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Published on: January 2, 2017
Early short-term imatinib treatment is sufficient to prevent the development of chronic allograft nephropathy
Johanna Savikko1, Jukka M Rintala, Sini E Rintala
1Transplantation Laboratory, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland. johanna.savikko@helsinki.fi
Background:
Chronic allograft nephropathy (CAN), now defined as interstitial fibrosis and tubular atrophy not otherwise specified, is a near universal finding in kidney grafts by the end of the first decade posttransplantation. Platelet-derived growth factor (PDGF) is a major mitogen mediating mesenchymal cell proliferation in CAN. Here, we investigated whether early short-term PDGF inhibition with imatinib could prevent CAN.
Methods:
Kidney transplantations were performed from Dark-Agouti (DA) to Wistar-Furth (WF) rats and syngenic controls were done between DA rats. Allografts were immunosuppressed with cyclosporine. One group was also treated with imatinib for the first 30 days after transplantation. Serum creatinine levels were measured once a week. Grafts were harvested 90 days after transplantation.
Results:
In control allografts, moderate to intense chronic changes were seen, whereas in syngenic grafts, no changes were seen. The early imatinib treatment prevented the development of CAN significantly compared to control allografts. Only few histological changes were seen. Fibrogenic growth factor ligand and receptor induction as well as inflammatory cell response was significantly inhibited by imatinib. Creatinine values of imatinib-treated allografts were also significantly lower compared to controls.
Conclusions:
We show that short-term imatinib treatment is sufficient to prevent CAN significantly, indicating that early PDGF induction has an important role in the pathogenesis of CAN. Here, we provide preclinical work that will need to be confirmed in patients with CAN.
Insights
Early short-term imatinib treatment effectively prevented chronic allograft nephropathy (CAN) in kidney transplants. This suggests platelet-derived growth factor (PDGF) inhibition is key to stopping CAN development.
Area of Science:
- Nephrology
- Transplantation Immunology
- Pharmacology
Background:
- Chronic allograft nephropathy (CAN) is a common complication after kidney transplantation.
- Platelet-derived growth factor (PDGF) drives the cellular changes seen in CAN.
- Investigating early intervention to prevent CAN is crucial.
Purpose of the Study:
- To determine if short-term inhibition of PDGF with imatinib can prevent CAN development.
- To assess the impact of early imatinib treatment on kidney graft histology and function.
Main Methods:
- Rat kidney allografts (Dark-Agouti to Wistar-Furth) and syngenic controls were used.
- Allografts received cyclosporine immunosuppression; one group also received imatinib for 30 days.
- Serum creatinine and graft histology were assessed 90 days post-transplantation.
Main Results:
- Early imatinib treatment significantly prevented CAN development compared to controls.
- Imatinib inhibited fibrogenic growth factor pathways and inflammatory responses.
- Creatinine levels were significantly lower in imatinib-treated allografts.
Conclusions:
- Short-term imatinib therapy is sufficient to prevent CAN, highlighting the role of early PDGF in its pathogenesis.
- These preclinical findings support further investigation in human kidney transplant patients.
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