transforming-growth-factor-beta and Vesico-Ureteral-Reflux

Familial clustering of vesicoureteral reflux suggests that genetic factors have an important role in the pathogenesis of vesicoureteral reflux. Transforming growth factor-beta1 is a multifunctional peptide that controls proliferation and differentiation in many cell types. Recently an association between the transforming growth factor-beta1 -509 and +869 gene polymorphism, and renal parenchymal scarring was reported. We investigated the genetic contribution of transforming growth factor-beta1 in familial vesicoureteral reflux by examining the genotype frequencies of transforming growth factor-beta1 polymorphic variants.. The study included 141 families in which 1 or more siblings had primary vesicoureteral reflux. Renal parenchymal scarring was assessed using dimercapto-succinic acid scans. Genotyping was performed in 280 patients with vesicoureteral reflux, including 133 index patients and 147 siblings, and in 74 controls for the position -509 and the coding region at position 10 (+869) of the transforming growth factor-beta1 gene polymorphism by polymerase chain reaction, gel analysis and appropriate restriction digest.. The genotype frequency of -509CC was significantly increased in the familial vesicoureteral reflux group compared to controls (58% vs 33%, p <0.01), whereas -509TT genotype frequency was significantly lower in the familial vesicoureteral reflux group compared to controls (7.5% vs 28%, p <0.01). Similarly there was a significant increase in the +869TT genotype (52% vs 32%, p <0.05), while the +869CC genotype was significantly lower in patients with familial vesicoureteral reflux compared to controls (11% vs 24%, p <0.01). There were no significant differences in transforming growth factor-beta1 genotype distribution between patients with vesicoureteral reflux with and without renal parenchymal scarring.. To our knowledge this study demonstrates for the first time the association of the cytokine transforming growth factor-beta1 gene polymorphism in patients with familial vesicoureteral reflux. Individuals with the transforming growth factor-beta1 -509CC and 869TT genotype may have increased susceptibility to vesicoureteral reflux.

Topics: Chi-Square Distribution; Child; Female; Genetic Predisposition to Disease; Genotype; Humans; Male; Polymerase Chain Reaction; Polymorphism, Genetic; Transforming Growth Factor beta; Vesico-Ureteral Reflux

To investigate the effect of hydrodynamic pressure mimicking vesicoureteral reflux on renal tubular epithelial cells in vitro, we constructed an intermittent pressure-loading (IPL) model of Madin-Darby canine kidney (MDCK) cells.. Three grades of pressure were loaded onto the MDCK cells intermittently. The concentration of cytokines in the supernatant, the amount of the protein and its mRNA in the MDCK cells were studied, respectively.. After 24 h, the concentration of transforming growth factor-beta1 (TGF-beta1) increased under intense IPL conditions (100 and 200 cm H2O) in the 15-min IPL group (p<0.05, p<0.01). The amount of cellular level of TGF-beta1 protein and its mRNA did not show any significant increase within 24 h under the present conditions. The concentration of monocyte chemoattractant peptide-1 (MCP-1) was not significantly different from that of the control.. These data suggest that the early TGF-beta1 secretion phenomenon without change in gene expression is the case in the renal tubular epithelial cells under certain intermittent pressure-loading conditions.

Topics: Analysis of Variance; Animals; Blotting, Western; Cell Survival; Cells, Cultured; Chemokine CCL2; Dogs; Enzyme-Linked Immunosorbent Assay; Epithelial Cells; In Vitro Techniques; Kidney Tubules; Models, Animal; Pressure; Reverse Transcriptase Polymerase Chain Reaction; RNA; Sensitivity and Specificity; Stress, Mechanical; Transforming Growth Factor beta; Transforming Growth Factor beta1; Vesico-Ureteral Reflux

Reflux nephropathy (RN) is recognized as a major cause of end stage renal failure in children and young adults. Transforming growth factor-beta1 (TGF-beta1) is a potent proinflammatory and fibrogenetic cytokine known to have a key role in the regulation of renal tissue fibrosis. We investigate genotype frequencies for polymorphisms of the TGF-beta1 gene at position -509, codon 10 and 25, and examine circulating levels of TGF-beta1 in patients with reflux nephropathy.. Renal scaring was evaluated with 99technetium dimercapto-succinic acid renal scan. Genotyping was performed in 123 patients with severe to moderate reflux nephropathy and 58 controls for the position -509, the coding region at position 10 and 25 of the TGF-beta1 gene polymorphisms by polymerase chain reaction, gel analysis and appropriate restriction digest. TGF-beta1 serum levels were measured with standard ELISA technique.. The genotype distribution of -509-CT was significantly increased in the RN group compared to controls, (82% vs 37%). Similarly, there was a significant increase in the CC Lue(10)-->Pro (codon 10) genotype (77% vs 27.5%, p <0.05), while TC Lue(10)-->Pro was significantly lower (7.3% vs 43%, p <0.05) in patients compared to controls. There was no significant difference in the Arg(25)-->Pro (codon 25) TGF-beta1 genotypes distribution between patients and controls. There were no statistically significant differences in the serum levels of TGF-beta1 in children with RN (4.2 +/- 0.3 mIU/ml) compared to controls (3.9 +/- 0.4 mIU/ml) (p >0.05).. Patients with TGF-beta1 -509 and Lue(10)-->Pro gene polymorphisms may be at higher risk for reflux nephropathy.

