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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제50권 제1호
발행연도
2009.1
수록면
105 - 111 (7page)

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Purpose: Recent studies have showed that epithelial-mesenchymal transition (EMT) is a key process of glomerular and tubulointerstitial pathology in many chronic kidney diseases. However, there are no data of EMT in humane autosomal dominant polycystic kidney disease (ADPKD). Patients and Methods: ADPKD kidneys (N=5) with end stage renal disease (ESRD) and control kidneys (N=4) were analyzed immnunohistochemically. We evaluated α-SMA, E-cadherin, vimentin, TGF-β1 and Smad 2/3 expression in ADPKD and compared them with those in control kidney. These immunohistochemical findings were quantitatively analyzed by computer-assisted image analyzer and positive tubules (%). Results: There were severe interstitial fibrosis and proliferation of α-SMA+ myofibroblasts in ADPKD. Cystic tubular epithelial cells in ADPKD lost epithelial marker (E-cadherin) and expressed mesenchymal markers (α-SMA, vimentin). There were significant increases of α-SMA (34.3±11.7% vs 0.9± 1.5%), vimentin (19.9±3.9% vs 3.3±1.4%), TGF-β1 (5.42± 2.83% vs 0%) and Smad 2/3 (3.4±1.7% vs 0.7±0.6%) in ADPKD kidneys compared with control kidneys evidenced by computer-assisted image analyzer. When we analyze the positive tubules (%), the results were the same as computer- assisted image analyzer. Conclusion: Our results showed that the end stage of ADPKD is associated with TGF-β, Smad 2/3 and markers of EMT. It suggests that TGF-β mediated EMT has a role in progression of ADPKD.

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