Plasma tissue factor and tissue factor pathway inhibitor in patients with primary glomerulonephritis

Low-grade risk of hypercoagulable state in patients suffering from diabetes mellitus type 2

OBJECTIVE

Diabetes, including type 1 and type 2, is associated with the hypercoagulable state. The aim of this study is to evaluate the concentration of selected hemostatic parameters and vascular endothelial growth factor-A (VEGF-A) in diabetic subjects.

METHODS

The study was conducted in 62 patients with diabetes. Group I consisted of 27 patients having uncontrolled diabetes with microalbuminuria and Group II included 35 well-controlled diabetic patients. The control group was made up of 25 healthy volunteers. In the citrate plasma, the concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin-antithrombin (TAT) complexes, and D-dimer were assayed. Serum concentrations of VEGF-A, lipid profile, creatinine, and plasma fasting glucose were measured and in the versene plasma the concentration of HbA1c was determined.

RESULTS

In the patients with uncontrolled diabetes, higher concentrations of TF, TFPI, and VEGF-A were observed, as compared with the well-controlled diabetics group and the control group. A significantly lower activity of antiplasmin was reported in patients from Group I as compared with the control group. In Group I, using the multivariate regression analysis, the glomerular filtration rate was independently associated with VEGF-A and dependently associated with total cholesterol.

CONCLUSIONS

The study showed higher concentrations of TF and TFPI in the patients with uncontrolled diabetes with microalbuminuria, which is associated with rapid neutralization of the thrombin formation, since TFPI inhibits the complex of TF/VIIa/Ca(2+). The manifestation of the above suggestions is the correct TAT complexes and D-dimer, which indicates a low grade of prothrombotic risk in this group of patients, but a higher risk of vascular complications.

A multicenter retrospective study of 151 renal biopsies in horses

BACKGROUND

Renal biopsies are uncommonly performed in horses and little is known about their diagnostic utility and associated complication rate.

OBJECTIVE

To describe the techniques, the complication rate, risk factors, and histopathology results; as well as evaluate the safety and diagnostic utility of renal biopsy in the horse.

ANIMALS

One hundred and forty-six horses from which 151 renal biopsies were obtained. Animals ranged in age from 48 hours to 30 years.

METHODS

Multicenter retrospective study, with participation of 14 institutions (1983-2009).

RESULTS

Renal biopsy in horses was associated with a similar rate of complications (11.3%) to that occurring in humans and companion animals. Complications were generally associated with hemorrhage or signs of colic, and required treatment in 3% of cases. Fatality rate was low (1/151; 0.7%). Biopsy specimens yielded sufficient tissue for a histopathologic diagnosis in most cases (94%) but diagnoses had only fair (72%) agreement with postmortem findings. Risk factors for complications included biopsy specimens of the left kidney (P = .030), a diagnosis of neoplasia (P = .004), and low urine specific gravity (P = .030). No association with complications was found for age, sex, breed, institution, presenting complaint, other initial clinicopathologic data, biopsy instrument, needle size, or use of ultrasonographic guidance.

CONCLUSIONS AND CLINICAL IMPORTANCE

Renal biopsy in horses has low morbidity and results in a morphological histopathologic diagnosis in 94% of cases. However, this procedure might result in serious complications and should only be used when information obtained would be likely to impact decisions regarding patient management and prognosis.

Peptide corresponding to the C terminus of tissue factor pathway inhibitor inhibits mesangial cell proliferation and activation in vivo

Mesangial cells (MsCs) are one of the resident cell types in the glomerulus and are important with respect to its function and structure. The activation and proliferation of MsCs occur in several types of glomerulonephritis, particularly proliferative glomerulonephritis, producing a series of protein factors and matrix components that impair the normal structure and function of the glomerulus. To inhibit proliferation or induction of apoptosis is considered to be one mechanism that can be used to treat these diseases. In previous studies, we found that the tissue factor pathway inhibitor (TFPI) induces the apoptosis of cultured rat MsCs. Here, we expressed a series of TFPI fragments as fusion proteins to maltose binding protein (MBP-TFPI(162-188), MBP-TFPI(187-241), MBP-TFPI(240-276), MBP-TFPI(162-241), MBP-TFPI(187-276) and MBP-TFPI(162-276)) and applied them to cultured rat mesangial cells. The C terminus of TFPI, a peptide corresponding to residues 240-276 of TFPI, was confirmed to induce apoptosis of MsCs in vitro. To observe the effect of this peptide on MsCs in vivo, we performed intramuscular gene transfer treatment on a rat model of proliferative glomerulonephritis with a plasmid containing the gene for the C terminus of TFPI. This revealed that the C terminus of TFPI exhibited suppressive effects on the activation and proliferation of MsCs and, thereby, improved renal function. Our data indicate that the C terminus of TFPI could be used in the treatment of proliferative glomerulonephritis.