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Histopathological changes and tumour necrosis factor‐α, transforming growth factor‐β and tenascin expression in patients with primary type I membranoproliferative glomerulonephritis in remission
Author(s) -
ARIKAN HAKKI,
KOC MEHMET,
CAKALAGAOGLU FULYA,
TUGLULAR SERHAN,
OZENER CETIN,
AKOGLU EMEL
Publication year - 2009
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2008.01048.x
Subject(s) - medicine , mesangial proliferative glomerulonephritis , membranoproliferative glomerulonephritis , tenascin , pathology , biopsy , univariate analysis , renal biopsy , glomerulonephritis , gastroenterology , kidney , extracellular matrix , multivariate analysis , biology , microbiology and biotechnology , fibronectin
SUMMARY Aim: Primary type I membranoproliferative glomerulonephritis (MPGN) is a rare cause of glomerular disease with a high relapse rate and poor prognosis. The aim of this study was: (i) to evaluate the histopathological findings associated with remission; and (ii) to document the possible clinical and histopathological factors predicting relapses. Methods: Eleven type I MPGN patients (five men, six women; mean age, 38.8 ± 13.5 years) who were in remission for at least 1 year after the cessation of immunosuppressive drugs were re‐biopsied. The intensity of immunostaining for tumor necrosis factor (TNF)‐α, transforming growth factor (TGF)‐β1, and tenascin was graded from 0 (no staining) to 3+ (maximum staining). Results: Mean baseline mesangial cellularity score and tubulointerstitial infiltration score were reduced and mesangial matrix expansion score was increased at protocol re‐biopsies compared to baseline. The glomerular and tubulointerstitial staining scores for TGF‐β1 and tenascin were higher than that of baseline. Reduced tubulointerstitial TNF‐α expression was found in re‐biopsy specimens compared to baseline. Patients have been followed for a mean time of 51.5 ± 22.2 months after the protocol biopsy. Eight patients had a relapse. Mesangial cellularity score and glomerular tenascin expression at re‐biopsy specimens were higher in relapsed patients compared to those without a relapse. Conclusion: Our study shows that mesangial cellularity and tubulointerstitial cell infiltration are reducing whereas mesangial matrix expansion, glomerular and tubulointerstitial TGF‐β1 and tenascin expression are increasing with remission. The higher mesangial cell proliferation and glomerular tenascin scores in remission are associated with the development of relapse.