Topics: Adolescent; Case-Control Studies; Chi-Square Distribution; Child; Child, Preschool; Cicatrix; Enzyme-Linked Immunosorbent Assay; Genetic Predisposition to Disease; Genotype; Humans; Infant; Kidney Function Tests; Polymorphism, Genetic; Radioisotope Renography; Transforming Growth Factor beta; Transforming Growth Factor beta1; Vesico-Ureteral Reflux

Tissue kallikrein regulates blood circulation. Low urinary kallikrein excretion was associated with hypertension and renal disease in blacks. The polymorphic KLK1 promoter includes -130 GN coupled with multiple single base substitutions. The -130 G12 allele in the KLK1 promoter was associated with lower transcriptional activity and hypertensive end-stage renal disease (ESRD) in blacks. Transforming growth factor-beta1 (TGF-beta1) regulates matrix production, and induces fibrosis in a variety of tissues. High circulating TGF-beta1 levels mediating renal fibrosis and loss of function in transgenic mice. The -509 T allele in the TGF-beta1 promoter showed marginally higher transcriptional activity, and was associated with increased TGF-beta1 production in humans. The aim of this study was to investigate whether the tissue KLK1 promoter and TGF-beta1 polymorphism are involved in primary vesicoureteric reflux (VUR) with renal progression in children.. Seventy-four primary VUR children were studied with regular annual follow-up for more than 18 years, all of them more than grade II (diagnosed by voiding cystourethroradiography). All of them were born before 1984. Patients were classified into two groups according to the renal function with progressive deterioration or not. Patients with baseline creatinine clearance (CCr) less than 25 mL/min were defined as having chronic renal insufficiency (CRI). The TGF-beta1 -509 T-C polymorphism was analyzed by Bsu36I restriction fragment length polymorphism (RFLP)-polymerase chain reaction (PCR). In KLK1 promoter, the -130 GN length polymorphism and multiple single base substitutions were analyzed by electrophoresis of fluoresced PCR products in sequencing gels, single strand conformation polymorphism (SSCP), allele-specific PCR, and DNA sequencing. Patients' TGF-beta1 and KLK1 promoter polymorphisms were evaluated for association with VUR susceptibility and progression in Taiwanese children. Annual echocardiography study was used to evaluate left ventricular mass index (LVMI).. Four alleles were identified in the complex KLK1 promoter: A (-130 G10), B (-130 G2CG7), H (-130 G11), and K (-130 G12). The polymorphic KLK1 promoter showed no association with VUR susceptibility. However, the frequency distribution of KLK1 promoter among VUR patients with or without CRI (A, 50.0% and 67.5%; B, 17.9% and 8.3%; H, 14.3% and 18.3%; K, 17.9% and 5.8%, respectively) was statistically different (P = 0.008). Significantly higher K allele frequency was present in primary VUR with CRI children, as it was in the renal survival curve study. A significant increase of LVMI was also found in the A allele group compared with the non-A allele group of KLK1 promoter gene at the age of 18 years old with renal progression. The TGF-beta1 gene polymorphism was determined, and we found significant over-representation of the TT genotype in primary VUR patients with CRI compared with normal renal function (P= 0.0035).. The K allele of KLK1 promoter and TT genotype of TGF-beta1 may be a genetic KLK1 -130 GN and -128 G-C, and the susceptibility factor contributing to progressive renal deterioration in Taiwanese primary VUR children.

Topics: Alleles; Child; Child, Preschool; Gene Frequency; Genetic Predisposition to Disease; Genotype; Humans; Hypertrophy, Left Ventricular; Infant; Kidney Failure, Chronic; Polymorphism, Genetic; Promoter Regions, Genetic; Tissue Kallikreins; Transforming Growth Factor beta; Transforming Growth Factor beta1; Vesico-Ureteral Reflux

To determine if there are measurable quantities of transforming growth factor-beta 1 (TGF-beta 1) in the urine of children with either normal or pathologic conditions of the urinary tract, specifically vesicoureteral reflux (VUR) and ureteropelvic junction obstruction (UPJO). We also sought to determine if the urine TGF-beta level could distinguish between renal obstruction and no obstruction.. Preoperative bladder urine from consecutive patients undergoing pyeloplasty (UPJO group; n = 13), ureteral reimplantation (VUR group; n = 11), or circumcision/orchiopexy (control group; n = 19) as well as urine from the renal pelvis of the UPJO group was collected. The urine level of TGF-beta 1 was measured using a quantitative sandwich enzyme immunoassay technique.. Urine level of TGF-beta 1 was detected in each group: control (26.6 +/- 6.3 pg/mL), reflux (22.1 +/- 9.6), UPJO-pelvic urine (82.4 +/- 19.3), UPJO-bladder urine (31.2 +/- 8.2). The urine TGF-beta 1 concentration in pelvic urine in the UPJO group was significantly higher than that in bladder urine in children in the UPJO group (p = 0.03). TGF-beta 1 concentrations were similar from the bladder of children in all three study groups (p = NS).. Urine TGF-beta 1 is detectable in children with normal and pathologic urinary tracts. The level of this urine marker is elevated in the renal pelvis of children with UPJO compared to the level in the bladder of either obstructed or nonobstructed upper urinary tracts.

Topics: Biomarkers; Child; Child, Preschool; Female; Humans; Hydronephrosis; Infant; Kidney Pelvis; Male; Transforming Growth Factor beta; Ureteral Obstruction; Vesico-Ureteral Reflux