Urinary VEGF-A165b mRNA expression in Fabry disease: Pilot study.

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Title: Urinary VEGF-A165b mRNA expression in Fabry disease: Pilot study.
Alternate Title: Expresión urinaria del ARNm de VEGF-A165b en enfermedad de Fabry: estudio piloto.
Authors: Jaurretche, Sebastián1,2 Sebastianjaurretche5@gmail.com, Perez, Germán3, Antongiovanni, Norberto4, Victoria del Rosal, María1, Luana Brajkovic, María1, Perretta, Fernando5, Venera, Graciela6
Source: Nefrologia. Jan2026, Vol. 46 Issue 1, p1-5. 5p.
Subjects: KIDNEY diseases, VASCULAR endothelial growth factors, CROSS-sectional method, ANGIOKERATOMA corporis diffusum, ENZYME replacement therapy, CYTOLOGY
Abstract (English): Background: Vascular endothelial growth factor (VEGF) is associated with renal pathogenesis of Fabry disease (FD). Proteomic studies have demonstrated that circulating levels of VEGF are higher in young FD patients compared with controls and an overexpression of tissue VEGF in animal models of Fabry nephropathy has been reported. In kidneys, VEGF-A is predominantly produced by podocytes, and its action on endothelial dysfunction is known. An alternative VEGF-A isoform, VEGF-A165b, confers benefit in microvascular disease states, and it was studied in diabetic nephropathy having demonstrated a protective function, acting on the restoration of the podocyte glycol-calyx. Methods: Cross-sectional design. Urinary mRNA was obtained by RT-qPCR. Results: 48 subjects were included; 24 FD patients (17F/7M - 23.7 ± 17.5 ys) and 24 healthy volunteers (17F/7M - 23.0 ± 17.0 ys). 12 adults and 12 pediatrics in both populations Median uACR (p = 0.999) and eGFR (p = 0.999) were similar between both groups. FD genotypes included were R301Q, R363H, R227Q, del3&4exon, L106R, E398X, L415P and C238Y; 15 FD patients were treatment naïve and 9 receiving ERT (agalsidase-ß); median time of ERT was 15.6 ± 28.3 months. Comparative expression of urinary VEGF-165bmRNA was higher among FD patients versus controls although without statistical significance (p = 0.369). No significant correlations were found between urinary VEGF-165b-mRNA and variables "Age" (p = 0.845), "Gender" (p = 0.369), "aGal-A" (p = 0.631), "Genotype" (p = 0.142), "Phenotype" (p = 0.898), "uACR" (p = 0.744), "eGFR" (p = 0.059) and "ERT or Naïve" (p = 0.507). A significant correlation between urinary VEGF-165b-mRNA and "time of ERT treatment" was found (p = 0.05). Conclusion: Overexpression of urinary VEGF-165b-mRNA (with known renal cyto-protective effects) is a probable response to injury in FD nephropathy. The only variable correlated with the highest urinary expression of VEGF-165b-mRNA was the time of ERT treatment. Probably in patients with longer treatment time there is a decrease in FD damage. A limitation of the present work is the low sample size and crosssectional design. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Antecedentes: El factor de crecimiento endotelial vascular (VEGF) está asociado a patogenia renal de la enfermedad de Fabry (EF). Los estudios proteómicos han demostrado que los niveles circulantes del VEGF son más altos en pacientes de EF jóvenes, en comparación con los controles, habiéndose reportado la sobreexpresión de VEGF tisular en modelos animales de nefropatía de Fabry. En los riñones, VEGF-A es producido predominantemente por los podocitos, desconociéndose su acción en la disfunción endotelial. Una isoforma alternativa de VEGF-A, VEGF-A165b, confiere beneficio en los estados microvasculares de la enfermedad, habiendo demostrado el estudio en nefropatía diabética una función protectora, actuando en la restauración del podocito glicol-cálix. Métodos: Diseño transversal. El ARNm de la orina se obtuvo mediante RT-qPCR. Resultados: Se incluyeron a 48 sujetos; 24 pacientes de EF (17M/7V - 