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F P Schena

Publications and source records attributed to F P Schena.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Echography in the diagnosis and follow-up of renal biopsy complications].

The introduction of echography represented a focal step in the management of renal biopsy, resulting in easier and faster procedures. Chiefly, echography allows the diagnosis and monitoring of complications of bioptic procedure. Here we present a series of 722 consecutive echo-guided renal biopsies, carried out from 1990 to 1995, 97 of which on kidney allografts. Echographic examination, performed 24 to 48 hours after renal biopsy, enable to diagnose the presence of perirenal hematoma in 30% of patients. Of these, only 10% presented with clinical symptoms and/or signs (reduction of Hct and arterial pressure, local pain). Our protocol comprises an echographic follow-up to control the evolution of hematoma, that usually resolves within 15-40 days, according to the initial size of the lesion. One time we observed an intra-parenchimal hematoma, which resulted in kidney rupture and consequent nephrectomy. 14% of all patients complained with macrohematuria: in 10% of these cases, echography showed the presence of coaguli in the urinary tract, which was associated with the clinical features of renal colic pain. Only in two cases of persistent macrohematuria, the echography together with echo- and color-doppler, allowed the diagnosis of the arterio-venous fistula. In conclusion, our experience demonstrates that the echographic examination allows not only to simplify the bioptic procedure, but also to early diagnose the complications due to this invasive manouvre.

Biopsy↗
PubMed1996

Urinary IL-6/EGF ratio: a useful prognostic marker for the progression of renal damage in IgA nephropathy.

Interleukin 6 (IL-6) is produced by human mesangial and tubular cells, and its urinary levels has been proposed as a marker of mesangial proliferation and tubulointerstitial damage. Epidermal growth factor (EGF) is expressed within the Henle's loop and the distal tubule and has been shown to accelerate recovery from renal injury. In the present study we have defined renal gene and protein expression of IL-6 and EGF in 10 normal, 10 nonproliferative glomerulonephritis (NPGN) and 30 IgA nephropathy (IgAN) human kidneys by RT-PCR, in situ hybridization and immunohistochemical techniques. Moreover, urinary IL-6 and EGF levels were measured in 41 patients with IgAN and in 20 normal subjects (N). In normal kidneys, EGF was localized in Henle's loop and distal convoluted tubule whereas IL-6 was mainly located in the proximal tubule and, less, within the glomerulus. In IgAN patients, EGF was decreased whereas IL-6 expression was upregulated. These modifications paralleled the degree of tubulointerstitial damage. Moreover, IgAN patients as a whole exhibited a reduction of EGF and an increase of IL-6 urinary concentration (EGF values: N, 12.96 +/- 1.15; IgAN Grades 1-2, 20.05 +/- 2.64; Grades 3-4 7.60 +/- 1.70: Grade 5, 3.14 +/- 0.71, ng/mg urinary creatinine. IL-6 values: N, 2.04 +/- 0.51; IgAN Grades 1-2, 3.26 +/- 0.38; Grades 3-4, 5.67 +/- 0.92; Grade 5, 27.20 +/- 9.70 pg/mg urinary creatinine), that correlated with the degree of histological lesions, the presence of hypertension and serum creatinine level. Interestingly, patients with the highest urinary IL-6/EGF ratio showed a worse evolution in a three year follow-up. In conclusion, our data show that: (1) renal IL-6 and EGF expression are strictly correlated to the degree of tubulointerstitial damage; and (2) urinary IL-6/EGF ratio might be a valuable prognostic marker for the progression of the renal damage in IgAN.

Adolescent↗
PubMed1996

Expression of epidermal growth factor and its receptor in normal and diseased human kidney: an immunohistochemical and in situ hybridization study.

The kidney is one of the major sites of EGF production and there it seems to play several biological functions, such as modulation of cell growth, renal repair following injury, regulation of cellular metabolism and glomerular haemodinamics. The present study was first aimed at localizing EGF and its receptor (R) in normal human kidney by immunohistochemical and in situ hybridization techniques. Then, the distribution of the growth factor and its R was explored in biopsy specimens from eight patients with acute tubulointerstitial damage. In the normal human kidney, both EGF immunoreactivity and EGF mRNA were localized in tubular profiles corresponding to Henle's loop and, although to a lesser intensity, to distal convoluted tubule. EGF immunostaining was remarkable mainly at the apical surface of tubular cells. EGF-R protein expression was detected in glomerular endothelial cells, in peritubular capillaries and arteriolar walls, as well as along the thick ascending limb of Henle's lop and distal convoluted tubule, where it colocalized with Tamm-Horsfall protein. Immunohistochemical analysis of tubular profiles revealed that EGF-R was located especially along the basolateral membrane of tubular cells and within the basal part of cytoplasm. Endogenous alkaline phosphatase and CHIP28 positive tubules did not show any signal for EGF and its receptor. Kidneys with acute tubulointerstitial injury exhibited a dramatic decrease of EGF expression, whereas EGF-R showed only minor modifications. Interestingly, EGF-R was localized to both apical and antiluminal membranes of positive tubular cells. It is concluded that EGF-EGF receptor loop may be relevant in the pathogenesis of acute tubulointerstitial damage and recovery from tubular injury, while its role in the physiological renewal of the urothelium remains speculative.

