Kidney Transplantation Clinical Trial
Official title:
Chronic Transplant Glomerulopathy and Regulation of Expression of Ephrin B1
The principal purpose is the study of the regulation of the expression of ephrin-B1 by immunofluorescence in kidney biopsies of patients with Chronic transplant glomerulopathy (CTG) compared to biopsies prior to the CTG, in same patients. Level of fluorescence in CTG biopsy will be the experimental reference value.
Chronic transplant glomerulopathy (CTG) is a specific lesion of kidney transplantation and a
poor prognostic factor affecting transplant survival. Diagnosis remains only microscopic and
lesions are irreversible. Recent studies prove that there is a strong correlation between
CTG and antibody mediated rejection (AMR) with a possible link with chronic aggression of
the endothelial cell. However, for unknown reason, all AMR does not lead to a CTG. Our
recent data on mice demonstrated that ephrin-B1 is expressed in the glomerular endothelial
cells and knockout mice for the gene encoding ephrin-B1 develop progressively
ultrastructural glomerular lesions close to modifications observed in CTG, as well as
proteinuria and chronic renal failure, suggesting that ephrin B1 could participate to CTG.
Moreover, in a preliminary study on human kidney transplant biopsy we observed decrease in
ephrin-B1 immunofluorescence on glomerulus when CTG, even in low grade. These data, and
ultrastructural modifications in Knock Out (KO) mice suggest that early regulation of kidney
expression of ephrin-B1 in the glomerulus may occur during the process leading to the CTG as
antibody-mediated kidney rejection (AMR).
The purpose of the study is to determinate if ephrin-B1 expression is modified in CTG.
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