23,7 ± 17,5 años) y 24 voluntarios sanos (17M/7V - 23 ± 17 años). Doce pacientes adultos y 12 pacientes pediátricos en ambas poblaciones. Los valores medios de uACR (p = 0,999) y eGFR (p = 0,999) fueron similares entre ambos grupos. Los genotipos de EF incluidos fueron R301Q, R363H, R227Q, del3&4exon, L106R, E398X, L415P y C238Y; 15 pacientes de EF recibieron tratamiento por vez primera y 9 recibieron TREP (agalsidasa-ß); el tiempo medio de la TREP fue de 15,6 ± 28,3 meses. La expresión comparativa del ARNm del VEGF-165b en la orina fue superior entre los pacientes de EF frente a los controles, aunque sin significación estadística (p = 0,369). No se encontraron correlaciones significativas entre el ARNm del VEGF-165b en la orina y las variables «Edad» (p = 0,845), «Sexo» (p = 0,369), «aGal-A» (p = 0,631), «Genotipo» (p = 0,142), «Fenotipo» (p = 0,898), «uACR» (p = 0,744), «eGFR» (p = 0,059) y «TREP o sin tratamiento» (p = 0,507). Se encontró una correlación significativa entre el ARNm del VEGF-165b en la orina y el «tiempo del tratamiento TREP» (p = 0,05). Conclusión: La sobreexpresión del ARNm del VEGF-165b en la orina (con efectos citoprotectores renales conocidos) es una respuesta probable a la lesión en la nefropatía de la EF. La única variable correlacionada con la mayor expresión de ARNm del VEGF-165b en la orina fue el tiempo del tratamiento TREP. Probablemente en los pacientes con mayor tiempo terapéutico existe una reducción del daño de la EF. Una limitación del presente trabajo es el tamaño muestral pequeño y el diseño transversal. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Background: Vascular endothelial growth factor (VEGF) is associated with renal pathogenesis of Fabry disease (FD). Proteomic studies have demonstrated that circulating levels of VEGF are higher in young FD patients compared with controls and an overexpression of tissue VEGF in animal models of Fabry nephropathy has been reported. In kidneys, VEGF-A is predominantly produced by podocytes, and its action on endothelial dysfunction is known. An alternative VEGF-A isoform, VEGF-A165b, confers benefit in microvascular disease states, and it was studied in diabetic nephropathy having demonstrated a protective function, acting on the restoration of the podocyte glycol-calyx. Methods: Cross-sectional design. Urinary mRNA was obtained by RT-qPCR. Results: 48 subjects were included; 24 FD patients (17F/7M - 23.7 ± 17.5 ys) and 24 healthy volunteers (17F/7M - 23.0 ± 17.0 ys). 12 adults and 12 pediatrics in both populations Median uACR (p = 0.999) and eGFR (p = 0.999) were similar between both groups. FD genotypes included were R301Q, R363H, R227Q, del3&4exon, L106R, E398X, L415P and C238Y; 15 FD patients were treatment naïve and 9 receiving ERT (agalsidase-ß); median time of ERT was 15.6 ± 28.3 months. Comparative expression of urinary VEGF-165bmRNA was higher among FD patients versus controls although without statistical significance (p = 0.369). No significant correlations were found between urinary VEGF-165b-mRNA and variables "Age" (p = 0.845), "Gender" (p = 0.369), "aGal-A" (p = 0.631), "Genotype" (p = 0.142), "Phenotype" (p = 0.898), "uACR" (p = 0.744), "eGFR" (p = 0.059) and "ERT or Naïve" (p = 0.507). A significant correlation between urinary VEGF-165b-mRNA and "time of ERT treatment" was found (p = 0.05). Conclusion: Overexpression of urinary VEGF-165b-mRNA (with known renal cyto-protective effects) is a probable response to injury in FD nephropathy. The only variable correlated with the highest urinary expression of VEGF-165b-mRNA was the time of ERT treatment. Probably in patients with longer treatment time there is a decrease in FD damage. A limitation of the present work is the low sample size and crosssectional design. [ABSTRACT FROM AUTHOR]
ISSN:02116995
DOI:10.1016/j.nefro.2025.501416