Biopsy↗
PubMed1996

Clinical and therapeutic aspects of renal amyloidosis.

Renal amyloidosis is not a frequent disease: its annual frequency is approximately 2.5-2.8% of all renal biopsies. Individual cases are normally rare and for this reason clinical findings and therapeutic results obtained by clinical multicentre studies are well considered. This review describes the clinical and therapeutic aspects of renal amyloidosis and refers particularly to the results obtained by the Italian Study Group for renal amyloidosis and by the multicentre Italian study protocol for AL amyloidosis.

Amyloidosis↗
PubMed1996

Monocyte chemotactic peptide-1 expression in acute and chronic human nephritides: a pathogenetic role in interstitial monocytes recruitment.

Tubulointerstitial damage is a common histopathological feature of acute and chronic renal diseases and a prognostic indicator of renal function outcome. Monocytes infiltrating the interstitium, through the release of cytokines and/or growth factors, may play a key role in the pathogenesis of tubulointerstitial damage. Monocyte chemotactic peptide-1 (MCP-1) is a specific and powerful chemoattractant and activating factor for monocytes. This study investigated MCP-1 expression and its correlation with monocyte infiltration and tubulointerstitial damage in biopsies of patients with acute interstitial nephritis (AIN) and a chronic glomerulonephritis, namely immunoglobulin. A nephropathy (IgAN), often characterized by tubulointerstitial involvement. Six patients with AIN and 20 patients with IgAN, nine with mild (G1 to 2) and 11 with moderate to severe histologic lesions (G3 to 5), were studied. MCP-1 gene and protein expression were evaluated by in situ hybridization and immunohistochemistry. Infiltrating CD68-positive cells were identified as monocytes. MCP-1, weakly expressed in normal kidneys, was clearly upregulated in AIN biopsies. The gene and the protein expression were primarily localized in tubular and glomerular parietal epithelial cells, as well as in infiltrating mononuclear cells. In IgAN, a striking increase in MCP-1 mRNA and protein expression was observed only in the biopsies with moderate to severe lesions, with a pattern of expression similar to AIN. The MCP-1 expression strictly correlated with monocyte infiltrates and tubulointerstitial damage. In addition, the urinary excretion of this chemokine was studied in 17 IgAN patients. MCP-1 protein concentration was higher, compared with healthy subjects, in IgAN patients, especially in the G3 to 5 group, and directly correlated with the renal MCP-1 gene expression. In conclusion, these data suggest that production of MCP-1 in the tubulointerstitial compartment may play a key role in modulating monocytes influx and, consequently, tubulointerstitial damage.

Acute Disease↗
PubMed1996

High glucose concentration induces the overexpression of transforming growth factor-beta through the activation of a platelet-derived growth factor loop in human mesangial cells.

High glucose concentration has been shown to induce the overexpression of transforming growth factor (TGF)-beta 1 mRNA and protein in different cell types, including murine mesangial cells, thus possibly accounting for the expansion of mesangial extracellular matrix observed in diabetic glomerulopathy. In the present study, we evaluated platelet-derived growth factor (PDGF) B-chain and PDGF-beta receptor gene expression in human mesangial cells (HMCs) exposed to different concentrations of glucose and then sought a possible relationship between a PDGF loop and the modulation of TGF-beta 1 expression. HMC [3H]thymidine incorporation was upregulated by 30 mmol/L glucose (HG) up to 24 hours, whereas it was significantly inhibited at later time points. Neutralizing antibodies to PDGF BB abolished the biphasic response to HG, whereas anti-TGF-beta antibodies reversed only the late inhibitory effect of hyperglycemic medium. HG induced an early and persistent increase of PDGF B-chain gene expression, as evaluated by reverse transcriptase polymerase chain reaction, whereas PDGF-beta receptor mRNA increased by twofold after 6 hours, thereafter declining at levels 70% lower than in controls after 24 hours. 125I-Labeled PDGF BB binding studies in HMCs exposed to HG for 24 hours confirmed the decrease of PDGF-beta receptor expression. TGF-beta 1-specific transcripts showed 43 and 78% increases after 24 and 48 hours of incubation in HG, respectively, which was markedly diminished by anti-PDGF BB neutralizing antibodies or suramin. We conclude that HG induces an early activation of a PDGF loop that, in turn, causes an increase of TGF-beta 1 gene expression, thus modulating both HMC proliferation and mesangial matrix production.

