Key result
Minimal-change nephropathy selectively increases urinary ET-1, while other glomerulonephritides show elevated ET-3 levels.
Why the study?
It is unknown if different endothelins are involved in the pathogenesis of various types of glomerulonephritis.
Case-Control (n=31)
Different types of glomerulonephritis are associated with distinct patterns of endothelin system activation, with ET-1 elevated in minimal-change nephropathy and ET-3 elevated in perimembraneous and mesangioproliferative GN.
Distinct urinary ET patterns by GN subtype should not change practice; leaves open isoform-specific targeting in cardiorenal research.
There is evidence that an activated renal endothelin (ET) system is involved in development of glomerulosclerosis. However it is still unknown if different ETs are involved in the pathogenesis of various types of glomerulonephritis (GN). This study characterized ET-1 and ET-3 levels in patients suffering from chronic GN. We performed a prospective study to evaluate the ET-1 and ET-3 levels in 19 patients with biopsy-proven GN, including four minimal-change nephropathies (MCN), six perimembraneous GN (PM-GN), and nine mesangioproliferative GN (MP-GN). Twelve healthy subjects matched for age and sex served as controls. ET-1 and ET-3 were measured in plasma (p) and in urine [spontaneous urine (sp.urine) and urine over 24 h (24-h urine)] using a specific radioimmunoassay. Patients and controls were compared using the Wilcoxon rank-sum test. In MCN, ET-1 levels were enhanced in sp. urine (p = 0.03) and 24-h urine (p = 0.01), whereas ET-3 levels did not differ from controls. In comparison, in PM-GN we found an increased ET-3 level in 24-h urine (p = 0.004). In MP-GN, ET-3 levels were also elevated in p (p = 0.0002) and urine specimens (sp. urine p = 0.05; 24-h urine p = 0.03). No positive correlation to C3 or C4 complement fractions was found. Age, blood pressure or renal function did not correlate with ET-1 or ET-3 levels. In MP-GN and PM-GN, ET-3 is elevated whereas ET-1 is not. In contrast ET-1 is increased in MC-GN. These data indicate an important role for the ET-1 and ET-3 systems in the pathophysiology of different forms of GN. This is significant with regard to an early preservation of renal function at the onset of GN by the use of selective ET antagonists.
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Wolf et al. (1998) conducted a case-control in Chronic glomerulonephritis (n=31). Glomerulonephritis vs. Healthy controls was evaluated on Endothelin-1 (ET-1) and Endothelin-3 (ET-3) levels in plasma and urine. Patients with minimal-change nephropathy had increased urinary ET-1 levels (p=0.01), whereas those with perimembraneous and mesangioproliferative glomerulonephritis had elevated ET-3 levels.
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