Yoshio Yoko, Miyazaki Masanobu, Abe Katsushige, Nishino Tomoya, Furusu Akira, Mizuta Yohei, Harada Takashi, Ozono Yoshiyuki, Koji Takehiko, Kohno Shigeru
Second Department of Internal Medicine, Division of Renal Care Unit, Nagasaki University School of Medicine, Nagasaki, Japan.
Kidney Int. 2004 Oct;66(4):1677-85. doi: 10.1111/j.1523-1755.2004.00935.x.
In patients on long-term peritoneal dialysis (PD), angiogenesis and vasculopathy are observed in the peritoneum, and the degree of vascularization correlates with the area of fibrotic tissue, suggesting the involvement of angiogenesis in the progression of peritoneal fibrosis. The aim of the present study was to evaluate the effect of TNP-470, an anti-angiogenic compound, on the development of peritoneal fibrosis induced by chlorhexidine gluconate (CG).
Peritoneal fibrosis was induced by injection of CG into peritoneal cavity of Institute for Cancer Research (ICR) mice. TNP-470 was injected subcutaneously with CG. Mice were sacrificed, and peritoneal tissues were dissected out at days eight and 16 after CG and TNP-470 injection. The expression patterns of CD31 (as a marker of endothelial cells), vascular endothelial cell growth factor (VEGF), alpha-smooth muscle actin (as a marker of myofibroblasts), heat shock protein 47 (HSP47), type III collagen, F4/80 (as a marker of mice macrophages), proliferating cell nuclear antigen (PCNA), and cyclin-dependent kinase 2 (Cdk2) were examined by immunohistochemistry.
CG-injected mice showed thickening of the submesothelial zone and increased number of vessels, myofibroblasts, and infiltrating macrophages. The expression levels of VEGF, type III collagen, and HSP47 were increased, and a large number of PCNA-positive cells and Cdk2-expressing cells were observed in the thickened submesothelial area. Treatment with TNP-470 suppressed the submesothelial zone thickening and reduced collagen III expression as well as angiogenesis. TNP-470 also decreased the number of VEGF-expressing cells, myofibroblasts, macrophages, PCNA-positive cells, and Cdk2-expressing cells.
Our results indicate the involvement of angiogenesis in the progression of peritoneal fibrosis, and suggest that TNP-470 may be potentially useful for the prevention of peritoneal fibrosis through inhibition of angiogenesis and suppression of myofibroblast proliferation.
在长期进行腹膜透析(PD)的患者中,腹膜存在血管生成和血管病变,血管化程度与纤维化组织面积相关,提示血管生成参与了腹膜纤维化的进展。本研究的目的是评估抗血管生成化合物TNP - 470对葡萄糖酸氯己定(CG)诱导的腹膜纤维化发展的影响。
通过向癌症研究所(ICR)小鼠腹腔内注射CG诱导腹膜纤维化。TNP - 470与CG一起皮下注射。在注射CG和TNP - 470后的第8天和第16天处死小鼠,取出腹膜组织。通过免疫组织化学检测CD31(作为内皮细胞标志物)、血管内皮生长因子(VEGF)、α - 平滑肌肌动蛋白(作为肌成纤维细胞标志物)、热休克蛋白47(HSP47)、III型胶原、F4/80(作为小鼠巨噬细胞标志物)、增殖细胞核抗原(PCNA)和细胞周期蛋白依赖性激酶2(Cdk2)的表达模式。
注射CG的小鼠显示间皮下区增厚,血管、肌成纤维细胞和浸润巨噬细胞数量增加。VEGF、III型胶原和HSP47的表达水平升高,在增厚的间皮下区域观察到大量PCNA阳性细胞和表达Cdk2的细胞。用TNP - 470治疗可抑制间皮下区增厚,减少胶原III表达以及血管生成。TNP - 470还减少了表达VEGF的细胞、肌成纤维细胞、巨噬细胞、PCNA阳性细胞和表达Cdk2的细胞数量。
我们的结果表明血管生成参与了腹膜纤维化的进展,并提示TNP - 470可能通过抑制血管生成和抑制肌成纤维细胞增殖对预防腹膜纤维化具有潜在作用。