Cell Division↗
PubMed1995

Biosynthesis of C3 by human mesangial cells. Modulation by proinflammatory cytokines.

Deposits of complement (C) components are found in the glomeruli of patients with various glomerulonephritides without detectable immunoglobulins, thus suggesting a pathogenetic role of the locally produced proteins of this system. In the present study, we have examined human mesangial cells (HMC) for their ability to secrete C3. Three different cell lines were examined and all showed a basal production of C3, which was up-regulated following stimulation with IL-1 beta. IL-6 had no direct stimulatory effect on its own, but synergized with IL-1 to induce an increased production of C3 in the culture supernatant and its relative amount was confirmed by SDS-PAGE and immunoblot. Another agonist such as lipopolysaccharide was not able to induce any significant C3 synthesis. Analysis of C3 HMC gene expression, performed by both reverse transcription-polymerase chain reaction of isolated RNA and Northern blot, confirmed the parallel increase of the specific transcript under IL-1 beta and IL-1 beta + IL-6 stimulation. From these data we conclude that production of C3 in the mesangium could have a pathophysiologic relevance.

Base Sequence↗
PubMed1995

Effects of in vitro nutrient supplementation on polymorphonuclear cell respiratory burst in primary IgA nephropathy.

Since recent findings have pointed out a key role for reactive oxygen species in kidney diseases, we investigated superoxide anion (O2-) and hydrogen peroxide (H2O2) generation by peripheral blood polymorphonuclear cells (PMN) in 20 patients with primary IgA nephropathy (IgAN). Results provided evidence for a significant enhancement of O2- and H2O2 production in IgAN subjects in comparison to patients affected by hypertensive renal injury and healthy donors. Among the IgAN group, the highest oxidative metabolism was observed in patients with severe histologic lesions. On the other hand, in vitro vitamin and/or trace element supplementation to PMN suspensions led to a down modulation of their oxidative responsiveness. These data were further supported by the assessment of O2- release on a kinetic basis. Nutrient pretreatment was in fact able to antagonize either the IgAN-related shortening of the lag period or the increase of maximum O2- production rate following agonist stimulation. Taken together, these findings indicate that an exaggerated PMN oxidative metabolism occurs in IgAN and suggest a potential role for micronutrients in the modulation of PMN metabolic pathway.

Adolescent↗
PubMed1995

Endotoxins modulate chronically tumour necrosis factor alpha and interleukin 6 release by uraemic monocytes.

We examined in vivo the release of tumour necrosis factor alpha (TNF alpha) and interleukin 6 (IL-6) by uraemic monocytes upon stimulation with endotoxin-contaminated bicarbonate concentrate. Twelve uraemic patients underwent 1-month-subsequent periods of standard haemodialysis (SHD) with cuprophane (CU), a high-complement-activating membrane (6 patients), or haemodiafiltration (HDF) with polyacrylonitrile (PAN), a low-complement-activating membrane (6 patients), by using a dialysate prepared with either non-sterile bicarbonate concentrate tanks (phase 1) or sterile bicarbonate concentrate bags (phase 2). TNF alpha and IL-6 concentrations were determined in monocyte supernatants by ELISA; endotoxin levels in bicarbonate concentrates were measured by a chromogenic limulus amoebocyte lysate (LAL) assay. A significant increase in LAL reactivity was found in bicarbonate concentrate tanks compared to sterile bags (P < 0.001). Non-sterile dialysate caused a significant (P < 0.001) predialytic increase in monocyte TNF alpha release as compared to controls and non-dialysed uraemic patients. One month treatment with sterile bicarbonate significantly decreased TNF alpha predialytic activity in monocyte supernatants (P < 0.001) to levels closer to those of non-dialysed uraemic patients. A similar decrease was observed for IL-6 production. Dialytic treatment induced a further increase in both TNF alpha and IL-6 production, particularly in phase 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Cultured human mesangial cells produce both type 1 and type 2 plasminogen activator inhibitors.

