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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Front+Immunol
2018 ; 9
(ä): 619
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Anti-Transforming Growth Factor ? IgG Elicits a Dual Effect on Calcium Oxalate
Crystallization and Progressive Nephrocalcinosis-Related Chronic Kidney Disease
#MMPMID29651290
Steiger S
; Grill JF
; Ma Q
; Bäuerle T
; Jordan J
; Smolle M
; Böhland C
; Lech M
; Anders HJ
Front Immunol
2018[]; 9
(ä): 619
PMID29651290
show ga
Crystallopathies are a heterogeneous group of diseases caused by intrinsic or
environmental microparticles or crystals, promoting tissue inflammation and
scarring. Certain proteins interfere with crystal formation and growth, e.g.,
with intrarenal calcium oxalate (CaOx) crystal formation, a common cause of
kidney stone disease or nephrocalcinosis-related chronic kidney disease (CKD). We
hypothesized that immunoglobulins can modulate CaOx microcrystal formation and
crystal growth and that therefore, biological IgG-based drugs designed to
specifically target disease modifying proteins would elicit a dual effect on the
outcome of CaOx-related crystallopathies. Indeed, both the anti-transforming
growth factor (TGF)? IgG and control IgG1 antibody impaired CaOx crystallization
in vitro, and decreased intrarenal CaOx crystal deposition and subsequent CKD in
mice on an oxalate-rich diet compared to oxalate-fed control mice. However, the
TGF?-specific IgG antibody showed nephroprotective effects beyond those of
control IgG1 and substantially reduced interstitial fibrosis as indicated by
magnetic resonance imaging, silver and ?-smooth muscle actin staining, RT-qPCR,
and flow cytometry for pro-fibrotic macrophages. Suppressing interstitial
fibrosis slowed the decline of glomerular filtration rate (GFR) compared to
treatment with control IgG1 [slope of m?=?-8.9 vs. m?=?-14.5??l/min/100?g body
weight (BW)/day, ??=?38.3%], an increased GFR at the end of the study (120.4 vs.
42.6??l/min/100?g BW, ??=?64.6%), and prolonged end stage renal disease
(ESRD)-free renal survival by 10?days (??=?38.5%). Delayed onset of anti-TGF? IgG
from day 7 was no longer effective. Our results suggest that biological drugs can
elicit dual therapeutic effects on intrinsic crystallopathies, such as anti-TGF?
IgG antibody treatment inhibits CaOx crystallization as well as interstitial
fibrosis in nephrocalcinosis-related CKD.