Long-Term Gene Therapy with Thrombospondin 2 Inhibits TGF-b Activation, Inflammation and Angiogenesis in Chronic Allograft Nephropathy

We recently identified Thrombospondin-2 (TSP-2) as a regulator of matrix remodelling and inflammation in experimental kidney disease by using TSP-2 null mice and successfully proved TSP-2 overexpression as a therapeutic concept in a short term glomerulonephritis model in the rat. In this current study, we investigated if long-term TSP-2 overexpression is also capable to ameliorate the progression of chronic kidney disease in the setting of the chronic allograft nephropathy F344-Lewis model in the rat. Two weeks after renal transplantation, two rat thigh muscles were transfected once only with either a TSP-2 overexpressing plasmid (n = 8) or a luciferase-expressing plasmid as control (n = 8). Rats were monitored for renal function, histological changes and gene expression in the graft for up to 30 weeks after transplantation. Unexpectedly, only in the TSP-2 treated group 2 rats died before the end of the experiment and renal function tended to be worsened in the TSP-2 group compared to the luciferase-treated controls. In addition, glomerular sclerosis and tubular interstitial injury as well as cortical fibronectin deposition was significantly increased in the TSP-2 treated kidneys despite reduced TGF-b activation and marked anti-inflammatory (macrophages, T-cells and B-cells) effects in this group. Long-term TSP-2 therapy impaired repair of renal endothelium, as demonstrated by significant higher glomerular and peritubular endothelial rarefaction and reduced endothelial cell proliferation in the transplanted kidneys from TSP-2 treated rats compared to controls. This TSP-2 effect was associated with decreased levels of renal VEGF but not VEGF1 receptor. In conclusion, despit

Long-Term Gene Therapy with Thrombospondin 2 Inhibits TGF-β Activation, Inflammation and Angiogenesis in Chronic Allograft Nephropathy

We recently identified Thrombospondin-2 (TSP-2) as a regulator of matrix remodelling and inflammation in experimental kidney disease by using TSP-2 null mice and successfully proved TSP-2 overexpression as a therapeutic concept in a short term glomerulonephritis model in the rat. In this current study, we investigated if long-term TSP-2 overexpression is also capable to ameliorate the progression of chronic kidney disease in the setting of the chronic allograft nephropathy F344-Lewis model in the rat. Two weeks after renal transplantation, two rat thigh muscles were transfected once only with either a TSP-2 overexpressing plasmid (n = 8) or a luciferase-expressing plasmid as control (n = 8). Rats were monitored for renal function, histological changes and gene expression in the graft for up to 30 weeks after transplantation. Unexpectedly, only in the TSP-2 treated group 2 rats died before the end of the experiment and renal function tended to be worsened in the TSP-2 group compared to the luciferase-treated controls. In addition, glomerular sclerosis and tubular interstitial injury as well as cortical fibronectin deposition was significantly increased in the TSP-2 treated kidneys despite reduced TGF-β activation and marked anti-inflammatory (macrophages, T-cells and B-cells) effects in this group. Long-term TSP-2 therapy impaired repair of renal endothelium, as demonstrated by significant higher glomerular and peritubular endothelial rarefaction and reduced endothelial cell proliferation in the transplanted kidneys from TSP-2 treated rats compared to controls. This TSP-2 effect was associated with decreased levels of renal VEGF but not VEGF1 receptor. In conclusion, despite its anti-inflammatory and TGF-β activation blocking effects, TSP-2 gene therapy did not ameliorate but rather worsened experimental chronic allograft nephropathy most likely via its anti-angiogenic properties on the renal microvasculature

Long-term gene therapy with thrombospondin 2 inhibits TGF-β activation, inflammation and angiogenesis in chronic allograft nephropathy.

We recently identified Thrombospondin-2 (TSP-2) as a regulator of matrix remodelling and inflammation in experimental kidney disease by using TSP-2 null mice and successfully proved TSP-2 overexpression as a therapeutic concept in a short term glomerulonephritis model in the rat. In this current study, we investigated if long-term TSP-2 overexpression is also capable to ameliorate the progression of chronic kidney disease in the setting of the chronic allograft nephropathy F344-Lewis model in the rat. Two weeks after renal transplantation, two rat thigh muscles were transfected once only with either a TSP-2 overexpressing plasmid (n = 8) or a luciferase-expressing plasmid as control (n = 8). Rats were monitored for renal function, histological changes and gene expression in the graft for up to 30 weeks after transplantation. Unexpectedly, only in the TSP-2 treated group 2 rats died before the end of the experiment and renal function tended to be worsened in the TSP-2 group compared to the luciferase-treated controls. In addition, glomerular sclerosis and tubular interstitial injury as well as cortical fibronectin deposition was significantly increased in the TSP-2 treated kidneys despite reduced TGF-β activation and marked anti-inflammatory (macrophages, T-cells and B-cells) effects in this group. Long-term TSP-2 therapy impaired repair of renal endothelium, as demonstrated by significant higher glomerular and peritubular endothelial rarefaction and reduced endothelial cell proliferation in the transplanted kidneys from TSP-2 treated rats compared to controls. This TSP-2 effect was associated with decreased levels of renal VEGF but not VEGF1 receptor. In conclusion, despite its anti-inflammatory and TGF-β activation blocking effects, TSP-2 gene therapy did not ameliorate but rather worsened experimental chronic allograft nephropathy most likely via its anti-angiogenic properties on the renal microvasculature

The mTOR Inhibitor Everolimus Attenuates the Time Course of Chronic Anti-Thy1 Nephritis in the Rat

