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The study was a retrospective study. The clinical data of 866 patients with IgA nephropathy (IgAN) in Beijing Anzhen Hospital, Capital Medical University from March 2010 to March 2021 were analyzed, to investigate the clinical pathology and renal prognosis of IgAN patients with intrarenal arteriolosclerosis, and to preliminarily explore whether abnormal activation of complement system is involved in the injury of arteriolosclerosis. The patients were divided into renal arteriolar lesions group and non-renal arteriolar lesions group according to the renal histopathology, and the differences of clinical pathological manifestations, prognosis between the two groups were compared. The results showed that, compared with the non-renal arteriolar lesions group ( n=236), IgAN patients in the renal arteriolar lesions group ( n=630) had higher proportions of hypertension and malignant hypertension, higher levels of urinary albumin-creatinine ratio, 24-hour urine protein quantification and serum uric acid, lower estimated glomerular filtration rate, and more severe MEST-C lesions of the Oxford classification (all P < 0.05). Cox regression analysis results showed that intrarenal arteriolosclerosis was the independent risk factor affecting the progression of IgAN to ESRD ( HR=6.437, 95% CI 2.013-20.585, P=0.002). Renal histopathology showed that the deposition of complement C3c on the wall of intrarenal arterioles in the renal arteriolar lesions group ( n=98) was stronger than that in non-renal arteriolar lesions group ( n=18, P < 0.05). IgAN patients with renal arteriolosclerosis present with serious clinical and pathological manifestations, and renal prognosis. Abnormal activation of complement system may be involved in the pathogenesis of intrarenal arteriolosclerosis.
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Objective:To investigate the influencing factors of non-remission of proteinuria in patients with nephrotic syndrome (NS) and idiopathic membranous nephropathy (IMN).Methods:The study was a retrospective observational study. The clinical data of patients with NS who were diagnosed as IMN by renal biopsy and serum albumin recovered normal after six months of treatment were collected from Beijing Anzhen Hospital, Capital Medical University from June 1, 2010 to January 31, 2022. Patients were divided into proteinuria remission group and non-proteinuria remission group according to whether urinary protein < 3.5 g/24 h and decreased 50% from the onset. The differences of clinical and pathological characteristics between the two groups at baseline were compared. The logistic regression model was used to analyze the influencing factors of non-remission of proteinuria.Results:Ninety-five NS patients with renal pathology of IMN were included in this study, with age of 57(43, 65) years old and 50 males (52.6%). There were 75 patients in the proteinuria remission group and 20 patients in the non-proteinuria remission group. Compared with the proteinuria remission group, the non-proteinuria remission group had higher baseline body mass index [(26.83±4.03) kg/m 2vs. (24.68±3.97) m 2, t=-2.149, P=0.034] and proportion of overweight (85.0% vs. 58.7%, χ2=4.765, P=0.029), and larger waist circumference [88.5(85.3, 101.5) cm vs. 87.0(77.5, 92.0) cm, Z=2.362, P=0.018]. Renal pathological results showed that the proportions of diabetes nephropathy (10.0% vs. 0, P=0.043) and glomerular hypertrophy (45.0% vs. 20.0%, χ2=5.227, P=0.022) were higher, and the average diameter of hypertrophic glomeruli was longer [(197.96±6.37) μm vs. (193.51±8.50) μm, t=2.029, P=0.041] in the proteinuria remission group than those in the non-proteinuria remission group. Multivariate logistic regression analysis results showed that waist circumference was an independent influencing factor of non-proteinuria remission in patients with IMN under waist circumference > 90 cm in men and >85 cm in women ( OR=1.083, 95% CI 1.005-1.168, P=0.037). Conclusion:Abdominal obesity is an independent risk factor of non-remission of proteinuria in NS patients with IMN after early treatment.
