Radiation induced fibrosis(RIF)can be understood as a form of chronic radiation-induced bystander effect(RIBE).It is a fibrotic process different than acute radiation syndrome(ARS),which is an inflammatory process that has different mediators and effector cells.It is triggered by Reactive Oxygen Species(ROS)activation of the matrixembedded L-TGF-βcomplex.TGF-βacts by directing cellular processes that culminate in a fibrotic state.These include epithelial and endothelial mesenchymal transition(EMT and EnMT),G1 phase growth arrest,stimulation of fibrosis,and apoptosis,characterized by hypocellularity with a predominance of fibrocytes and myofibroblasts,fibrosis,and variable loss of tissue function.Fat grafting is the only clinically available tool to reverse RIF.The reversal of RIF is mediated by the mesenchymal stem cells(MSCs)embedded in the stromal vascular fraction(SVF)adipose tissue.The mechanism of action is the release of HGF(hepatocyte growth factor)by the MSCs into the surrounding RIF tissue.The HGF initiates a“mitotic growth program”that reprograms cell behavior.These changes include EMT and EnMT,stimulation of cell proliferation and morphogenesis,anti-apoptosis,downregulation of TGF-β,dissolution of fibrosis,and cell motility.The“mitotic growth program”culminates in tissue regeneration and reversal of RIF.
Objective: To observe the effects of Irbesartan combined with Atorvastatin on early diabetic nephropathy patients' serum Cys C, Hcy, TNF-α, ET and TGF-b1 levels. Methods: A total of 60 early diabetic nephropathy patients were randomly divided into observation group (30 cases) and control group (30 cases). Observation group: Irbesartan combined with Atorvastatin;control group: patients were treated only by Irbesartan. Recording and comparing the levels of Cys C, Hcy, TNF-α, ET and TGF-b1before and after treatment. Results: (1) {17}efore treatment, there was no statistically significant difference in the serum F{17}G, TG, Scr, {17}UN levels between the two groups. After treatment, compared with the same group before treatment, the serum TG, Scr, {17}UN levels of the two groups were significantly lower, and those levels of observation group were significantly better than the control group, the difference between two groups was statistically significant;(2) {17}efore treatment, there was no statistically significant difference in the serum Cys C, Hcy, TNF-α, ET, TGF-b1 levels between the two groups. After treatment, compared with the same group before treatment, the serum Cys C, Hcy, TNF-α, ET, TGF-b1 levels of the two groups were significantly lower, and those levels of observation group were significantly better than the control group, the difference between two groups was statistically significant. Conclusion: Irbesartan combined with Atorvastatin for early diabetic nephropathy patients can reduce the levels of serum Cys C, Hcy, TNF-α, ET, TGF-b1 and be beneficial to protect their nephritic function.
