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Biomedical subjects

A S Woolf

Publications and source records attributed to A S Woolf.

At least 73 records · Page 4Linked to original sources

The hepatocyte growth factor/scatter factor (HGF/SF) receptor, met, transduces a morphogenetic signal in renal glomerular fibromuscular mesangial cells.

Previous studies have demonstrated that hepatocyte growth factor/scatter factor (HGF/SF) is secreted by mesenchymal cells and that it elicits motility, morphogenesis and proliferation of epithelia expressing the met receptor. We now report that HGF/SF may act as an autocrine factor in fibromuscular renal mesangial cells. These cells mechanically support glomerular endothelia, control the rate of plasma ultrafiltration and are implicated in the pathogenesis of a variety of chronic renal diseases. We detected met protein in the vascular stalk of metanephric glomeruli and in the mature mesangium. Mesangial lines from a mouse transgenic for a temperature-sensitive simian virus 40 T antigen expressed met mRNA and protein, and recombinant HGF/SF phosphorylated the met receptor tyrosine kinase. Cells were immortal in the permissive condition and HGF/SF enhanced proliferation in a defined medium. In the absence of the immortalising protein, division ceased and recombinant HGF/SF caused multipolar cells to become bipolar. The factor diminished stress fibres, their focal contacts and immunostaining for extracellular fibronectin, hence suggesting reduced substratum adhesion and enhanced motility. Mesangial lines also expressed HGF/SF mRNA and secreted bioactive factor; immunocytochemistry showed both ligand and receptor in individual cells. HGF/SF blocking antibody aggregated the cells, suggesting that mesangial-derived factor affects basal cell conformation in an autocrine manner. We conclude that mesangial cells express both HGF/SF and met, and the factor induces morphogenesis of cultured mesangial cells. Therefore HGF/SF may have an autocrine role in mesangial biology but further studies are now required to investigate the potential importance of the factor in vivo.

Animals↗

Clinical impact and biological basis of renal malformations.

Little is understood regarding the pathogenesis of human renal malformations. These disorders include the total absence of renal tissue (or renal aplasia) and organs that contain undifferentiated kidney cells (or renal dysplasia). Various lines of evidence from animal studies suggest that kidney malformations can be generated by (1) the mutation of master genes expressed during nephrogenesis, (2) the prenatal obstruction of the urinary tract, and (3) also by teratogens. Although the majority of human renal malformations occur sporadically, some are familial and would thus seem to have a genetic basis. It is possible but unproven that some sporadic cases may represent new mutations. A understanding of the biology of normal and abnormal nephrogenesis will ultimately lead to earlier diagnoses of renal malformations and will make it possible to conceive of therapeutic strategies that may enhance the differentiation and survival of metanephric precursor cells.

Animals↗

Taxol inhibits progression of congenital polycystic kidney disease.

Polycystic kidney diseases (PKD) are the most common hereditary diseases of the human kidney and account for ten per cent of patients requiring renal transplantation or dialysis. Renal cyst formation has been attributed to enhanced cell proliferation, unbalanced cell death, abnormal targeting of membrane proteins, aberrant kidney development and tubular obstruction, but there is no treatment that blocks the formation and enlargement of renal cysts. We have now developed an in vitro model of spontaneous cyst formation that distinguishes polycystic kidney epithelium from its normal counterpart. Inhibitors of DNA, RNA and protein synthesis did not prevent in vitro cyst formation, but this was reversibly inhibited by ouabain, amiloride and the microtubule-specific agents colchicine, vinblastine and taxol. The cpk mouse is a well-characterized recessive PKD model and we find that cpk/cpk mice develop PKD and die from uraemia by 4-5 weeks of age, but when treated weekly with taxol they survive for more than 200 days with minimal loss of renal function, show limited collecting-dust cyst enlargement, and attain adult size. Our results indicate that the microtubule cytoskeleton has a central role in the pathogenesis of PKD in cpk mice and that taxol may also be useful in treating human PKD.

Animals↗

Genetically engineered kidneys.

We review the available methods of creating genetically engineered kidneys. These include transgenic technology to introduce novel genes or delete existing genes and methods of gene transfer into the post-natal or adult kidney. The use of such technology has provided insights into renal development and growth and created new animal models of human diseases. Although some of these techniques are of potential use for introducing therapeutically useful gene products into the diseased kidney, many problems remain to be solved before this aim is attained.

Animals↗

Gene transfer into the mammalian kidney: first steps towards renal gene therapy.