Background: The antiproliferative immunosuppressant everolimus adversely affects the acute reversible anti-Thy1 nephritis model. We hypothesized that everolimus treatment started after the acute proliferative phase could even be beneficial in the chronic anti-Thy1 nephritis model in the rat. Methods: Chronic anti-Thy1 nephritis was induced by injection of the monoclonal antibody 1-22-3 in 20 male Sprague-Dawley rats 7 days after uninephrectomy. Two weeks after disease induction, rats were randomly treated with either everolimus or vehicle for 14 weeks. Changes in progression of renal disease were investigated by immunohistochemistry and real-time PCR 16 weeks after disease induction. Results: During chronic anti-Thy1 nephritis, the formation of focal segmental glomerulosclerosis lesions, the degree of interstitial fibrosis as well as the increase in proteinuria over 14 weeks was ameliorated by everolimus treatment. Increased glomerular hypertrophy observed in the vehicle-treated rats was completely prevented in the everolimus- treated nephritic rats. Increased glomerular fibronectin mRNA and protein as well as the renal influx of monocytes/ macrophages was significantly reduced in the evero- limus group. Everolimus reduced the pro-angiogenic factor vascular endothelial growth factor (VEGF) and VEGF mRNA in glomeruli, while the transforming growth factor- _ signaling pathway was not affected. Conclusion: ‘Late’ start of everolimus treatment demonstrates beneficial effects on the time course of chronic anti-Thy1 nephritis

Influence of TSP-2 gene therapy on VEGF/VEGF receptor expression and MMP-2 activity.

<p>VEGF and VEGF receptor 1 expression was assessed by semiquantitative scoring of immunohistochemistry. VEGF was reduced in glomeruli (A) as well as in the tubulointerstitial compartment (B) from TSP-2 treated rats. Representative pictures from VEGF stained glomeruli showing pronounced VEGF expression in podocyted as well as mesangial cells in kidneys from control plasmid treated animals (C, brown staining). In contrast, VEGF was only rarely detected in glomeruli from TSP-2 treated rats (D, brown staining). Expression of VEGF receptor 1 was similar in glomeruli (E) as well as cortex (F) of both groups. Glomerular VEGF mRNA expression was comparable in both groups (G). Serum MMP-2 activity at endpoint of the study was detected by zymography (I) and evaluated by densitometry (H). Control (n = 8) vs. TSP-2 treated (A–F:n = 8; G–I:n = 6); *p<0,05.</p

TSP-2 inhibits renal endothelial cell proliferation.

<p>Since total renal proliferation, as assessed by PCNA staining, was similar in both groups (A), TSP-2 gene therapy specifically reduced endothelial proliferative activity (B), as assessed by CD31/PCNA double positive cells (C, endothelial cells stained in brown and PCNA positive nuclei in blue). Control (n = 8) vs. TSP-2 treated (n = 8); *p<0,007. The effect of TSP-2 on proliferation of isolated rat endothelial cells was investigated by a BrdU-incorporation assay (D, n = 6; *p<0,05).</p

Fibronectin and alpha-smooth muscle actin staining in renal grafts treated with TSP-2 gene therapy.

<p>Representative microphotographs from immunohistological staining of kidney grafts for active TGF-β (A, control plasmid; B, TSP-2 therapy, brown cytosolic staining), P-smad 2/3 (C, control plasmid; D, TSP-2 therapy, brown nuclear staining), PAI-1 (E, control plasmid; F, TSP-2 therapy, brown staining), fibronectin (G, control plasmid; H, TSP-2 therapy, brown staining) and alpha-smooth muscle actin (I, control plasmid; J, TSP-2 therapy, brown staining) are shown.</p

Expression of TSP-1 and TSP-2 in F344 Lewis rat renal allograft model.

<p>Renal TSP-1 and TSP-1 expression was evaluated in biopsies from rats treated with the overexpression plasmid for luciferase control or TSP-2 using immunohistochemistry. TSP-1 expression was localized in glomeruli and within and around the Bowman's capsule (A, brown staining) as well as in fibroblasts and atrophic tubular cells (B). A semiquantitative evaluation of TSP-1 expression revealed no significant differences between the two groups (C). Staining for endogenous TSP-2 showed marked expression within some tubules (F), while glomerular staining for TSP-2 is lacking (E). Endogenous TSP-2 expression shows a tendency to increased TSP-2 expression within the TSP-2 treated group compared to the controls. Control (n = 8) vs. TSP-2 treated (n = 8).</p

Immunohistochemistry of inflammatory cells in renal grafts after TSP-2 gene therapy.

<p>Representative microphotographs from immunohistological staining of kidney grafts for CD8a positive T-cells (A, control plasmid; B, TSP-2 therapy, brown staining), MHC II positive antigen presenting cells (C, control plasmid; D, TSP-2 therapy, brown staining) and CD45R positive B-cells (E, control plasmid; F, TSP-2 therapy, brown staining) are shown.</p

TSP-2 gene therapy reduced TGF-β activation while not affecting total TGF-β expression.

<p>In gene therapy, treated rats with renal transplants TGF-β were evaluated by immunohistochemistry. Active TGF-β was either detected directly by using an antibody recognizing active TGF-β (A) or indirectly by evaluation of phosphorylation of the TGF-β signaling molecule smad2/3 (B) or expression of the TGF-β downstream target PAI-1 within the glomeruli (C) or the cortex (D). Representative microphotographs of PAI-1 staining in renal grafts treated with control (E) and TSP-2 overexpressing plasmid (F) are shown. Total TGF-β1 (G) and TGF-β2 (H) was similar in both groups. Control (n = 8) vs. TSP-2 treated (n = 8); *p<0,05.</p