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Vascular endothelial growth factor expression in human chronic renal allograft rejection
H L Pilmore1, J M Eris, D M Painter
1Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Background:
Chronic renal allograft rejection is characterized by interstitial fibrosis and vasculopathy. Vascular endothelial growth factor (VEGF) is an endothelial mitogen with increased expression in inflammation and vasculopathy.
Methods:
Renal tissue from 17 patients with chronic rejection was examined for VEGF protein and the presence of CD 68-positive macrophages, and compared to biopsies from patients with temporary allograft dysfunction, acute rejection, and native kidneys with thin membrane disease.
Results:
In the chronic rejection group, there was markedly increased expression of VEGF protein in the interstitium (P<0.0001). In serial sections, VEGF colocalized with the expression of CD 68-positive macrophages. Significantly more macrophages were in the tubulointerstitium in tissue with chronic rejection than in those with temporary allograft dysfunction (P<0.005). Additionally, VEGF protein expression in the glomeruli and the vascular compartment of patients with chronic rejection was increased.
Conclusion:
The up-regulation of VEGF in chronic renal allograft rejection may be important in inflammation and development of fibrosis.