Paydas Saime, Balal Mustafa, Tanriverdi Kahraman, Sertdemir Yasar, Baslamisli Fikri
Department of Internal Medicine, Cukurova University Faculty of Medicine, Adana, Turkey.
Ren Fail. 2007;29(7):779-84. doi: 10.1080/08860220701540136.
In this study, serum and urinary VEGF levels and VEGF expression in PBMNC were correlated with daily proteinuria, renal function tests, and renal histopathologic findings in untreated patients with different glomerulonephritis and with the course of renal function and proteinuria for one year. Forty-five untreated patients with different glomerulonephritis and 11 healthy persons comprised the study and control groups, respectively. VEGF mRNA expression was detected by RT- PCR in peripheral blood mononuclear cells (PBMNC), and VEGF levels were measured by ELISA in serum and urine samples simultaneously. Male/female ratio was 24/21 and mean ages were 34.49 +/- 14.98. Serum and urinary VEGF levels, VEGF expressions in PBMNC, and the ratios of urine VEGF/urine creatinine were found to be similar in patients and controls. There were important correlations between urinary VEGF levels and baseline serum Cr (p = 0.035) and ESR (p = 0.022). There was also a marginal correlation between urinary VEGF levels and baseline CCr (p = 0.072). There was no correlation between serum and urinary VEGF levels and PBMNC mRNA expression and pathological findings such as with or without glomerular sclerosis, tubulointerstitial fibrosis (TIF), periglomerular fibrosis, and mesangial cell proliferation in renal biopsy. Serum and urinary VEGF levels or VEGF expression in PBMNC in patients with renal amyloidosis or proliferative or nonproliferative glomerulonephritis were similar with that of healthy controls and each other. Serum and urinary VEGF levels and PBMNC VEGF mRNA expression in untreated patients with different glomerulonephritis and controls were similar. We found only one important correlation, that between urinary VEGF levels and baseline serum creatinine levels in patients with different glomerulonephritis. Urinary VEGF can be an important pathogenesis of glomerular disease or a simple proteinuria. Serum and urinary VEGF levels and PBMNC VEGFmRNA did not change by periglomerular sclerosis, periglomerular fibrosis, or tubulointerstitial fibrosis on renal biopsy. PBMNC VEGF mRNA expression decreased in patients undergoing remission. In addition to the important correlation between urinary VEGF and serum creatinine, we also found an important correlation between erythrocyte sedimentation rate and urinary VEGF. This finding was interesting because we could not find a similar conclusion in other studies.
在本研究中,不同肾小球肾炎未治疗患者的血清和尿血管内皮生长因子(VEGF)水平以及外周血单个核细胞(PBMNC)中的VEGF表达与每日蛋白尿、肾功能检查及肾脏组织病理学结果相关,且与肾功能和蛋白尿病程相关,为期一年。45例不同肾小球肾炎未治疗患者和11名健康人分别组成研究组和对照组。通过逆转录聚合酶链反应(RT-PCR)检测外周血单个核细胞(PBMNC)中的VEGF mRNA表达,同时采用酶联免疫吸附测定(ELISA)法检测血清和尿液样本中的VEGF水平。男女比例为24/21,平均年龄为34.49±14.98。患者和对照组的血清和尿VEGF水平、PBMNC中的VEGF表达以及尿VEGF/尿肌酐比值相似。尿VEGF水平与基线血清肌酐(p = 0.035)和红细胞沉降率(ESR,p = 0.022)之间存在显著相关性。尿VEGF水平与基线内生肌酐清除率(CCr,p = 0.072)之间也存在微弱相关性。血清和尿VEGF水平以及PBMNC mRNA表达与肾活检中的病理结果如有无肾小球硬化、肾小管间质纤维化(TIF)、肾小球周围纤维化和系膜细胞增殖之间无相关性。肾淀粉样变性或增殖性或非增殖性肾小球肾炎患者的血清和尿VEGF水平或PBMNC中的VEGF表达与健康对照组相似,且彼此之间也相似。不同肾小球肾炎未治疗患者和对照组的血清和尿VEGF水平以及PBMNC VEGF mRNA表达相似。我们仅发现一个显著相关性,即不同肾小球肾炎患者的尿VEGF水平与基线血清肌酐水平之间的相关性。尿VEGF可能是肾小球疾病的重要发病机制或单纯蛋白尿。肾活检中肾小球周围硬化、肾小球周围纤维化或肾小管间质纤维化并未改变血清和尿VEGF水平以及PBMNC VEGFmRNA。病情缓解的患者PBMNC VEGF mRNA表达降低。除了尿VEGF与血清肌酐之间的显著相关性外,我们还发现红细胞沉降率与尿VEGF之间存在显著相关性。这一发现很有趣,因为我们在其他研究中未得出类似结论。