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F Nolasco

Publications and source records attributed to F Nolasco.

10 recordsLinked to original sources

Impact of donor and recipient cytokine genotypes on renal allograft outcome.

Allelic differences in gene promoter or codifying regions have been described to affect regulation of gene expression, consequently increasing or decreasing cytokine production and signal transduction responses to a given stimulus. This observation has been reported for interleukin (IL)-10 (-1082 A/G; -819/-592 CT/CA), transforming growth factor (TGF)-beta (codon 10 C/T, codon 25 G/C), tumor necrosis factor (TNF)-alpha (-308 G/A), TNF-beta (+252 A/G), interferon (IFN)-gamma (+874 T/A), IL-6 (-174 G/C), and IL-4R alpha (+1902 G/A). To evaluate the influence of these cytokine genotypes on the development of acute or chronic rejection, we correlated the genotypes of both kidney graft recipients and cadaver donors with the clinical outcome. Kidney recipients had 5 years follow-up, at least 2 HLA-DRB compatibilities, and a maximum of 25% anti-HLA pretransplantation sensitization. The clinical outcomes were grouped as follows: stable functioning graft (NR, n = 35); acute rejection episodes (AR, n = 31); and chronic rejection (CR, n = 31). The cytokine genotype polymorphisms were defined using PCR-SSP typing. A statistical analysis showed a significant prevalence of recipient IL-10 -819/-592 genotype among CR individuals; whereas among donors, the TGF-beta codon 10 CT genotype was significantly associated with the AR cohort and the IL-6 -174 CC genotype with CR. Other albeit not significant observations included a strong predisposition of recipient TGF-beta codon 10 CT genotype with CR, and TNF-beta 252 AA with AR. A low frequency of TNF-alpha -308 AA genotype also was observed among recipients and donors who showed poor allograft outcomes.

Cytokines↗

Immune mechanisms in idiopathic membranous nephropathy: the role of the interstitial infiltrates.

Mononuclear inflammatory cells in renal biopsies from 36 patients with membranous nephropathy (MN) were analyzed, using monoclonal antibodies. In the interstitium, monocytes/macrophages and T cells were the predominant cell types (210 +/- 27 and 171 +/- 25/mm2, respectively); in contrast, very few intraglomerular leucocytes, mostly macrophages (1.0 +/- 0.7 cell/glomerular cross-section), were found. Among the interstitial T-cell population, helper/inducer cells (CD4+) predominated (CD4:CD8 ratio, 2.2 +/- 1.5). Natural killer (NK) cells and B lymphocytes were a minor component of the interstitial infiltrates and were almost absent in the glomeruli. Significantly higher numbers of DR-expressing cells were found in the interstitium (322 +/- 20/mm2) than in controls (109 +/- 30), but tubular DR expression was similar to controls (17 +/- 12 mm2). The numbers of total leukocytes and their subsets CD4+, CD8+, monocytes/macrophages, and B cells all correlated with the degree of renal impairment at the time of biopsy, but surprisingly there was no correlation between interstitial cell numbers and the histological severity of tubulointerstitial lesions. Progressive renal impairment over 5 years was associated with many interstitial T cells and monocytes/macrophages in the initial biopsy. Our results suggest that interstitial mononuclear cells may be important determinants in the pathogenesis of MN. Both cellular and humoral immune mechanisms may play a major role in the initiation of the disease, whereas progression toward renal failure seems to be determined mainly by cell-mediated immunity.

Antibodies, Monoclonal↗

The role of interstitial infiltrates in IgA nephropathy: a study with monoclonal antibodies.

The leucocyte subpopulations in the interstitium and the glomeruli in renal biopsies from 34 patients with IgA nephropathy were analysed using monoclonal antibodies and immunoperoxidase techniques. Monocyte/macrophages and T-cells constituted the predominant infiltrating cell type in the interstitium (278 +/- 24 and 269 +/- 37 cells/mm2 respectively). Few intraglomerular leucocytes were seen, the majority of them belonging to the monocyte/macrophage phenotype (1.1 +/- 0.1 cells/glomerular cross-section). CD4+ lymphocytes predominated among the interstitial and glomerular T-cell populations and the CD4:CD8 ratio was 2.1 +/- 1.1 and 2.4 +/- 1.5 respectively. Only small numbers of NK cells and B cells were found in the interstitium, and almost none in the glomeruli. In contrast, significantly increased numbers of DR-expressing interstitial cells were seen (487 +/- 29/mm2), whereas DR expression by the tubular cells was minimal (37 +/- 6/mm2). Numbers of total leukocytes and T-cells were well correlated with the degree of tubulointerstitial damage and there was a significant correlation between renal functional impairment at the time of biopsy and the numbers of interstitial T cells (P less than 0.05) and CD4+ T cells (P less than 0.01). In contrast, interstitial mononuclear cells did not correlate with subsequent progression of the disease over 2-3 years. However, a more rapid decline of renal function was associated with increased numbers of interstitial B cells. No association was found between intraglomerular cells and degree of renal impairment either at the time of biopsy or in the long term.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

HLA-DR display by renal tubular epithelium and phenotype of infiltrate in interstitial nephritis.

