23 December 2008
As transforming growth factor- β1 (TGF- β1) is implicated in the pathogenesis of glomerulosclerosis, the aim of the study was to demonstrate if levels of glomerular TGF- β1 mRNA in renal biopsies correlated with glomerulosclerosis. Glomeruli were collected by microdissection from renal biopsies in patients with membranous nephropathy, lupus nephritis, diabetic nephropathy, minimal change disease and IgA nephropathy presented by proteinuria when serum creatinine was < 3 mg%. Glomerular mRNAs were reverse transcribed and TGF- β1, α2(IV) collagen, β-actin cDNA quantitated by competitive polymerase chain reaction (PCR). By semiquantitative electron microscopy, a 3.5-fold increase of glomerular TGF- β1/β-actin mRNA ratio in the moderate sclerotic group (n = 23, p < 0.01) and a 1.5-fold increase in the mild sclerotic group (n = 22, p < 0.05) were observed when compared to the minimal sclerotic group (n = 12). A concordant increase of glomerular α2(IV) collagen mRNA was found with 2.2- and 1.3-fold in moderate and mild sclerotic groups, respectively. The TGF- β1/β-actin mRNA ratios were highest in membranous nephropathy (466.4 ± 133.4, n = 11), followed by lupus nephritis (394.9 ± 94.8, n = 12) and diabetic nephropathy (333.2 ± 97.6, n = 10). Patients with minimal change disease (233.1 ± 54.1, n= 15) and IgA nephropathy (185.3 ± 39.6, n = 9) had low levels. The degree of glomerulosclerosis in each group followed the TGF- β1/β-actin mRNA ratios indicating that the level is the major determinant of glomerulosclerosis but not the disease entities. Glomerular TGF- β1/β-actin mRNA ratio did not correlate with clinical parameters such as the urinary protein excretion and creatinine clearance. These results suggest that glomerular TGF- β1/β-actin mRNA ratio may be used as a marker of glomerulosclerosis in renal biopsy to reflect the local sclerotic process.