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Paschall RE, Quimby JM, Cianciolo RE, McLeland SM, Lunn KF, Elliott J. Assessment of peritubular capillary rarefaction in kidneys of cats with chronic kidney disease. J Vet Intern Med 2023; 37:556-566. [PMID: 36807589 DOI: 10.1111/jvim.16656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 02/03/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Hypoxia is a key driver of fibrosis and is associated with capillary rarefaction in humans. OBJECTIVES Characterize capillary rarefaction in cats with chronic kidney disease (CKD). ANIMALS Archival kidney tissue from 58 cats with CKD, 20 unaffected cats. METHODS Cross-sectional study of paraffin-embedded kidney tissue utilizing CD31 immunohistochemistry to highlight vascular structures. Consecutive high-power fields from the cortex (10) and corticomedullary junction (5) were digitally photographed. An observer counted and colored the capillary area. Image analysis was used to determine the capillary number, average capillary size, and average percent capillary area in the cortex and corticomedullary junction. Histologic scoring was performed by a pathologist masked to clinical data. RESULTS Percent capillary area (cortex) was significantly lower in CKD (median 3.2, range, 0.8-5.6) compared to unaffected cats (4.4, 1.8-7.0; P = <.001) and was negatively correlated with serum creatinine concentrations (r = -.36, P = .0013), glomerulosclerosis (r = -0.39, P = <.001), inflammation (r = -.30, P = .009), and fibrosis (r = -.30, P = .007). Capillary size (cortex) was significantly lower in CKD cats (2591 pixels, 1184-7289) compared to unaffected cats (4523 pixels, 1801-7618; P = <.001) and was negatively correlated with serum creatinine concentrations (r = -.40, P = <.001), glomerulosclerosis (r = -.44, P < .001), inflammation (r = -.42, P = <.001), and fibrosis (r = -.38, P = <.001). CONCLUSIONS AND CLINICAL IMPORTANCE Capillary rarefaction (decrease in capillary size and percent capillary area) is present in kidneys of cats with CKD and is positively correlated with renal dysfunction and histopathologic lesions.
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Affiliation(s)
- Rene E Paschall
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, Ohio, USA
| | - Jessica M Quimby
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, Ohio, USA
| | - Rachel E Cianciolo
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, Ohio, USA
| | - Shannon M McLeland
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, Ohio, USA
| | - Katharine F Lunn
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, Ohio, USA
| | - Jonathan Elliott
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, Ohio, USA
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Abstract
The Banff Classification of Allograft Pathology is an international consensus classification for the reporting of biopsies from solid organ transplants. Since its initial conception in 1991 for renal transplants, it has undergone review every 2 years, with attendant updated publications. The rapid expansion of knowledge in the field has led to numerous revisions of the classification. The resultant dispersal of relevant content makes it difficult for novices and experienced pathologists to faithfully apply the classification in routine diagnostic work and in clinical trials. This review shall provide a complete and simple illustrated reference guide of the Banff Classification of Kidney Allograft Pathology based on all publications including the 2017 update. It is intended as a concise desktop reference for pathologists and clinicians, providing definitions, Banff Lesion Scores and Banff Diagnostic Categories. An online website reference guide hosted by the Banff Foundation for Allograft Pathology (www.banfffoundation.org) is being developed, which will be updated with future refinement of the Banff Classification from 2019 onward.
