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NDT Advance Access originally published online on April 8, 2009
Nephrology Dialysis Transplantation 2009 24(9):2755-2762; doi:10.1093/ndt/gfp152
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Patients with IgA nephropathy exhibit high systemic PDGF-DD levels

Peter Boor1,2*, Frank Eitner1,*, Clemens D. Cohen3, Maja T. Lindenmeyer3 for the ERCB-Consortium, Peter R. Mertens1,4, Tammo Ostendorf1, Jürgen Floege1

1 Division of Nephrology and Immunology, RWTH University of Aachen, Germany and Department of Nephrology 2 Department of Clinical and Experimental Pharmacotherapy, Research Base of Slovak Medical University, Bratislava, Slovakia 3 Institute of Physiology and Nephrology Clinic, University of Zürich, Zürich, Switzerland 4 Department of Nephrology and Hypertension, Otto-von-Guericke University Magdeburg, Germany

Correspondence and offprint requests to: Peter Boor; E-mail: boor{at}email.cz



  Abstract

Background. Platelet-derived growth factor (PDGF) is a central mediator of mesangioproliferative glomerulonephritis (GN). In experimental mesangioproliferative GN, PDGF-DD serum levels, unlike PDGF-BB, increased up to 1000-fold.

Methods. We assessed disease activity in 72 patients with GN, established a novel PDGF-D ELISA and then determined their PDGF-DD levels. In parallel, we studied renal PDGF-DD mRNA expression by RT-PCR.

Results. PDGF-DD serum levels in patients with IgA nephropathy (IgAN) were significantly higher (1.67 ± 0.45 ng/ml) and in patients with lupus nephritis significantly lower (0.66 ± 0.86 ng/ml) compared to healthy controls (1.17 ± 0.46 ng/ml), while patients with focal segmental glomerulosclerosis, membranous GN and ANCA-positive vasculitis did not differ from controls. The subgroup of IgAN patients with elevated PDGF-DD levels (27% of samples) did not differ in their clinical features from those with normal PDGF-DD levels. In IgAN patients with repetitive PDGF-DD determinations, most exhibited only minor fluctuations of serum levels over time. Intrarenal PDGF-DD mRNA expression did not differ between controls and patients, suggesting an extrarenal source of the elevated PDGF-DD in IgAN.

Conclusions. Serum PDGF-DD levels were specifically elevated in patients with IgAN, in particular in those with early disease, i.e. preserved renal function. Our data support the rationale for anti-PDGF-DD therapy in mesangioproliferative GN.

Keywords: glomerulonephritis; growth factor; serum marker

* Both authors contributed equally.

Received for publication: 21.11.08
Accepted in revised form: 13. 3.09


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