In this review we discuss two strategies for successful retrovirally-mediated transfer (transduction) of a reporter gene (bacterial beta-galactosidase) into the mammalian kidney. Retroviruses only integrate into dividing cells, but the adult kidney has a very low cell turnover. One approach used is the rapidly-dividing metanephros, or precursor of the adult kidney, as a target for proviral integration. After infection and microtransplantation of fragments of this tissue into the renal cortex of neonatal mice, the implants grew and developed within the host kidney and reporter gene expression was located in glomerular and interstitial cells. A similar approach has been used by other investigators to grow genetically-engineered metanephros in a subcapsular location in the kidney. However, access of the gene product to the parenchyma of the kidney may be limited using this approach. A second strategy was to induce renal tubular cell replication by causing nephrotoxic damage with a folic acid injection. This created a 'biological window' in which a specific cell population, that is, tubular cells, was targeted for retroviral infection. One to four weeks later foci of tubular cells were found to express the reporter gene product. In both models, 50 to 90% of the experiments showed evidence of proviral integration as judged by the presence of a 559 base-pair DNA fragment amplified by the polymerase chain reaction. This persisted for four to seven weeks, the limit of the period of observation.

Animals↗

Adverse reactions to diuretics.

Diuretics can result in various undesired biochemical changes, such as impotence, skin rashes, nausea, dizziness and lethargy as well as subjective side effects. The side effects are mostly predictable, their effects depending on both the circulatory blood volume and on the transport of water and solute in the renal tubules. Two of the commonest side effects are mild hypovolaemia, when any diuretic is used, and mild hypokalaemia when the non-potassium-sparing diuretics, such as thiazides and frusemide are used. Its occurrence is dose dependent and can be corrected by potassium supplements, but potassium-retaining diuretics, which also correct the often associated fall in serum magnesium, are preferable. Many reports link hypokalaemia with cardiac arrhythmias, but some dispute this association in the absence of the concomitant use of digoxin. Hyponatraemia rarely occurs, but can be life threatening. Calcium excretion is markedly reduced, but unlike other electrolyte disturbances from diuretics, this may be valuable: some suggest diuretics have an anti-osteoporotic action. Diuretics increase glucose and insulin resistance and should be used sparingly in diabetics. They rarely cause a non-ketotic hyperosmolar coma. Urate is raised, but clinical gout is not common. Cholesterol elevation has been reported in some studies, but long-term studies indicate that lipid changes are minor. Other rare side effects are not predictable from their pharmacological actions and these include the occurrence of skin rashes, thrombocytopenia, pancreatitis and interstitial nephritis; and ototoxicity from frusemide.

Blood Volume↗

Nephrogenesis and the development of renal disease.

Over the last few years there has been considerable progress in analysing the cellular basis of nephrogenesis and a start has been made towards elucidating the underlying molecular controls of this process. In this review we begin by describing how the kidney forms and then consider recent work on the mechanisms underlying these events. We review evidence implicating a neural basis for kidney induction and go on to show how the induced metanephric mesenchyme aggregates and forms condensations which themselves polarize to form epithelia and filtering nephrons. We then discuss how changes in the extracellular matrix are implicated in these processes and how the expression of nuclear transcription factors may regulate the final phenotype of the kidney. Finally, we show how the study of nephrogenesis is beginning to shed light on the aetiology of a range of disorders that include renal malformations, renal tumours, and inherited glomerular and polycystic kidney diseases.

Animals↗

Growth factors in the pathogenesis of renovascular complications of diabetes mellitus.

PURPOSE: We reviewed the evidence that links altered levels of circulating and intrarenal growth factors with the genesis of renal glomerular hypertrophy, microvascular disease and interstitial fibrosis as seen in diabetes mellitus. ANIMAL DATA: Insulin-like growth factor 1 (IGF-1) appears to be a hypertrophic factor in experimental renal disease, and is also known to be mitogenic for mesangial and vascular smooth muscle cells. However, an alteration in the balance of other factors, such as platelet-derived growth factor and angiotensin (Ang) II, could contribute to the growth disorder. Data from healthy animals suggest that the paracrine stimulation of interstitial fibroblasts by adjoining renal epithelial cells may contribute to the progressive interstitial fibrosis and microvascular occlusion found in diabetic nephropathy and other chronic renal diseases. HUMAN DATA: The progressive fall in the glomerular filtration rate in patients with diabetic nephropathy may be partly explained by structural damage in the glomerulus subsequent to hyperfiltration and hypertrophy. However, interstitial disease is independently correlated with serum creatinine. There is no evidence to show whether growth factors contribute to the genesis of human diabetic nephropathy, and circulatory levels of IGF-1 and Ang II are not clearly correlated with renal disease. It is possible, but not proven, that intrarenal levels of growth factors may be particularly relevant to the pathogenesis of glomerular microvascular and interstitial disease.

Angiotensin II↗

Do glomerular hemodynamic adaptations influence the progression of human renal disease?

