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논문분류	춘계학술대회 초록집
제목	ROLE OF BONE MARROW-DERIVED STEM CELLS, RENAL PROGENITOR CELLS AND STEM CELL FACTOR IN CHRONIC RENAL ALLOGRAFT NEPHROPATHY
저자	Hayam El Aggan* 1, Mona Salem2, Nahla Farahat3, Ahmad El Koraie1, Ghaly kotb4
출판정보	2016; 2016(1):
키워드	Chronic allograft nephropathy, Renal transplantation, Stem cell factor, Stem cells
초록	Background: Chronic allograft nephropathy (CAN) is a poorly understood clinico-pathological entity associated with chronic allograft loss. CAN could be due to immunological and non immunological causes. Bone marrow derived stem cells (BMSCs) are undifferentiated cells typically characterized by their capacity for self-renewal, ability to give rise to multiple differentiated cellular population, including hematopoietic (HSCs) and mesenchymal stem cells (MSCs). Characterization of HSCs includes their multipotency, expression of typical surface markers such as CD34 and CD45, while characterization of MSC includes their multipotency, expression of typical surface markers such as CD90 and CD105, and the absence of hemopoietic lineage markers. So, the aim of the present work was to study the role of bone marrow-derived HSCs and MSCs, renal progenitor cells and stem cell factor (SCF) in CAN in relation to renal hemodynamics and histopathological changes Methods: Thirty patients with kidney transplantation for more than 6 months were divided into 15 patients with stable renal function (Group I), 15 patients who developed CAN (Group II) and 15 healthy subjects of matched age and sex were included as controls (Group III). Enumeration of HSCs and MSCs in the peripheral blood using flow cytometry was done via detection of CD34, CD45, CD117 and CD106, respectively. Urinary alkaline phosphatase (U.ALP) was used as a tubular marker and C-reactive protein (CRP) were measured. Immunohistochemical detection of CD34, CD133, VEGF and aSMA in renal allograft biopsies of patients with CAN were done. Doppler ultrasound was done to the transplanted kidney with the calculation of the resistive index (RI), palsatility index (PI), renal allograft artery cross sectional area and renal blood flow Results: There was a significant increase in the levels of SCF, number of peripheral blood HSCs and MSCs in both transplanted patient groups than the controls and they were higher in patients with CAN than patients with stable renal function, P < 0.001). The renal hemodynamic study showed a significant increase in RI and PI with a significant decrease in renal artery cross sectional area and renal blood flow in patients with CAN than patients with stable renal function and controls. The U.ALP showed a significant decrease in patients with CAN than the other groups and this was accompanied by evident expression of markers of renal repair with increase in CD34 and CD133 positive cells in renal tissues and their correlation with the markers inflammation, tubular and renal dysfunction. Conclusion: Renal transplantation is associated with mobilization of MDSCs into the circulation in parallel with an increased production of SCF, particularly with severe kidney injury. However, the mobilized BMSCs are not sufficient to bring out renal repair and the activation of endogenous renal stem cells may have some beneficial effects in limiting renal fibrosis and enhancing renal vasculature as a part of set up for renal repair.
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