Renal tubular P-glycoprotein expression is reduced in plasma cell disorders

Cihan Heybeli; Mehmet Asi Oktan; Hayri Ustun Arda; Serkan Yildiz; Mehtat Unlu; Caner Cavdar; Aykut Sifil; Ali Celik; Sulen Sarioglu; Taner Camsari

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저자정보: Cihan Heybeli (Dokuz Eylül University Izmir Turkey) Mehmet Asi Oktan (Dokuz Eylül University Izmir Turkey) Hayri Ustun Arda (Dokuz Eylül University Izmir Turkey) Serkan Yildiz (Dokuz Eylül University Izmir Turkey) Mehtat Unlu (Dokuz Eylül University Izmir Turkey) Caner Cavdar (Dokuz Eylül University Izmir Turkey) Aykut Sifil (Dokuz Eylül University Izmir Turkey) Ali Celik (Dokuz Eylül University Izmir Turkey) Sulen Sarioglu (Dokuz Eylül University Izmir Turkey) Taner Camsari (Dokuz Eylül University Izmir Turkey)

저널정보: 대한신장학회 Kidney Research and Clinical Practice Kidney Research and Clinical Practice Vol.38 No.2

발행연도: 2019.1

수록면: 186 - 195 (10page)

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Background: P-glycoprotein (P-gp) transports many chemicals that vary greatly in their structure and function. It is normally expressed in renal proximal tubular cells. We hypothesized that P-gp expression influences light chain excretion. Therefore, we investigated whether renal tubular P-gp expression is altered in patients with plasma cell disorders. Methods: We evaluated renal biopsy specimens from patients with plasma cell disorders (n = 16) and primary focal segmental glomerulosclerosis (the control group, n = 17). Biopsies were stained with an anti-P-gp antibody. Loss of P-gp expression was determined semi-quantitatively. Groups were compared for loss of P-gp expression, and clinical variables. Results: P-gp expression loss was more severe in patients with plasma cell disorders than it was in those with glomerulonephritis (P = 0.021). In contrast, clinical and histological parameters including serum creatinine, level of urinary protein excretion, and interstitial fibrosis/tubular atrophy grade were not significantly different between the groups. P-gp expression loss increased with age in patients with plasma cell disorders (P = 0.071). This expression loss was not associated with serum creatinine, the level of urinary protein excretion or the interstitial fibrosis/tubular atrophy grade. There was no significant association between the severity of P-gp expression loss with the types and serum levels of light chains, isotypes and serum immunoglobulin levels. Conclusion: Renal tubular P-gp expression is significantly down-regulated in patients with plasma cell disorders characterized by nephrotic range proteinuria. Additional studies are needed to determine whether reintroduction of renal tubular P-gp expression would mitigate the proximal tubular injury that is caused by free-light chains.

#Amyloidosis #Immunoglobulin light chains #Multipl myeloma #P-glycoprotein

참고문헌 (28)

참고문헌 신청

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Hutchison CA / 2011 / The pathogenesis and diagnosis of acute kidney injury in multiple myeloma / Nat Rev Nephrol 8:43~51

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