Expression And Clinical Significance Of TGF-β₁ And VEGF In Children With Primary Nephrotic Syndrome

Objective To study the relationship of transforming growth factor beta 1 (TGF-β1) and vascular endothelial growth factor (VEGF) with proteinuria in children with primary nephrotic syndrome(PNS) and the expression discrepancy in varied pathology type by renal biopsy and to explore mechanism of the proteinuria and influence factors of fibrosis in PNS in order to guide the treatment and to judge the prognosis. Methods Twenty-eight patients were as test group, and ten healthy children were as control group. In test group 7 cases were in remission and others were divided into three groups which were confirmed by renal biopsy: minimal change nephrotic syndrome (MCNS) in 5 patients, mesangial proliferative glomerulonephritis (MSPGN) in 12 and focal segmental glomerulo- sclerosis (FSGS) in 4. The peripheral blood serum levels for the protein of TGF-β1 and VEGF were measured by enzyme-linked immunosorbent assay (ELISA), comparing the associated for their serum levels of protein with proteinuria and pathologic types. The protein expression of TGF-β1 and VEGF were analysed by immunohistochemistry staining with streptavidin-peroxidase in nephritic tissues of different pathologic types in twelve cases and control group in three . Results 1.The protein levels of TGF-β1, VEGF in blood serum were higher in the test group with proteinuria than remission (P<0.05), and there was positive relation between the two index(r =0.4305).2. The protein levels of TGF-β1 in blood serum was much higher in FSGS than MCNS, MSPGN and control (P<0.01). 3. The protein levels of VEGF in blood serum was much higher in FSGS and MSPGN than MCNS and control group (P<0.01). 4. The expression for positive area of TGF-β1 and VEGF were much higher in nephritic tissues with NS than that with control group(P<0.01). 5. The expression for positive intensity of TGF-β1 protein was higher and higher in different nephritic tissues from MCNS, MSPGN, MN to FSGS, especially the increasing expression of TGF-β1 which was associated with fibrosis degree of tubule and interstitial, and there were statistical significance (P<0.01). But the expression for positive intensity of VEGF protein was no statistical significance in all test groups include interstitial fibrosis (P>0.05). Conclusions 1. Serum levels of TGF-β1 and VEGF were associated with proteinuria and different types of pathology in children with primary nephrotic syndrome. 2. Positive expression intensity of TGF-β1 and VEGF in nephritic tissues was higher in PNS than in control group, especially the increasing expression of TGF-β1 which was associated with fibrosis degree of tubule and interstitial in PNS. 3. Anti-VEGF and Anti- TGF-β1 may be a important means in treating proteinuria, improving the prognosis and preventing the fibrosis in PNS.