Paula Adriana Rozenfeld1, María de Los Angeles Bolla2, Pedro Quieto3, Antonio Pisani4, Sandro Feriozzi5, Pablo Neuman6, Constanza Bondar7. 1. IIFP, Universidad Nacional de La Plata, CONICET, Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, 47 y 115 (1900), La Plata, Argentina. Electronic address: paurozen@biol.unlp.edu.ar. 2. Servicio de Anatomía Patológica, Hospital San Martin, Calle 1 y 70 (1900), La Plata, Argentina. 3. Servicio de Nefrología, Hospital Rodolfo Rossi, Calle 37 N° 193 (1900), La Plata, Argentina. 4. Chair of Nephrology, Department of Public Health, University Federico II of Naples, Italy. 5. Nephrology and Dialysis Unit, Belcolle Hospital, Viterbo, Italy. 6. Servicio de Diálisis y Nefrologia, IPENSA, Calle 59 N°434 (1900), La Plata, Argentina. 7. IIFP, Universidad Nacional de La Plata, CONICET, Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, 47 y 115 (1900), La Plata, Argentina.
Abstract
BACKGROUND: Kidney is one of the main target organs in Fabry disease, a lysosomal X-linked genetic disorder. Renal involvement is characterized by proteinuria and progressive chronic kidney disease leading to end-stage renal disease. Pathogenic mechanisms in the progression of renal damage in Fabry disease are not thoroughly known yet. The lysosomal Gb3 deposition is the first step of complex pathological pathways resulting in renal sclerosis/fibrosis. Our hypothesis is that Fabry disease associated cellular alterations in tubular cells induce the production of TGF-β1, which mediate transdifferentiation of renal cells into myofibroblasts resulting in fibrosis of renal tissue. OBJECTIVES: The aim of this work is to study the mechanisms leading to fibrosis in kidney from human Fabry patients. METHODS: Fifteen renal biopsies from naïve Fabry patients were included. Histological and immunohistochemical analysis was carried out. RESULTS: Positive staining for TGF-β1 was found in tubular epithelial cells in biopsies from Fabry patients. Apoptosis was determined by active caspase 3 staining in tubular and mesangial glomerular cells. Due to TGF-β1 is the main profibrotic cytokine and induces accumulation of myofibroblasts, we performed a study for its marker α-smooth muscle actin (α-SMA). This study revealed expression of α-SMA on pericytes surrounding peritubular capillaries, smooth muscle cells of blood vessels, mesangial cells and periglomerular zone. TGF-β1 is produced mainly by tubular cells in Fabry kidney biopsies probably inducing cellular trans-differentiation of renal cells into myofibroblasts. A positive staining for a marker of myofibroblasts was present, affirming the presence of those profibrotic cells. CONCLUSIONS: These results show for the first time that TGF-β1 is expressed in human renal tissue from Fabry patients, and that this profibrotic cytokine is mainly produced by proximal tubular cells. In addition both, peritubular interstitium and glomeruli, presented cells positive for myofibroblasts markers.
BACKGROUND: Kidney is one of the main target organs in Fabry disease, a lysosomal X-linked genetic disorder. Renal involvement is characterized by proteinuria and progressive chronic kidney disease leading to end-stage renal disease. Pathogenic mechanisms in the progression of renal damage in Fabry disease are not thoroughly known yet. The lysosomal Gb3 deposition is the first step of complex pathological pathways resulting in renal sclerosis/fibrosis. Our hypothesis is that Fabry disease associated cellular alterations in tubular cells induce the production of TGF-β1, which mediate transdifferentiation of renal cells into myofibroblasts resulting in fibrosis of renal tissue. OBJECTIVES: The aim of this work is to study the mechanisms leading to fibrosis in kidney from human Fabry patients. METHODS: Fifteen renal biopsies from naïve Fabry patients were included. Histological and immunohistochemical analysis was carried out. RESULTS: Positive staining for TGF-β1 was found in tubular epithelial cells in biopsies from Fabry patients. Apoptosis was determined by active caspase 3 staining in tubular and mesangial glomerular cells. Due to TGF-β1 is the main profibrotic cytokine and induces accumulation of myofibroblasts, we performed a study for its marker α-smooth muscle actin (α-SMA). This study revealed expression of α-SMA on pericytes surrounding peritubular capillaries, smooth muscle cells of blood vessels, mesangial cells and periglomerular zone. TGF-β1 is produced mainly by tubular cells in Fabry kidney biopsies probably inducing cellular trans-differentiation of renal cells into myofibroblasts. A positive staining for a marker of myofibroblasts was present, affirming the presence of those profibrotic cells. CONCLUSIONS: These results show for the first time that TGF-β1 is expressed in human renal tissue from Fabry patients, and that this profibrotic cytokine is mainly produced by proximal tubular cells. In addition both, peritubular interstitium and glomeruli, presented cells positive for myofibroblasts markers.
Authors: Cassiano Augusto Braga Silva; Luis Gustavo Modelli de Andrade; Maria Helena Vaisbich; Fellype de Carvalho Barreto Journal: J Bras Nefrol Date: 2022 Apr-Jun
Authors: Cassiano Augusto Braga Silva; José A Moura-Neto; Marlene Antônia Dos Reis; Osvaldo Merege Vieira Neto; Fellype Carvalho Barreto Journal: Can J Kidney Health Dis Date: 2021-01-19