Background. Renal microvascular injury characterizes thrombotic microangiop
athy (TMA). The possibility that angiogenic growth factors may accelerate r
ecovery in TMA has not been studied.
Methods. TMA was induced in rats by the selective right renal artery perfus
ion of antiglomerular endothelial cell IgG (30 mg/kg). Twenty-four hours la
ter, rats received vascular endothelial growth factor (VEGF(121), 100 mug/k
g/day) or vehicle (control) daily until day 14. To evaluate renal function,
the unperfused left kidney was removed at day 14, and rats were sacrificed
at day 17.
Results. The induction of TMA was associated with loss of glomerular and pe
ritubular capillary endothelial cells and decreased arteriolar density at d
ay 1. Some spontaneous capillary recovery was present by day 17; however, r
epair was incomplete, and severe tubulointerstitial damage occurred. The la
ck of complete microvascular recovery was associated with reduced VEGF immu
nostaining in the outer medulla. VEGF-treated rats had more glomeruli with
intact endothelium, less glomerular ischemia (collapsed glomeruli), and gre
ater peritubular capillary density with less peritubular capillary loss. Th
is was associated with less tubulointerstitial fibrosis, less cortical atro
phy, and improved renal function.
Conclusions. VEGF accelerates renal recovery in this experimental model of
TMA. These studies suggest that angiogenic growth factors may provide a new
therapeutic strategy for diseases associated with endothelial cell injury.