Boratyńska M
Department of Nephrology, Medical University, Wrocław, Poland.
Ann Transplant. 1999;4(2):23-8.
Transforming growth factor-beta1 (TGF-beta1) a multifunctional growth cytokine, has been implicated in the pathogenesis of chronic allograft nephropathy (chgn). The primary objective of the present study was to establish whether or not concentration of TGF-beta1 in the sera and urine of transplant patients might be regarded as a chgn diagnostic factor and chgn activity indicator. Another objective was to investigate the response of this growth factor to arterial hypertension and metabolic disorder. Examined were 34 patients with chgn (Group I), 50 patients with a stable allograft function (Group II), and 25 healthy subjects (control). Follow-up since transplantation was 76 +/- 34 months in patients of Group I and 59 +/- 36 months in patients of Group II. Both groups of patients received maintenance triple immunosuppressive therapy. In all the subjects examined, determinations were carried out for serum and urine levels of TGF-beta1 by the immunoenzymatic method. Hypertension was found in all patients of Group I and in 60% of patients of Group II; low levels of HDL cholesterol below I mM were observed in 52% of Group I patients and in 22% of Group II patients. Serum concentrations of TGF-beta1 were similar in all the subjects examined. Patients with chgn showed elevated urine excretion of TGF-beta1, as compared to patients with no graft dysfunction or to the control. Urine excretion of TGF-beta1 was noticeably higher in patients with developed interstitial tissue fibrosis (I-st degree of interstitial fibrosis 6.8 +/- 4.9ng/mg cr. vs. 13.3 +/- 4.7 ng/mg cr. in III-rd degree of fibrosis). Urinary TGF-beta1 levels were correlated with arterial blood pressure, but they had a negative correlation with the HDL cholesterol level.
转化生长因子-β1（TGF-β1）是一种多功能生长细胞因子，与慢性移植肾肾病（chgn）的发病机制有关。本研究的主要目的是确定移植患者血清和尿液中TGF-β1的浓度是否可被视为chgn的诊断因素和chgn活动指标。另一个目的是研究这种生长因子对动脉高血压和代谢紊乱的反应。研究对象包括34例chgn患者（第一组）、50例移植肾功能稳定的患者（第二组）和25名健康受试者（对照组）。第一组患者移植后的随访时间为76±34个月，第二组患者为59±36个月。两组患者均接受维持性三联免疫抑制治疗。对所有研究对象采用免疫酶法测定血清和尿液中TGF-β1的水平。发现第一组所有患者和第二组60%的患者患有高血压；第一组52%的患者和第二组22%的患者观察到高密度脂蛋白胆固醇水平低于1 mM。所有研究对象的血清TGF-β1浓度相似。与无移植功能障碍的患者或对照组相比，chgn患者的尿液中TGF-β1排泄量升高。在出现间质组织纤维化的患者中，尿液中TGF-β1的排泄量明显更高（间质纤维化I度为6.8±4.9ng/mg肌酐，而III度纤维化为13.3±4.7 ng/mg肌酐）。尿TGF-β1水平与动脉血压相关，但与高密度脂蛋白胆固醇水平呈负相关。
1）在慢性肾移植排斥反应中，TGF-β 的尿液分泌增加；2）TGF-β 的尿液分泌与动脉高血压、间质组织纤维化程度和移植肾功能不全的进展有关；3）高密度脂蛋白水平与TGF-β 的尿液分泌之间的负相关（在慢性排斥反应患者和移植肾功能稳定的受者中均如此）表明血脂异常对这种生长因子分泌的影响。