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Gueler F, Shushakova N, Mengel M, Hueper K, Chen R, Liu X, Park JK, Haller H, Wensvoort G, Rong S. A novel therapy to attenuate acute kidney injury and ischemic allograft damage after allogenic kidney transplantation in mice. PLoS One 2015; 10:e0115709. [PMID: 25617900 PMCID: PMC4305280 DOI: 10.1371/journal.pone.0115709] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 11/27/2014] [Indexed: 11/21/2022] Open
Abstract
Ischemia followed by reperfusion contributes to the initial damage to allografts after kidney transplantation (ktx). In this study we tested the hypothesis that a tetrapeptide EA-230 (AQGV), might improve survival and attenuate loss of kidney function in a mouse model of renal ischemia/reperfusion injury (IRI) and ischemia-induced delayed graft function after allogenic kidney transplantation. IRI was induced in male C57Bl/6N mice by transient bilateral renal pedicle clamping for 35 min. Treatment with EA-230 (20–50mg/kg twice daily i.p. for four consecutive days) was initiated 24 hours after IRI when acute kidney injury (AKI) was already established. The treatment resulted in markedly improved survival in a dose dependent manner. Acute tubular injury two days after IRI was diminished and tubular epithelial cell proliferation was significantly enhanced by EA-230 treatment. Furthermore, CTGF up-regulation, a marker of post-ischemic fibrosis, at four weeks after IRI was significantly less in EA-230 treated renal tissue. To learn more about these effects, we measured renal blood flow (RBF) and glomerular filtration rate (GFR) at 28 hours after IRI. EA-230 improved both GFR and RBF significantly. Next, EA-230 treatment was tested in a model of ischemia-induced delayed graft function after allogenic kidney transplantation. The recipients were treated with EA-230 (50 mg/kg) twice daily i.p. which improved renal function and allograft survival by attenuating ischemic allograft damage. In conclusion, EA-230 is a novel and promising therapeutic agent for treating acute kidney injury and preventing IRI-induced post-transplant ischemic allograft injury. Its beneficial effect is associated with improved renal perfusion after IRI and enhanced regeneration of tubular epithelial cells.
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Affiliation(s)
- Faikah Gueler
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Nelli Shushakova
- Department of Nephrology, Hannover Medical School, Hannover, Germany
- Phenos GmbH, Hannover, Germany
| | - Michael Mengel
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Canada
| | - Katja Hueper
- Diagnostic and Investigative Radiology, Hannover Medical School, Hannover, Germany
| | - Rongjun Chen
- Department of Nephrology, Hannover Medical School, Hannover, Germany
- The kidney disease centre of the First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Xiaokun Liu
- Department of Nephrology, Hannover Medical School, Hannover, Germany
- Department of Gastrointestinal Surgery, First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Joon-Keun Park
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Hermann Haller
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Gert Wensvoort
- Exponential Biotherapies Inc., The Hague, The Netherlands
- * E-mail:
| | - Song Rong
- Department of Nephrology, Hannover Medical School, Hannover, Germany
- Phenos GmbH, Hannover, Germany
- The Transplantation Center of the affiliated hospital, Zunyi Medical College, Zunyi, China
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High-Throughput Proteomic Approaches to the Elucidation of Potential Biomarkers of Chronic Allograft Injury (CAI). Proteomes 2013; 1:159-179. [PMID: 28250402 PMCID: PMC5302743 DOI: 10.3390/proteomes1020159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 09/06/2013] [Accepted: 09/09/2013] [Indexed: 12/12/2022] Open
Abstract
This review focuses on the role of OMICs technologies, concentrating in particular on proteomics, in biomarker discovery in chronic allograft injury (CAI). CAI is the second most prevalent cause of allograft dysfunction and loss in the first decade post-transplantation, after death with functioning graft (DWFG). The term CAI, sometimes referred to as chronic allograft nephropathy (CAN), describes the deterioration of renal allograft function and structure as a result of immunological processes (chronic antibody-mediated rejection), and other non-immunological factors such as calcineurin inhibitor (CNI) induced nephrotoxicity, hypertension and infection. Current methods for assessing allograft function are costly, insensitive and invasive; traditional kidney function measurements such as serum creatinine and glomerular filtration rate (GFR) display poor predictive abilities, while the current “gold-standard” involving histological diagnosis with a renal biopsy presents its own inherent risks to the overall health of the allograft. As early as two years post-transplantation, protocol biopsies have shown more than 50% of allograft recipients have mild CAN; ten years post-transplantation more than 50% of the allograft recipients have progressed to severe CAN which is associated with diminishing graft function. Thus, there is a growing medical requirement for minimally invasive biomarkers capable of identifying the early stages of the disease which would allow for timely intervention. Proteomics involves the study of the expression, localization, function and interaction of the proteome. Proteomic technologies may be powerful tools used to identify novel biomarkers which would predict CAI in susceptible individuals. In this paper we will review the use of proteomics in the elucidation of novel predictive biomarkers of CAI in clinical, animal and in vitro studies.
