Diamond J R, van Goor H, Ding G, Engelmyer E
Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey 17033.
Am J Pathol. 1995 Jan;146(1):121-9.
Interstitial fibrosis is a common outcome of longterm ureteral obstruction. One pathological arm of the fibrotic reaction in diverse tissue loci and experimental models is the retraction of granulation tissue. The role of the myofibroblast in granulation tissue contraction and fibrocontractive diseases has been well established, but the mechanisms leading to differentiation of fibroblastic cells into myofibroblasts during the evolution of inflammation are not yet fully clarified. Investigators using other model systems have shown that macrophage-derived transforming growth factor-beta 1 (TGF-beta 1) may be pivotal in the process of myofibroblast modulation. Our laboratory has shown that the unilateral ureteral obstruction in the rat is characterized by a 20-fold increment in infiltrating renal cortical interstitial macrophages, an increase in cortical TGF-beta 1 gene expression, which parallels the infiltrating macrophage burden, and immunolocalization of this peptide growth factor in close proximity to resident interstitial fibroblasts. Because of this model's features, it was our aim to assess whether a myofibroblastic modulation was operant in the renal cortex of obstructed rat kidneys versus the control contralateral unobstructed kidney specimens. Immunolabeling for alpha-smooth muscle actin and the intermediate filament protein, desmin, was detected and steadily intensified from 24 to 96 hours after unilateral ureteral obstruction in obstructed kidneys only. In temporal concert with the detection of alpha-smooth muscle actin protein, the mRNA expression for this cytoskeletal component exhibited 3.7-, 15.7-, and 4.1-fold increments in the renal cortex of obstructed kidneys versus the contralateral unobstructed kidney specimens at 24, 48, and 96 hours after unilateral ureteral obstruction, respectively. Whole body X-irradiation, administered to rats 11 days before proximal left ureteral ligation, significantly lowered cortical interstitial macrophage number, cortical TGF-beta and alpha-smooth muscle actin mRNA levels as well as the intensity of immunolabeling for alpha-smooth muscle actin from 12 to 96 hours after unilateral ureteral obstruction. These data support a postulate that renal cortical TGF-beta 1, derived from the infiltrating macrophage, in part, contributes to the subsequent interstitial fibrosis response to renal injury by fostering the modulation of fibroblasts to myofibroblasts within the renal cortex after ureteral obstruction.
间质纤维化是长期输尿管梗阻的常见后果。在不同组织部位和实验模型中,纤维化反应的一个病理分支是肉芽组织的收缩。肌成纤维细胞在肉芽组织收缩和纤维收缩性疾病中的作用已得到充分证实,但在炎症演变过程中导致成纤维细胞分化为肌成纤维细胞的机制尚未完全阐明。使用其他模型系统的研究人员表明,巨噬细胞衍生的转化生长因子-β1(TGF-β1)可能在肌成纤维细胞调节过程中起关键作用。我们实验室的研究表明,大鼠单侧输尿管梗阻的特征是浸润性肾皮质间质巨噬细胞增加20倍,皮质TGF-β1基因表达增加,这与浸润性巨噬细胞负荷平行,并且该肽生长因子在靠近驻留间质成纤维细胞的位置进行免疫定位。由于该模型的特点,我们的目的是评估在梗阻大鼠肾脏的肾皮质与对照侧未梗阻肾脏标本中,是否存在肌成纤维细胞调节作用。仅在梗阻肾脏中,在单侧输尿管梗阻后24至96小时内检测到α-平滑肌肌动蛋白和中间丝蛋白结蛋白的免疫标记,并持续增强。与α-平滑肌肌动蛋白蛋白的检测同步,在单侧输尿管梗阻后24、48和96小时,梗阻肾脏肾皮质中该细胞骨架成分的mRNA表达相对于对侧未梗阻肾脏标本分别增加了3.7倍、15.7倍和4.1倍。在左输尿管近端结扎前11天对大鼠进行全身X射线照射,可显著降低单侧输尿管梗阻后12至96小时的皮质间质巨噬细胞数量、皮质TGF-β和α-平滑肌肌动蛋白mRNA水平以及α-平滑肌肌动蛋白的免疫标记强度。这些数据支持一种假设,即浸润性巨噬细胞衍生的肾皮质TGF-β1部分通过促进输尿管梗阻后肾皮质内成纤维细胞向肌成纤维细胞的调节,促成随后对肾损伤的间质纤维化反应。