Transforming Growth Factor beta1
D015415:Biomarkers; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D020778:Matrix Metalloproteinase 2