THE REMODELING PROCESS OF EXTRACELLULAR MATRIX IN PROGRESSION OF GLOMERULONEPHRITIS IN CHILDREN
Abstract
The aim of the study was to investigate the remodeling process in the extracellular matrix by the matrix metalloproteinase-2 and 9 serum level activities (MMP-1, MMP-9) in children with glomerulonephritis, state of apoptosis control system, and to specify their role in disease progression.
Materials and methods. MMP-2 and 9, caspase-3 were studied in children with glomerulonephritis, nephrotic syndrome (GN) at the different disease stages (active stage and remission). There was documented Chronic Kidney Disease stage I (CKD I: n = 25) and CKD II-III (n = 13) depends on the Glomerular Filtration Rate (GFR). Apoptosis level was determined in renal biopsy sample with focal segmental glomerulosclerosis (TUNEL-test, n=8).
Results. Significant increase in MMP-2 and 9 was found dominated in CKD II-III. Clinical remission of GN after therapy was associated with decreased endopeptidases level only of safe GFR (CKD I). It was found that high levels of remodeling processes (MMP) were accompanied by apoptosis activation. This is confirmed by a significant increase in of proapoptotic effector caspase-3 (prevalence in CKD II-III), and a high level of apoptotic cells in sclerosal glomerulus or in periglomerular area, in tubules and interstitium at global renal sclerosis. Conclusions. Progression of renal damage in children with GN and GFR delay is accompanied by high serum levels of MMPs and caspase-3, expansion of apoptosis in the kidney, indicated the activation extracellular matrix remodeling process.
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