The relationship of the total expression of transforming growth factor β1, monocytic chemoattractive protein-1, vascular endothelial growth factor-A in renal tissue with clinical and morphological manifestations in glomerulonephritis

Abstract

Objective: to study the effect of the total expression of vascular endothelial growth factor A (VEGF A), tissue growth factor β1 (TGF-β1) and monocytic chemoattractant factor 1 (MCP-1) on the course of glomerulonephritis.Material and methods: the study was a prospective (12-month) open comparative clinical and morphological study with the inclusion of 75 patients aged 18 to 75 years (males - 52, females - 23) with glomerulonephritis in the acute stage. All patients were initially examined, including assessment of clinical, laboratory and instrumental parameters, including puncture nephrobiopsy. In addition to the standard, sections of biopsies were stained with labeled antibodies to VEGF A, TGF-β1 and MCP-1 to assess their expression in kidney tissue. After 12 months, the development of remission of glomerulonephritis, parameters of the general analysis of urine, creatinine, urea, uric acid of blood, calculation of GFR were evaluated.Results: it was found that the severity of the total expression of MCP-1+VEGF-A+TGFß1 is observed to a greater extent in hematuric forms of glomerulonephritis, occurring without changes in the level of blood albumin. The same follows from the results demonstrating the relationship of the total expression of MCP-1+VEGF-A+TGFß1 with morphological manifestations more characteristic of nephritic forms of glomerulonephritis (IgA deposits, mesangial hypercellularity). The increased expression of the studied factors has shown its influence on the development of fibrosis and thickening of the walls of renal vessels, glomerular fibrosis and interstitium, reflecting the whole complex of reparative remodeling of renal tissue in the inflammatory process. The effect of the total expression of MCP-1+VEGF-A+TGFß1 on the further course of glomerulonephritis, accompanied by the progression of the disease in the form of a decrease in GFR after 12 months of observation of patients, was revealed.Conclusions: an increase in the total expression of MCP-1+VEGF-A+TGFß1 in hematuric forms of glomerulonephritis indicates the role of these factors in the development of the inflammatory process to a greater extent in these forms of the disease. It was found that an increase in the severity of the total expression of MCP-1+VEGF-A+TGFß1 is associated with manifestations of renal remodeling in glomerulonephritis. It has been shown that an increase in the severity of the total expression of MCP-1+VEGF-A+TGFß1 is accompanied by an increase in the likelihood of a rapid decrease in renal function in glomerulonephritis at 12-month follow-up.