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Revelo MP, Miller DV, Stehlik J, Brunisholz K, Drakos S, Gilbert EM, Everitt M, Budge D, Alharethi R, Snow G, Hammond EH, Kfoury AG. Longitudinal evaluation of microvessel density in survivors vs. nonsurvivors of cardiac pathologic antibody-mediated rejection. Cardiovasc Pathol 2012; 21:445-54. [DOI: 10.1016/j.carpath.2012.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 12/09/2011] [Accepted: 01/27/2012] [Indexed: 11/26/2022] Open
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QIU JUNJUN, LIU MANHUA, ZHANG ZHONGXIN, CHEN LIPING, YANG QICHANG, LIU HONGBING. Transvaginal color Doppler sonography predicts ovarian interstitial fibrosis and microvascular injury in women with ovarian endometriotic cysts. Acta Obstet Gynecol Scand 2012; 91:605-12. [DOI: 10.1111/j.1600-0412.2012.01370.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Colvin RB, Hirohashi T, Farris AB, Minnei F, Collins AB, Smith RN. Emerging role of B cells in chronic allograft dysfunction. Kidney Int 2011:S13-7. [PMID: 21116310 DOI: 10.1038/ki.2010.436] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
B cells have many possible mechanisms by which they can affect allograft survival, including antigen presentation, cytokine production, immune regulation, and differentiation into alloantibody-producing plasma cells. This report reviews the last mechanism, which the authors regard as most critical for the long-term survival of allografts, namely, the promotion of chronic rejection by alloantibodies. Chronic humoral rejection characteristically arises late after transplantation and causes transplant glomerulopathy, multilamination of peritubular capillary basement membranes, and C4d deposition in PTCs and glomeruli. Circulating antidonor human leukocyte antigen class II antibodies are commonly detected and may precede the development of graft injury. Prognosis is poor, especially when recognized after graft dysfunction has developed. Improved detection and treatment are critically needed for this common cause of late graft loss.
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Affiliation(s)
- Robert B Colvin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
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Reuter S, Reiermann S, Wörner R, Schröter R, Edemir B, Buck F, Henning S, Peter-Katalinic J, Vollenbröker B, Amann K, Pavenstädt H, Schlatter E, Gabriëls G. IF/TA-related metabolic changes--proteome analysis of rat renal allografts. Nephrol Dial Transplant 2010; 25:2492-501. [PMID: 20176611 DOI: 10.1093/ndt/gfq043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chronic allograft nephropathy, now more specifically termed interstitial fibrosis and tubular atrophy without evidence of any specific aetiology (IF/TA), is still an important cause of late graft loss. There is no effective therapy for IF/TA, in part due to the disease's multifactorial nature and its incompletely understood pathogenesis. METHODS We used a differential in-gel electrophoresis and mass spectrometry technique to study IF/TA in a renal transplantation model. Dark Agouti (DA) kidneys were allogeneically transplanted to Wistar-Furth (DA-WF, aTX) rats. Syngeneic grafts (DA-DA, sTX) served as controls. Nine weeks after transplantation, blood pressure, renal function and electrolytes were studied, in addition to real-time PCR, western blot analysis, histology and immunohistochemistry. RESULTS In contrast to sTX, the aTX developed IF/TA-dependent renal damage. Ten differentially regulated proteins were identified by 2D gel analysis and mass spectrometry, whereupon five proteins are mainly related to oxidative stress (aldo-keto reductase, peroxiredoxin-1, NAD(+)-dependent isocitrate dehydrogenase, iron-responsive element-binding protein-1 and serum albumin), two participate in cytoskeleton organization (l-plastin and ezrin) and three are assigned to metabolic functions (creatine kinase, ornithine aminotransferase and fructose-1,6-bisphosphatase). CONCLUSION The proteins related to IF/TA and involved in oxidative stress, cytoskeleton organization and metabolic functions may correspond with novel therapeutic targets.
