| Abstract | BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory cytokine produced by macrophages, and by renal mesangial and tubular epithelial cells. It stimulates the release of interleukin (IL)-1beta, monocyte chemoattractant protein-1 (MCP-1), and transforming growth factor-beta (TGF-beta). Blockade of TNF-alpha is currently used clinically in several autoimmune inflammatory diseases. We hypothesised that blocking TNF-alpha with a monoclonal antibody would prevent inflammation and renal fibrosis in crescentic glomerulonephritis. METHODS: Nephrotoxic nephritis was induced in Wistar Kyoto (WKY) rats by intravenous injection of rabbit antirat glomerular basement membrane (GBM) nephrotoxic serum (NTS). Anti-TNF-alpha monoclonal antibody or saline was given intraperitoneally three times per week in four protocols: experiment 1, days 0 to 7; experiment 2, days 0 to 14 and days 4 to 14; experiment 3, days 4 to 28; and experiment 4, days 14 to 28. RESULTS: In experiment 1, rats treated from disease induction had less glomerular fibrinoid necrosis and fewer glomerular macrophages at day 7. In experiment 2, rats treated from day 0 or day 4 showed improved renal function, as judged by serum creatinine, with a significant reduction in crescents. In experiment 3, anti-TNF-alpha treatment significantly reduced urine protein to creatinine ratio and urinary MCP-1 levels. Serum creatinine was preserved at both day 14 and day 28. Tubulointerstitial inflammation, glomerular and tubulointerstitial scarring, and markers of fibrosis [alpha-smooth muscle actin (alpha-SMA) and type IV collagen] were significantly less in treated rats at day 28. In experiment 4, serum creatinine was higher and tubulointerstitial scarring was less in delayed-treated animals. CONCLUSION: Neutralization of endogenous TNF-alpha reduces glomerular inflammation, crescent formation, and tubulointerstitial scarring, with preservation of renal function, in experimental crescentic glomerulonephritis. TNF-alpha blockade is effective even when introduced at the time of maximum glomerular inflammation. |
| Authors | Sarah B Khan, H Terence Cook, Gurjeet Bhangal, Jennifer Smith, Frederick W K Tam, Charles D Pusey
(Affiliation: Renal Section and Department of Histopathology, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom.)
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| Journal | Kidney international
(Kidney Int)
Vol. 67
Issue 5
Pg. 1812-20
(May 2005)
ISSN: 0085-2538 United States |
| PMID | 15840028
(Publication Type: Journal Article)
|
| Chemical References |
- Antibodies, Monoclonal
- Tumor Necrosis Factor-alpha
- Creatinine
|
| Topics |
- Animals
- Antibodies, Monoclonal
(therapeutic use)
- Basement Membrane
(immunology)
- Creatinine
(blood)
- Glomerulonephritis
(etiology, immunology, pathology, therapy)
- Kidney Glomerulus
(immunology)
- Male
- Rabbits
- Rats
- Rats, Inbred WKY
- Time Factors
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
|
