Prevention of chronic allograft nephropathy with vitamin D

Transpl Int. 2005 Oct;18(10):1175-86. doi: 10.1111/j.1432-2277.2005.00187.x.

Abstract

Chronic allograft nephropathy (CAN) is the leading cause of late allograft loss in kidney transplantation. Interstitial fibrosis and glomerulosclerosis are characteristic of CAN. Transforming growth factor beta-1 (TGFbeta-1) is associated with both of these histologic findings in the transplant setting. Recent studies have suggested that vitamin D signaling pathways may interact with and regulate TGFbeta-1 mediated events. We examined the efficacy of 1,25-dihydroxyvitamin D(3), the active metabolite of vitamin D [1,25-(OH)(2)D(3)], the active metabolite of vitamin D, as monotherapy to prolong allograft survival and preserve renal function in a rat model of CAN, the Fisher 344 to Lewis model. Recipients went without treatment or were treated with cyclosporine A (CSA; 10 days) or 1,25(OH)(2)D(3) (1000, 500 or 250 ng/kg/day). Grafts were harvested at the time of rejection or at 24 weeks post-transplant. A portion of the graft was processed for histology and immunohistochemistry and a second portion was analyzed for protein expression by western blotting. Not only did 1,25-(OH)(2)D(3) treatment significantly prolong graft survival, but it also prevented histological changes associated with CAN. 1,25-(OH)(2)D(3) treatment significantly decreased Smad 2 expression. This TGFbeta signaling molecule is likely involved in fibrosis. Moreover, 1,25-(OH)(2)D(3) treatment increased Smad 7 expression, an important feedback molecule in the TGFbeta-1 signaling pathway. This suggests that 1,25-(OH)(2)D(3) interacts with TGFbeta-1 in limiting histological injury in this model of CAN. Furthermore, 1,25-(OH)(2)D(3), treatment increased expression of matrix metalloproteinase 2 (MMP-2), thus directly affecting levels of another important matrix molecule. Taken together our data suggests that 1,25-(OH)(2)D(3) mitigates CAN in this model by altering TGFbeta-1 and matrix-regulating molecules.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Blotting, Western
  • Chronic Disease
  • Cyclosporine / pharmacology
  • Electrophoresis, Polyacrylamide Gel
  • Enzyme-Linked Immunosorbent Assay
  • Extracellular Matrix / metabolism
  • Fibrosis / metabolism
  • Graft Rejection
  • Graft Survival / drug effects
  • Graft Survival / immunology*
  • Immunohistochemistry
  • Immunosuppressive Agents / pharmacology
  • Kidney Diseases / etiology*
  • Kidney Diseases / pathology*
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods*
  • Matrix Metalloproteinases / metabolism
  • Rats
  • Rats, Inbred F344
  • Rats, Inbred Lew
  • Rats, Sprague-Dawley
  • Signal Transduction
  • Smad7 Protein / metabolism
  • Time Factors
  • Transforming Growth Factor beta / metabolism
  • Transforming Growth Factor beta1
  • Transplantation, Homologous / adverse effects
  • Vitamin D / chemistry*
  • Vitamin D / therapeutic use*

Substances

  • Immunosuppressive Agents
  • Smad7 Protein
  • Smad7 protein, rat
  • Tgfb1 protein, rat
  • Transforming Growth Factor beta
  • Transforming Growth Factor beta1
  • Vitamin D
  • Cyclosporine
  • Matrix Metalloproteinases