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Affiliation(s)
- Stefan Reuter
- Department of Medicine D, University of Münster, Münster, Germany.
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Ballermann BJ. Dependence of renal microvessel density on angiotensin II: only in the fetus? J Am Soc Nephrol 2010; 21:386-8. [PMID: 20167704 DOI: 10.1681/asn.2010010069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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10
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Rabelink TJ, Wijewickrama DC, de Koning EJ. Peritubular endothelium: The Achilles heel of the kidney? Kidney Int 2007; 72:926-30. [PMID: 17609688 DOI: 10.1038/sj.ki.5002414] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The development of renal ischemia has been postulated to be a main cause of the progressive nature of kidney diseases. In recent years, it has become clear that inappropriate and sustained activation of the endothelium could mediate this phenomenon. Endothelial activation will result in leucostasis and can compromise peritubular flow. The associated sustained redox signaling will also accelerate the development of endothelial senescence. In addition, risk factors for renal disease progression can reduce endothelial repair. In the course of these events, loss of capillary structure and rarefaction develops, which drives the further development of nephron loss. In this mini review, the evidence for this pathophysiological concept as well as the possibility to detect such endothelial activation in the clinical arena is summarized.
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Affiliation(s)
- T J Rabelink
- Department of Nephrology, Einthoven Centre of Experimental Vascular Medicine and Diabetes, Leiden University Medical Center, Leiden, The Netherlands.
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Adair A, Mitchell DR, Kipari T, Qi F, Bellamy COC, Robertson F, Hughes J, Marson LP. Peritubular capillary rarefaction and lymphangiogenesis in chronic allograft failure. Transplantation 2007; 83:1542-50. [PMID: 17589335 DOI: 10.1097/01.tp.0000266689.93615.cd] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chronic renal allograft failure is a common and multifactorial but incompletely understood process with no effective treatment strategy. METHODS We used immunohistochemistry to evaluate changes in density and turnover (proliferation) of the microvasculature and lymphatic vessels in endstage human transplant nephrectomies and control tissue derived from macroscopically normal areas of native nephrectomy specimens removed for renal carcinoma. We also examined the expression of angiogenic and lymphangiogenic growth factors in the associated inflammatory infiltrate. RESULTS Endstage allografts showed reduced microvascular density in cortex and medulla compared with controls (P<0.0001), despite the presence of endothelial cell proliferation. However, the grafts also showed new lymphatic vessels in the tubulointerstitium, not evident in controls, and which appeared to be functional with luminal macrophages. Double labeling studies showed a subpopulation of the graft-infiltrating macrophages to be immunopositive for inducible nitric oxide synthase or vascular endothelial growth factor-C (a lymphatic-specific growth factor). B cells also strongly expressed the inflammatory and angiogenic cytokine vascular endothelial growth factor A. CONCLUSIONS The present results identify contrasting changes in the microanatomy of vascular and lymphatic beds in endstage renal allografts associated with subpopulations of infiltrating macrophages and B cells that potentially regulate some of these changes. These cells and processes could become a new therapeutic target in chronic allograft failure.
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Affiliation(s)
- Anya Adair
- Phagocyte Laboratory, MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
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Affiliation(s)
- Paul Terasaki
- Terasaki Foundation Laboratory, 11570 Olympic Blvd., Los Angeles, CA 90064, USA.
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