Cultured human mesangial cells (HMC) derived from normal kidneys have been shown to synthesize tissue-type plasminogen activator (t-PA) and excess amounts of PA inhibitor type 1 (PAI-1). Conflicting results have been obtained concerning the production of urokinase-type PA (u-PA) and efforts to show PA inhibitor 2 (PAI-2) met with failure. We evaluated the fibrinolytic profile of cultured HMC lines obtained from 12 patients with renal carcinoma and one cadaveric kidney donor. Subconfluent cells (third passage) were incubated overnight in serum-free medium. t-PA, u-PA, PAI-1 and PAI-2 antigens were assayed by ELISA methods and PA and PAI activities by amidolytic methods both in conditioned medium (CM) and cell extracts (CE). Besides PAI-1, PAI-2 antigen was detected in all but one HMC lines. At variance with the former, which was largely released in the culture medium, PAI-2 was mainly cell-associated. t-PA antigen was found in all but two cell lines while u-PA antigen was detected in relatively high concentrations in 8 cell lines. PA activity, identified as u-PA by functional and immunological criteria, was measured in CM of six of the eight u-PA producing cell lines, whereas PAI activity was undetectable or very low in CM of all cell lines, suggesting that PAI-1 was largely inactive. Functional assays of cell extracts demonstrated the presence of PA activity, again identified as u-PA, only in samples (five lines) containing u-PA antigen in excess over PAI-2. PAI activity was found instead in the extracts in which the inhibitor was higher than the activator (six lines) and was identified as PAI-2, as it inhibited u-PA but not single-chain t-PA and was neutralized by a polyclonal anti-PAI-2 antibody. The heterogeneous fibrinolytic pattern of HMC lines was confirmed by mRNA analysis of three representative lines. Results were similar when HMC lines at passage five were used, except that the u-PA content was significantly reduced both in CM and CE. These findings indicate that the fibrinolytic profile of cultured HMC is more complex than previously reported. The production of large amounts of PAI-2 may represent an additional control mechanism of proteinase activity.

Blotting, Northern↗
PubMed1994

Trapidil inhibits human mesangial cell proliferation: effect on PDGF beta-receptor binding and expression.

Mesangial cell (MC) proliferation, a histopathologic feature common to many human glomerular diseases, is regulated by several growth factors through their binding to specific cell surface receptors. Platelet-derived growth factor (PDGF) is a peptide exerting a potent mitogenic activity on MC. Recently, an increased expression of both PDGF protein and its receptor has been localized in the mesangial areas of several experimental as well as human proliferative glomerulonephritides (GN). Thus, it may be postulated that the inhibition of PDGF action could prevent MC proliferation during mesangial proliferative GN. Trapidil, an antiplatelet drug, has been shown to inhibit the growth of several cell types both in vitro and in vivo. The present study was aimed at evaluating the effect of Trapidil on human MC in vitro. The addition of 100 to 400 micrograms/ml Trapidil significantly reduced cell proliferation induced by different growth factors (FCS, PDGF-BB, bFGF, EGF), the highest inhibitory effect being on PDGF-BB stimulated MC growth. The effect of the drug was dose-dependent and seemingly specific: aspirin was devoid of any anti-proliferative action, while dypiridamole proved to be toxic. Receptor binding experiments showed that Trapidil competitively inhibited 125I-PDGF-BB binding to its cell surface receptors, without inducing receptor internalization, at least after short-term (2 hr) incubation. In contrast, long-term (48 hr) exposure to 400 micrograms/ml Trapidil caused a sharp increase of PDGF-BB binding. Similar effects on cell proliferation and 125I-PDGF-BB binding were observed when NIH-3T3 fibroblasts were exposed to the test substance.(ABSTRACT TRUNCATED AT 250 WORDS)

3T3 Cells↗
PubMed1994

Profiles of immunoregulatory cytokine production in vitro in patients with IgA nephropathy and their kindred.

We hypothesized that the altered immunoglobulin synthesis and/or lymphocyte function apparent in patients with IgA nephropathy (IgAN) is due to a primary defect in lymphokine regulation. In addition, we reasoned that such changes in lymphokine production might be, at least partially, genetically determined. To assess the extent of lymphocyte abnormalities, we investigated the profile of cytokine production from peripheral blood mononuclear cells (PBMC) in 34 IgAN patients and 44 of their first degree relatives, 10 of whom had persistent microhaematuria. Compared with healthy volunteers (n = 34), PBMC from patients showed increased IL-2 production both spontaneously or after phytohaemagglutinin (PHA) (20 micrograms/ml) stimulation, whereas IL-4 and interferon-gamma (IFN-gamma) production were significantly higher only after stimulation. Microhaematuric relatives had a similar pattern of cytokine production, whereas non-microhaematuric relatives showed no significant difference versus normals. The altered pattern of cytokine production appeared to be quite specific to IgAN patients and their microhaematuric relatives, because patients with other forms of primary glomerulonephritis (n = 17) did not differ from normal individuals. Patients and relatives that hyperproduced IL-4 were also hyperproducers of IL-2. No such congruence was seen in any other group or with any other pairing of cytokines. We propose that a subpopulation of IgAN patients bear lymphocytes intrinsically hyperresponsive. Among those individuals such hyperresponsiveness may be causally related to the pathogenesis and/or character of IgAN.

Adolescent↗