Renal tubular display of HLA-DR was estimated semi-quantitatively in 28 biopsies from 27 patients with various forms of tubulointerstitial nephritis (10 following use of non-steroidal anti-inflammatory drugs) using a monoclonal anti-MHC class II non-polymorphic antibody (DK-22). Normal donor kidneys and biopsies from patients with minimal-change nephrotic syndrome were examined as controls. The phenotype of infiltrating cells was also studied quantitatively, using monoclonal antibodies on frozen biopsy tissue; the number of cells infiltrating the interstitium was counted per tubular cross-section. Display of HLA-DR was seen in up to 5% of control tubular cells, but up to 100% expressed HLA-DR in tubulointerstitial nephritis biopsies. There was a correlation between the expression of HLA-DR and the severity of both tubular atrophy and tubulointerstitial fibrosis judged semi-quantitatively by optical microscopy. In controls up to 50 leucocytes per tubular cross-section were evident, but in patients with tubulointerstitial nephritis up to 1500 were observed, approximately 50% being T-lymphocytes, the majority expressing the helper phenotype except in early, active drug-induced tubulointerstitial nephritis; the remainder were mostly monocytes. There were no qualitative differences between the different causes of tubulointerstitial nephritis. Tubular DR expression correlated with the number of DR-positive cells in the interstitium, but not with total leucocytes or T-lymphocytes. HLA-DR tubular expression was greater in the early stages than late stages of NSAID-induced tubulointerstitial nephritis, but this relationship was not present in the group as whole. HLA-DR expression by renal tubular epithelial cells may play a role in localising or amplifying tubular injury in tubulointerstitial nephritis.

Adolescent↗

Adult-onset minimal change nephrotic syndrome: a long-term follow-up.

A series of 89 adult-onset nephrotic patients with minimal changes on renal biopsy was analyzed to compare the rate of response to corticosteroids and cytotoxic agents and the stability of remission or frequency of relapses at different ages. Severe hypertension and diminished renal function were more common in patients aged over 60 years, who formed 22.5% of the group. Seventy-five patients were given a first course of prednisolone in an initial dose of 60 mg/24 hr. After an eight week course of tapering doses of corticosteroids, only 45 of the 75 patients were in complete remission, 55 patients after 16 weeks and eventually 58 lost their proteinuria. The respective estimates of remission were 60%, 76% and 81%. Subsequently, of the 58 treated patients who responded, 24% never relapsed. Fifty-six percent of the patients relapsed on a single occasion or infrequently, and only 21% were frequent relapsers. Cyclophosphamide was used in 36 patients, in two as initial treatment, in 11 because of corticosteroid resistance, and in the remainder because of relapses. The time-course of loss of proteinuria was similar to that following treatment with corticosteroids, 25 (69%) losing proteinuria within 16 weeks. Only four patients failed to lose their nephrotic syndrome. Two of them had presented in acute renal failure and all four were over 60 years of age. The stability of remission after cyclophosphamide was better than that reported for children, only 13 of 36 showing relapses and 66% being in remission at five years, after which no further relapses were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗

Glomerular C3b receptor loss in renal allografts.

There is almost no data from the glomeruli of allografted kidneys with respect to changes in the CR-1 (C3b) receptor expressed on glomerular podocytes. We studied 22 renal graft biopsies from rejecting and stable allografts, using a panel of monoclonal antibodies. We found that the CR-1 expression was decreased in a focal and segmental fashion in some biopsies, particularly in rejecting kidneys. These changes correlated with the intensity of glomerular mononuclear cell infiltration, but in contrast no correlation was seen with peripheral capillary wall deposition of complement (C3). Thus, some active process is occurring in the glomeruli of rejecting grafts which affects the expression of the CR-1 receptor.

Graft Rejection↗

Interstitial foam cells in the nephrotic syndrome belong to the monocyte/macrophage lineage.

Interstitial foam cells are occasionally seen in patients with the nephrotic syndrome. In a group of patients with the nephrotic syndrome we were able to demonstrate that these cells express markers characteristic of the monocyte/macrophage lineage. Their presence was related to the previous duration of proteinuria, but they had no apparent influence on the subsequent evolution of renal function. The mechanisms leading to their presence are unknown.

Adult↗

Adult-onset nephrotic syndrome with minimal changes: response to corticosteroids and cyclophosphamide.

Eighty-nine patients with onset of nephrotic syndrome over the age of 15 years and minimal changes on renal biopsy have been studied. Seventy-five patients were given a course of prednisone in an initial dosage of 60mg/24hr, tapering over the following 8-16 weeks. Only 45 were in remission after eight week's treatment, 55 after 16 weeks; eventually, a total of 58 lost their proteinuria completely. Of these, 24 per cent never relapsed, 56 per cent relapsed on a single occasion or infrequently, and only 21 per cent were frequent relapsers. Cyclophosphamide, used in 36 patients, had a similar time to response. Stability of remission was better than in similar children, 66 per cent being in remission at five years, after which no further relapses were seen.

Adolescent↗