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*
Department of Urology, Osaka University Graduate School of Medicine,
Osaka, Japan
Department of Anatomy and Biology, Osaka Medical College, Osaka,
Japan
Department of Urology, Osaka University Graduate School of Medicine,
Osaka, Japan
Division of Biochemistry, Biomedical Research Center, Osaka University
Graduate School of Medicine, Osaka, Japan
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Department of Internal Medicine and Therapeutics, Osaka University
Graduate School of Medicine, Osaka, Japan
¶
Laboratory of Immunogenetics and Transplantation, Brigham and Women's
Hospital, Harvard Medical School, Boston, Massachusetts.
Correspondence to Dr. Shiro Takahara, Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. Phone: +81-6-6879-3531; Fax: +81-6-6879-3539; E-mail: takahara{at}uro.med.osaka-u.ac.jp
Abstract. Long-term renal isografts in humans and laboratory
animals exhibit features similar to those of chronic allograft nephropathy
(CAN), indicating that antigen-independent factors, such as acute renal
ischemia, are likely to be involved in the development of CAN. Hepatocyte
growth factor (HGF) has been demonstrated to play a renotropic role in renal
regeneration and protection from acute ischemic injury. This study was thus
conducted to investigate the effect of HGF on the development of CAN, using an
established rat model. HGF was administered daily (100 µg/d, intravenously)
for 4 wk after engraftment. Control animals received saline solution.
Allografts from control animals exhibited early evidence of severe structural
collapse and necrotic cell death in the proximal tubules and outer medulla,
with mononuclear cell infiltration, within 1 wk after engraftment. This was
followed by sequential upregulation of adhesion molecules and cytokines,
accompanied by dense macrophage infiltration. Fibrogenic events, as indicated
by marked increases in transforming growth factor-ß1 expression and the
accumulation of smooth muscle
-actin, occurred during the same period.
Control animals ultimately developed features typical of CAN, with functional
deterioration and severe histologic changes; a survival rate of 50.6% by 32 wk
was observed. In contrast, remarkably little early injury and no late
fibrogenic events were observed for the HGF-treated group. All treated animals
survived, with well preserved graft function, during the 32-wk follow-up
period. These results indicate that renal protection and recovery from early
allograft injury with HGF treatment greatly contribute to a reduction of
susceptibility to the subsequent development of CAN in a rat model. The
potential application of HGF in the prevention of CAN warrants further
attention.
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