Dysregulation of apoptosis: a possible mechanism leading to chronic progressive renal histological changes in lupus nephritis  

作　　者：陆福明 沈雯 张秀荣 郭慕依 林善锬 

机构地区：[1]Department of Nephrology,Huashan Hospital,Shanghai 200040,China [2]Department of Pathology,Shanghai Medical University,Shanghai 200032,China

出　　处：《Chinese Medical Journal》2000年第12期26-30,共5页中华医学杂志（英文版）

基　　金：This work was supported by a grant from Shanghai Scientific Technologi cal Committee(No 954119005).

摘　　要：To evaluate apoptosis in lupus nephritis and the relationship between the existence of apoptotic cells in renal tissue and histopathological or clinical changes Methods Apoptosis was detected by in situ nick end labeling techniques (TUNEL) in renal biopsies from 25 patients with type Ⅳ lupus nephritis (LN), 12 patients with IgA nephropathy IgAN, 4 patients with idiopathic mesangioproliferative glomerulonephritis (MsPGN) and 3 patients with acute poststreptococcal glomerulonephritis (APGN) Normal renal tissue obtained at nephrectomy for hypernephroma in 4 adults was used as control Proliferating cells were identified by proliferating cell nuclear antigen (PCNA) in these patients Results Compared to other proliferative glomerulo^nephritis and controls, the patients with lupus nephritis had less apoptotic cells, a higher ratio of PCNA+ cells/TdT+ cells (P/T) in renal tissues; and their P/T ratio in glomeruli and tubulointerstitium correlated with the chronicity index, r =0 4983 ( P =0 0132), r =0 8399 ( P <0 001), r =0 6614 ( P =0 0033), respectively P/T ratios in the glomerulus and tubule had a positive correlation with 24 hour urinary protein, r =0 8554 ( P <0 001) and r =0 7134 ( P =0 001); and a negative correlation with creatinine clearance (Ccr), r =-0 4880 ( P =0 0133) and r =-0 7229 ( P =0 001), which in tubules positively correlated with serum creatinine (Scr), r =0 4107 ( P =0 0414) Conclusions Apoptosis is reduced in proliferative lupus nephritis Intense proliferation without a commensurate increase in apoptosis is a possible mechanism that leads to chronic progressive renal histopathological changesTo evaluate apoptosis in lupus nephritis and the relationship between the existence of apoptotic cells in renal tissue and histopathological or clinical changes Methods Apoptosis was detected by in situ nick end labeling techniques (TUNEL) in renal biopsies from 25 patients with type Ⅳ lupus nephritis (LN), 12 patients with IgA nephropathy IgAN, 4 patients with idiopathic mesangioproliferative glomerulonephritis (MsPGN) and 3 patients with acute poststreptococcal glomerulonephritis (APGN) Normal renal tissue obtained at nephrectomy for hypernephroma in 4 adults was used as control Proliferating cells were identified by proliferating cell nuclear antigen (PCNA) in these patients Results Compared to other proliferative glomerulo^nephritis and controls, the patients with lupus nephritis had less apoptotic cells, a higher ratio of PCNA+ cells/TdT+ cells (P/T) in renal tissues; and their P/T ratio in glomeruli and tubulointerstitium correlated with the chronicity index, r =0 4983 ( P =0 0132), r =0 8399 ( P <0 001), r =0 6614 ( P =0 0033), respectively P/T ratios in the glomerulus and tubule had a positive correlation with 24 hour urinary protein, r =0 8554 ( P <0 001) and r =0 7134 ( P =0 001); and a negative correlation with creatinine clearance (Ccr), r =-0 4880 ( P =0 0133) and r =-0 7229 ( P =0 001), which in tubules positively correlated with serum creatinine (Scr), r =0 4107 ( P =0 0414) Conclusions Apoptosis is reduced in proliferative lupus nephritis Intense proliferation without a commensurate increase in apoptosis is a possible mechanism that leads to chronic progressive renal histopathological changes

关 键 词：lupus nephritis APOPTOSIS proliferating cell nuclear antigen 

分 类 号：R363.1[医药卫生—病理学]