Although experiments in the rat suggest that glomerular hemodynamic alterations following a reduction of renal mass may be implicated in the progression of chronic renal failure, we argue that the deleterious effects of similar adaptations in human renal disease are unproven. In the otherwise normal solitary kidney the supranormal glomerular filtration rate (GFR) remains stable over the longterm, and in early diabetic nephropathy which is also accompanied by hyperfiltration, renal deterioration cannot be dissociated from a rise in systemic blood pressure. In patients with miscellaneous renal diseases and a depressed basal GFR there is indirect evidence that hyperfiltration might occur in some of the remnant glomeruli. However, at present there is little conclusive evidence to indicate that therapies which might normalize glomerular hemodynamics, e.g., dietary protein restriction, have any effect on progression of renal disease, or that angiotensin converting-enzyme inhibitors, which lower glomerular capillary pressure, have any advantage over other antihypertensive agents which are equally efficacious in lowering systemic blood pressure.

Adaptation, Physiological↗

Integration of new embryonic nephrons into the kidney.

The current report summarizes our experiments exploring the feasibility of creating a chimeric kidney, that is, an organ constituted by cells derived from more than one fertilized ovum. The overall strategy has been to obtain donor renal tissue from avian and murine embryos and to implant this into the host avian mesonephric mesoderm or into the cortex of murine neonatal kidney. In both models, donor cells were distinguished from the host by the presence of characteristic nuclear or cytoplasmic markers. Examination of quail to chick transplants showed the tandem development of mesonephric tissue in the form of bilobed organ. In the mouse chimeric kidney, examined 2 to 4 weeks postnatally, transplanted metanephric tissue grew and developed glomeruli, proximal tubules, and cords of cells, which extended into the medulla of the host kidney. Before death, intravenous FITC-dextran was administered to the host mouse. Some transplanted tubules were connected to filtering glomeruli, as judged by the presence of fluorescein within their lumens. These experimental models provide novel means with which to study nephrogenesis in vivo. Finally, if the embryonic donor tissue could be genetically engineered before implantation, the prospect of "nephron therapy" arises, in which altered implanted nephrons could deliver therapeutically useful molecules into the urine or kidney interstitium.

Animals↗

Does atrial natriuretic factor contribute to the progression of renal disease?

In chronic renal failure, non-immunological mechanisms may cause disease progression. It is postulated that the high plasma levels of atrial natriuretic factor which occur in some patients with chronic renal impairment are biologically active. They would not only serve to maintain sodium balance but also alter glomerular haemodymanics and enhance proteinuria to the long-term detriment of renal function.

Animals↗

Creation of a functioning chimeric mammalian kidney.

The possibility of adding new nephrons to the mammalian kidney was studied. Embryonic metanephric tissue was implanted into the renal cortex of neonatal mice less than 24 hours old, and the development of the chimeric kidney was followed over the following two to four weeks. Donor tissue was obtained from the homozygous beige mouse and a mouse line transgenic for the beta-globin gene, which provided distinct cellular and nuclear markers which were used to distinguish donor from recipient nephrons. Differentiation and growth of donor nephrons occurred in the host kidney and included vascularized glomeruli, mature proximal tubules, and tubular extensions into the renal medulla. Glomerular filtration was demonstrable in donor nephrons using FITC-dextran as a marker of filtration into the proximal tubules. Transplantation of metanephric tissue into adult mouse kidneys did not lead to glomerular or tubular differentiation. This study demonstrates the feasibility of adding functioning nephrons to mammalian kidneys in species in which there is ongoing nephrogenesis post-natally.

Animals↗

The effects of low dose intravenous 99-126 atrial natriuretic factor infusion in patients with chronic renal failure.

The aim was to study the renal and hormonal effects of intravenous 99-126 atrial natriuretic factor (ANF) infusion in a mixed group of patients who had moderate to severe chronic renal failure (CRF) and who were not treated with dialysis. The peak mean plasma level of ANF achieved during the experiment was at the upper limit of an absolute range of basal values previously recorded in a larger group of patients with similar degrees of renal impairment. A significant tissue effect was confirmed by rises in plasma and urinary cyclic guanosine monophosphate, the 'second-messenger' of ANF. ANF infusion increased sodium excretion rate by a mean of 68% compared with a fall of 40% in a placebo group, and significant increases in urinary albumin excretion occurred during the peptide infusion. Thus, the high levels of plasma ANF found in CRF may have a role in the maintenance of sodium balance. In addition, the proteinuric effect may be detrimental to long-term renal function.

Atrial Natriuretic Factor↗

Effects of physiological infusion of atrial natriuretic factor on healthy subjects and patients with the nephrotic syndrome.

We followed the renal and hormonal effects of physiological intravenous infusions of atrial natriuretic factor (ANF) in 6 water-loaded patients with nephrotic syndrome and 7 healthy subjects. Two of the patients had impaired renal function, 3 had active sodium retention, and none took drugs. The ensuing natriuresis, increase in plasma and urinary cyclic guanosine monophosphate and suppression of the renin-aldosterone axis were similar in normals and nephrotics. In both groups, significant increases in filtration fraction (inulin/PAH clearance) were observed, and in the nephrotics, major increases also occurred in both the absolute and fractional urinary albumin excretion. The renal and hormonal responses to ANF are not impaired in the nephrotic syndrome.

Adult↗