Long-term renal isografts in humans and laboratory animals exhibit features
similar to those of chronic allograft nephropathy (CAN), indicating that a
ntigen-independent factors, such as acute renal ischemia, are likely to be
involved in the development of CAN. Hepatocyte growth factor (HGF) has been
demonstrated to play a renotropic role in renal regeneration and protectio
n from acute ischemic injury. This study was thus conducted to investigate
the effect of HGF on the development of CAN, using an established rat model
. HGF was administered daily (100 mug/d, intravenously) for 4 wk after engr
aftment. Control animals received saline solution. Allografts from control
animals exhibited early evidence of severe structural collapse and necrotic
cell death in the proximal tubules and outer medulla, with mononuclear cel
l infiltration, within 1 wk after engraftment. This was followed by sequent
ial upregulation of adhesion molecules and cytokines, accompanied by dense
macrophage infiltration Fibrogenic events, as indicated by marked increases
in transforming growth factor-beta1 expression and the accumulation of smo
oth muscle alpha -actin, occurred during the same period. Control animals u
ltimately developed features typical of CAN, with functional deterioration
and severe histologic changes; a survival rate of 50.6% by 32 wk was observ
ed. in contrast, remarkably Little early injury and no late fibrogenic even
ts were observed for the HGF-treated group. All treated animals survived, w
ith well preserved graft function, during the 32-wk follow-up period. These
results indicate that renal protection and recovery from early allograft i
njury with HGF treatment greatly contribute to a reduction of susceptibilit
y to the subsequent development of CAN in a rat model. The potential applic
ation of HGF in the prevention of CAN warrants further attention.