부산대학교 도서관

Background: Trefoil factor 3 (TFF-3) is a peptide that restores the epithelium as protection against injury. Recently, TFF-3 was shown to be expressed in kidney tubular cells and was associated with fibrosis. We aimed to determine whether TFF-3 is associated with kidney outcomes. Methods: We evaluated TFF-3 expression and its relationship with mesangial hypercellularity, endocapillary hypercellularity, segmental glomerulosclerosis, tubular atrophy/interstitial fibrosis and crescents (MEST-C) score, tumor necrosis factor alpha (TNF-[alpha]), interleukin-10 (IL-10), and transforming growth factor-beta (TGF-[beta]) expression in the kidney. We included 28 immunoglobulin A (IgA) patients with initial estimated glomerular filtration rate (eGFR) [greater than or equal to] 30 mL/min/1.73 [m.sup.2] and proteinuria [greater than or equal to] 0.5 g/day. Kidney biopsies were scored using MEST-C and were stained for TFF-3, IL10, TGF-[beta], and TNF-[alpha]. Results: Mean patient age was 37.0 [+ or -] 13.8 years and eGFR was 74.6 [+ or - ] 41.2 mL/min/1.73 [m.sup.2]. Patients were followed for 9.1 [+ or -] 3.6 years. Trefoil factor 3 was positive in 67.9% of patients exclusively in tubular cells. Tumor growth factor-[beta] was also observed only in tubular cells in 71.4% of patients and was higher in TFF-3- positive patients (89.5% vs. 22.2%, P < .05). When patients with and without TFF-3 staining were compared, there was no difference in age, eGFR, albumin, or proteinuria. Yearly eGFR change was also similar (-0.5 [+ or -] 2.3 vs. -1.3 [+ or -] 2.4 mL/min/1.73 [m.sup.2], P = .44). Trefoil factor 3 was not associated with kidney survival. The MEST-C score was not correlated with TFF-3. Trefoil factor 3 staining showed correlation with TGF-[beta] but was not associated with kidney survival in IgA patients. Conclusion: Findings of the study imply TFF-3 is not a marker of permanent damage but might simply be a marker of the repair of ongoing tubular injury. Keywords: Glomerulonephritis, IgA nephropathy, kidney biopsy, MEST-C score, trefoil factor 3
INTRODUCTION Trefoil factor 3 (TFF-3) is a peptide secreted by epithelial cells and plays an essential role in restitution and regeneration of mucosal surfaces, restoring the epithelium as protection against [...]