Vol 49, No 3 (2011)
Original paper
Published online: 2011-10-28
Nephrotic syndrome unfavorable course correlates with downregulation of podocyte vascular endothelial growth factor receptor (VEGFR)-2
DOI: 10.5603/FHC.2011.0067
Folia Histochem Cytobiol 2011;49(3):472-478.
Abstract
Idiopathic nephrotic syndrome (INS) in children is most commonly caused by primary glomerulopathies.
Morphological lesions observed in INS might be secondary to inflammatory factors of mainly extra-renal
origin. The vascular endothelial growth factor (VEGF) family is regarded as playing a crucial role in this pathomechanism.
The aim of the present work was to analyze the possible relation between VEGF-C and VEGF
receptor (VEGFR)-2 expressions at electron microscopy level in different INS cases. The study group comprised
18 children with minimal change disease (MCD), 30 patients diagnosed with diffuse mesangial proliferation
(DMP) and 11 subjects with focal segmental glomerulosclerosis (FSGS). An indirect immunohistochemical
assay employing monoclonal anti-VEGF-C and anti-VEGFR-2 antibodies was applied in the study. The immunohistochemical
expression of VEGF-C within podocyte cytoplasm was significantly increased in DMP subjects
who were resistant to steroids and in all FSGS patients compared to MCD children and controls (p < 0.05).
VEGF-C over-expression in these cases was followed by downregulation of VEGFR-2. Nephrotic syndrome progression
correlates with the downregulation of podocyte VEGFR-2. For this reason, decreased VEGFR-2 expression
in the podocyte processes of children with idiopathic nephrotic syndrome might be regarded as a potent
factor of unfavorable prognosis. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 472–478)
Keywords: VEGFR-2nephrotic syndromeelectron microscopychildren