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Qian HS, Weldon SM, Matera D, Lee C, Yang H, Fryer RM, Fogo AB, Reinhart GA. Quantification and Comparison of Anti-Fibrotic Therapies by Polarized SRM and SHG-Based Morphometry in Rat UUO Model. PLoS One 2016; 11:e0156734. [PMID: 27257917 PMCID: PMC4892485 DOI: 10.1371/journal.pone.0156734] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 05/18/2016] [Indexed: 12/20/2022] Open
Abstract
Renal interstitial fibrosis (IF) is an important pathologic manifestation of disease progression in a variety of chronic kidney diseases (CKD). However, the quantitative and reproducible analysis of IF remains a challenge, especially in experimental animal models of progressive IF. In this study, we compare traditional polarized Sirius Red morphometry (SRM) to novel Second Harmonic Generation (SHG)-based morphometry of unstained tissues for quantitative analysis of IF in the rat 5 day unilateral ureteral obstruction (UUO) model. To validate the specificity of SHG for detecting fibrillar collagen components in IF, co-localization studies for collagens type I, III, and IV were performed using IHC. In addition, we examined the correlation, dynamic range, sensitivity, and ability of polarized SRM and SHG-based morphometry to detect an anti-fibrotic effect of three different treatment regimens. Comparisons were made across three separate studies in which animals were treated with three mechanistically distinct pharmacologic agents: enalapril (ENA, 15, 30, 60 mg/kg), mycophenolate mofetil (MMF, 2, 20 mg/kg) or the connective tissue growth factor (CTGF) neutralizing antibody, EX75606 (1, 3, 10 mg/kg). Our results demonstrate a strong co-localization of the SHG signal with fibrillar collagens I and III but not non-fibrillar collagen IV. Quantitative IF, calculated as percent cortical area of fibrosis, demonstrated similar response profile for both polarized SRM and SHG-based morphometry. The two methodologies exhibited a strong correlation across all three pharmacology studies (r2 = 0.89–0.96). However, compared with polarized SRM, SHG-based morphometry delivered a greater dynamic range and absolute magnitude of reduction of IF after treatment. In summary, we demonstrate that SHG-based morphometry in unstained kidney tissues is comparable to polarized SRM for quantitation of fibrillar collagens, but with an enhanced sensitivity to detect treatment-induced reductions in IF. Thus, performing SHG-based morphometry on unstained kidney tissue is a reliable alternative to traditional polarized SRM for quantitative analysis of IF.
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Affiliation(s)
- Hu Sheng Qian
- CardioMetabolic Disease Research, Boehringer Ingelheim Pharmaceutics, Inc, Ridgefield, Connecticut, United States of America
- * E-mail:
| | - Steve M. Weldon
- CardioMetabolic Disease Research, Boehringer Ingelheim Pharmaceutics, Inc, Ridgefield, Connecticut, United States of America
| | - Damian Matera
- CardioMetabolic Disease Research, Boehringer Ingelheim Pharmaceutics, Inc, Ridgefield, Connecticut, United States of America
| | - ChungWein Lee
- CardioMetabolic Disease Research, Boehringer Ingelheim Pharmaceutics, Inc, Ridgefield, Connecticut, United States of America
| | - Haichun Yang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Ryan M. Fryer
- CardioMetabolic Disease Research, Boehringer Ingelheim Pharmaceutics, Inc, Ridgefield, Connecticut, United States of America
| | - Agnes B. Fogo
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Glenn A. Reinhart
- CardioMetabolic Disease Research, Boehringer Ingelheim Pharmaceutics, Inc, Ridgefield, Connecticut, United States of America
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Dörje C, Reisaeter AV, Dahle DO, Mjøen G, Midtvedt K, Holdaas H, Flaa-Johnsen L, Syversveen T, Hartmann A, Jenssen T, Scott H, Reinholt FP. Total inflammation in early protocol kidney graft biopsies does not predict progression of fibrosis at one year post-transplant. Clin Transplant 2016; 30:802-9. [PMID: 27101801 DOI: 10.1111/ctr.12753] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION There is an uncertainty whether total inflammation in early protocol kidney graft biopsies is associated with fibrosis progression. We investigated whether total inflammation, both in fibrotic and non-fibrotic areas, at week 6 would predict fibrosis progression at one yr post-transplant. METHODS We included 156 single adult ABO compatible kidney recipients with adequate week 6 and one yr transplant protocol biopsies (312 biopsies). Biopsies were scored according to the current Banff criteria. In addition, fibrosis and inflammation in fibrotic and non-fibrotic areas were scored in a 10-grade semi-quantitative eyeballing system from 0% to 100%. RESULTS Fibrosis increased significantly from week 6 to one yr both by the 10-grade scoring system from 0.69 ± 1.07 to 1.45 ± 1.86, (mean ± SD), p < 0.001 and by Banff interstitial fibrosis (ci) scoring 0.81 ± 0.65 to 1.13 ± 0.87, p < 0.001. The 10-grade scoring system detected a larger proportion of fibrosis progressors than the Banff scoring 40.4% vs. 35.5%, p < 0.001. No significant positive association was found between inflammation at week 6 and progression of fibrosis in either of the scoring systems. CONCLUSIONS Total inflammation in kidney transplant biopsies at week 6 did not predict progression of fibrosis at one yr post-transplant.
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Affiliation(s)
- Christina Dörje
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Dag Olav Dahle
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Geir Mjøen
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Karsten Midtvedt
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Hallvard Holdaas
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Linda Flaa-Johnsen
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Anders Hartmann
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Trond Jenssen
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.,Metabolic and Renal Research Group, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Helge Scott
- Department of Pathology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Finn P Reinholt
- Department of Pathology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
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Becker LE, Weritz B, Yi X, Gross-Weissmann ML, Waldherr R, Zeier M, Sommerer C. Evolution of allograft fibrosis and function in kidney transplant recipients: a retrospective analysis of stable patients under CNI and mTORi. Transpl Int 2015; 28:553-64. [DOI: 10.1111/tri.12529] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 10/02/2014] [Accepted: 01/22/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - Bernhard Weritz
- Division of Nephrology; University of Heidelberg; Heidelberg Germany
| | - Xue Yi
- Department of Pathology; University of Heidelberg; Heidelberg Germany
| | | | - Rüdiger Waldherr
- Department of Pathology; University of Heidelberg; Heidelberg Germany
| | - Martin Zeier
- Division of Nephrology; University of Heidelberg; Heidelberg Germany
| | - Claudia Sommerer
- Division of Nephrology; University of Heidelberg; Heidelberg Germany
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Abstract
Interstitial fibrosis is a hallmark structural correlate of progressive and chronic kidney disease. There remain many uncertainties about how to best measure interstitial fibrosis both in research settings and in evaluations of renal biopsies performed for management of individual patients. Areas of uncertainty include determination of the composition of the matrix in a fibrotic parenchyma, the definition of how the interstitium is involved by fibrosing injuries, the choice of histologic stains for evaluation of renal fibrosis, and the reproducibility and robustness of measures currently employed by pathologists, both with and without the assistance of computerized imaging and assessments. In this review, we address some of these issues while citing the key studies that illustrate these difficulties. We point to future approaches that may allow a more accurate and meaningful assessment of renal interstitial fibrosis.
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