title: Novel indicators of fibrosis-related complications in children with chronic kidney disease.
abstract: OBJECTIVE
  Tumor growth factor (TGF)β1 initiates renal fibrosis, whereas matrix metalloproteinases (MMPs), their tissue inhibitors (TIMPs), adhesion molecules and heat shock proteins (hsps) may act in further stages of this process. The aim of this study was to assess the concentrations of Hsp90α, sE-selectin, MMP-2, TIMP-1, TIMP-2 and TGFβ1 in children with advanced chronic kidney disease (CKD) and their role as markers of fibrosis.
  
  
  METHODS
  80 children with CKD stages 1-5 and 30 controls were enrolled in the study. Serum concentrations of examined parameters were assessed by ELISA.
  
  
  RESULTS
  Median values of all markers were significantly elevated in CKD patients vs. controls. sE-selectin and MMP-2 concentrations kept growing from the beginning of renal failure progression. TIMP-1, TIMP-2 and TGFβ1 levels remained unchanged in the late CKD stages, whereas Hsp90α concentrations decreased significantly in CKD stage 5. All parameters, except for MMP-2, correlated with TGFβ1, but the strongest predictive value was seen in the case of TIMP-1 and TIMP-2.
  
  
  CONCLUSIONS
  The increased concentrations of examined parameters indicate enhanced cell damage, inflammation and aggravation of proteolytic processes in CKD children. Variability in behavior of selected markers and existing correlations point at the complexity of relations between different elements responsible for the fibrosis puzzle.
authors.affiliation: Department of Pediatric Nephrology, Wrocław Medical University, Poland. Electronic address: kinga_musial@hotmail.com.
authors.forename: Kinga
authors.initials: K
authors.lastname: Musiał
authors.affiliation: Department of Pediatric Nephrology, Wrocław Medical University, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Zwolińska
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000175:diagnosis
chemical_list: D015415:Biomarkers
keywords: Hsp90α; MMP-2; TGFβ1; TIMP-1; TIMP-2; sE-selectin