Rapamycin prevents interstitial fibrosis in renal allografts through decreasing angiogenesis and inflammation
| Autor: | Aydan Özdemir, R Erdal, F.N. Ozdemir, Özdemir Bh, Mehmet Haberal |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Urinary system Biopsy Antigens CD34 Gastroenterology Fibrosis Internal medicine medicine Humans Transplantation Homologous Lymphocytes Antibacterial agent Cell Proliferation Inflammation Sirolimus Transplantation Kidney Protein synthesis inhibitor medicine.diagnostic_test Neovascularization Pathologic business.industry Macrophages Graft Survival medicine.disease Kidney Transplantation medicine.anatomical_structure Cyclosporine Surgery Female business Immunosuppressive Agents medicine.drug |
| Zdroj: | Transplantation proceedings. 43(2) |
| ISSN: | 1873-2623 |
| Popis: | Rapamycin (RPM) has antiangiogenic and antiproliferative effects on cells. The aim of this study was to evaluate the mechanism of RPM as a novel antifibrotic agent by assessing its effect on interstitial fibrosis (IF). Among 60 renal transplant recipients, group 1 patients (n = 20) were treated with RPM and group 2 (n = 40), with cyclosporine. The proportions of infiltrating macrophages and lymphocytes in the interstitium were evaluated in 1-year biopsies. The microvessels were highlightened with CD34. After an initial biopsy, the development of diffuse IF over 18 months was evaluated by follow-up biopsies. The mean microvessel density (MVD) was significantly lower among group 1 (69.3 ± 16) versus group 2 (96.5 ± 30; P < .001). The proportions of macrophages and lymphocytes were lower in group 1 compared to group 2 biopsies (P < .001 for both). Fourteen (35%) group 2 and only 2 (10%) group 1 cases developed IF over 18 months (P < .05). The mean MVD in the initial biopsy was 75.6 ± 18 in cases that did not versus 120 ± 28 among those who did develop IF (P < .001). The amount of interstitial inflammation was greater among patients who did compared with cases who did not develop IF (P < .01). The overall 1-, 3-, and 5-year graft survival rates for group 1 were 95%, 95%, and 89% versus 95%, 65%, and 45% for group 2 patients, respectively (P < .001). RPM-treated patients showed a lower incidence of diffuse IF, which can be explained by antiproliferative and antiangiogenic effects of RPM. In conclusion, RPM therapy displayed an independently positive impact on long-term graft survival. |
| Databáze: | OpenAIRE |
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