Estimation of damaged tubular epithelium in renal allografts by determination of vimentin expression

Abstract

Background : Various invasive and non-invasive methods have been investigated for their prognostic value in predicting the outcome of renal allografts. In the present study, vimentin expression in tubular epithelial cells (TEC) was determined by the immunohistochemical examination of biopsy specimens and the prognostic value of this method was assessed. Methods : Ninety-two renal transplant recipients were recruited for the present study. Protocol biopsy of the renal graft was performed 1, 3 and 5 years after transplantation in each case. All biopsy specimens were treated with conventional stains and immunostained with an antivimentin antibody.The correlation between vimentin expression and glomerular filtration rate (GFR) and the association between vimentin expression and histopathological findings were determined. Results : Vimentin was localized in TEC adjacent to interstitial lesions with lymphocyte infiltration and also in TEC with tubulitis or in atrophic tubules. Vimentin positivity significantly correlated with GFR and both vimentin positivity and GFR were significantly associated with the extent of chronic allograft nephropathy, but not with acute rejection. Additionally, vimentin expression and GFR 3 and 5 years after transplantation were higher in cases where graft loss occurred between 5 and 7 years after transplantation compared with graft survival cases.Conclusions : These results suggest that immunohistochemistry using antivimentin antibodies on protocol biopsy specimens is useful for the detection of injured TEC and as a predictor of allograft outcome.

Positive association of anticytoskeletal endothelial cell antibodies and cardiac allograft rejection

“…On the other hand, these proteins are normally not expressed on the cell surface. However, expression of vimentin was demonstrated in renal tubular epithelial cells adjacent to lymphocytic infiltration or tubulitis [17]. We could speculate that cytosol-released self-proteins, abnormally expressed in a high concentration as a consequence of cell injury, could trigger a humoral immune response leading to antibody-mediated graft damage [5].…”

High Urinary Excretion of Kidney Injury Molecule-1 Is an Independent Predictor of Graft Loss in Renal Transplant Recipients

“…Urinary excretion of KIM-1 is therefore a reflection of the degree of histopathological tubular damage that exists at a certain timepoint (19 -21). Since renal damage and tubular dedifferentiation have been shown to predict renal function decline and graft loss (31,32), KIM-1 may be a noninvasively assessable marker of these two entities.…”

Risk Factors for Early Epithelial to Mesenchymal Transition in Renal Grafts

“…The fact that acute tubular necrosis and subclinical acute rejection are two major risk factors for CAN in the Nankivell study, and for EMT in our study, suggest that EMT and CAN could be induced by the same insults. To date, two studies have reported that two major EMT markers, S100A4 and vimentin, are preferentially expressed by TECs in the vicinity of a T-cell infiltrate (17,18). Transforming growth factor beta carried by T cells could be the major stimulus triggering EMT in this situation (17,19).…”