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Objective:To investigate the role of complement activation in the pathogenesis of primary malignant hypertension (MHT) with nephrosclerosis complicated with severe cardiorenal injury.Methods:Data of MHT patients with nephrosclerosis proven by biopsy from January 2010 to December 2020 in the Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. The expressions of complement-related component C4d, C1q, complement factor H-related protein 5, C3c and C5b-9 were detected by immunohistochemical staining. According to whether the patients were complicated with acute heart failure (AHF) and/or acute kidney injury (AKI), they were divided into severe cardiorenal injury group and non-severe cardiorenal injury group. The differences of clinicopathological data between the two groups were compared. According to the degree of C4d deposition in renal tissues, patients were divided into C4d diffused deposition group and non-C4d diffused deposition group. The severity of cardiorenal injury and the pathological characteristics of thrombotic microangiopathy in renal tissues were compared between the two groups.Results:A total of 33 patients were enrolled in this study, of which 17 cases (51.5%) were complicated with severe cardiorenal injury; AHF occurred in 16 patients (48.5%), AKI occurred in 8 patients (26.7%), and AHF and AKI were combined in 7 patients (21.2%). Compared with non-severe cardiorenal injury group, patients in severe cardiorenal injury group had higher levels of baseline lactate dehydrogenase [326.0 (217.0, 366.0) IU/L vs 197.0 (165.0, 220.0) IU/L, Z=37.000, P=0.002] and hemoglobin [(143.6±24.0) g/L vs (106.4±24.7) g/L, t=38.500, P<0.001], lower levels of 12 h urinary incontinence osmolality [400.0 (342.5, 504.0) mmol/L vs 476.0 (432.3, 616.5) mmol/L, Z=72.000, P=0.021] and serum albumin [(36.2±9.4) g/L vs (43.2±6.2) g/L, t=6.423, P=0.017], and thicker left ventricular posterior wall [(14.0±2.1) mm vs (12.1±1.1) mm, t=6.552, P=0.018]. The immunohistochemical results of kidney tissue showed that the proportions of C4d and C5b-9 diffused deposition in severe cardiorenal injury group were significantly higher than those in non-severe cardiorenal injury group (5/16 vs 0/15, P=0.043; 12/16 vs 5/15, P=0.032). Compared with non-C4d diffused deposition group, C4d diffused deposition group had higher incidence of AHF (5/5 vs 10/26, P=0.018), poorer heart function, more severe ventricular remodeling, and shorter history of hypertension [2.0 (0, 12.0) months vs 48.0 (9.5, 84.0) months, Z=22.500, P=0.022]. Conclusions:The incidence of severe cardiorenal injury in MHT patients with nephrosclerosis is about 51.5%. The proportion of diffuse deposition of complement activated components in renal tissues in patients with severe cardiorenal injury is higher than that in patients with non-severe cardiorenal injury. Overactivation of complement may be involved in the pathogenic process of severe heart and kidney injury caused by MHT.
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Objective To evaluate the diagnostic value of pathological features of atypical membranous nephropathy (AMN). Methods Ninety - one patients with AMN diagnosed by renal biopsy during 2011 and 2017 were enrolled in this study. On the basis of M - type phospholipase A2 receptor (PLA2R) and thrombospondin type - 1 domain - containing 7A protein (THSD7A) by immunohistochemistry, patients were divided into AMN group (25 cases without PLA2R and THSD7A) and idiopathic membranous nephropathy (IMN) group (66 cases with positive PLA2R or THSD7A). The results of immunofluorescence (IF), light microscopy (LM) and electron microscopy (EM) of these two groups were compared, and the parameters with statistical difference were screened out in order to assess their value in the diagnosis of AMN in fourfold table. Results IF results showed that in AMN group the proportions of IgG deposition on capillary wall and mesangial area as well as positive otherIgG subclasses and complement C1q but negative IgG4 were significantly higher than those in IMN group (respectively, 56.0％ vs 12.1％ , 44.0％ vs 0, both P＜0.05). Their diagnostic specificities for AMN were 87.9％ and 100.0％, respectively. However, the positive rates of IgG accompanied with IgA and/or IgM, predominant IgG4 with other IgG subclasses and complement C1q in two groups were not significantly different (all P＞0.05). LM results showed that the proportions of false double track sign on basement membrane and fuchsinophilic proteins under epithelium, endothelium, basement membrane and mesangial region in AMN group were significantly higher than those in IMN group (respectively, 36.0％ vs 0, 44.0％ vs 1.5％, both P＜0.05). Their diagnostic specificities for AMN were 100.0％ and 98.5％ , respectively. However, the scores of mesangial cell proliferation of these two groups showed no significantly difference (P＞0.05). EM results showed that the rate of endothelial electron dense deposits in AMN group was significantly higher than that in IMN group (36.0％ vs 1.5％, P＜0.05), and its diagnostic specificity for AMN was 98.5％. Conclusions IgG deposition on both capillary wall and mesangial area, positive other IgG subclasses and C1q with negative IgG4, false -double contour sign, multi - site fuchsinophilic deposits and endothelial electron dense deposits may help for the AMN diagnosis in the absence of PLA2R and THSD7A related data.
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Objective To investigate whether the clinical and pathological injury of kidney in IgA nephropathy (IgAN) patients with hypertension is associated with circadian blood pressure rhythm change, particularly with elevated nocturnal blood pressure (BP). Methods This study was a retrospective cross-sectional study. Clinic and renal histopathological injury data were obtained from 83 IgAN patients with hypertension. First, 24 h ambulatory BP monitoring (ABPM) data were analyzed. Second, all these IgAN patients were divided into two groups, elevated nocturnal BP group and nocturnal normotensive BP group, and the clinical and pathological differences between this two groups were analyzed. Third, logistic regression analysis was used to analyze the influencing factors of renal tubulointerstitial injury in IgAN patients with hypertension. At last, all these IgAN patients were divided into two groups according to the level of estimated glomerular filtration rate (eGFR), group of patients with eGFR≥60 ml·min-1·(1.73 m2)-1 and the other group with eGFR<60 ml·min-1·(1.73 m2)-1, and the 24 h ABPM data were compared. Results (1) The proportion of non-dipper circadian rhythm of BP in IgAN patients with hypertension was 79.5％. (2) Compared with nocturnal normotensive BP group, patients in elevated nocturnal BP group had significantly higher levels of 24-hour urinary protein quantity and blood uric acid (both P<0.05), and lower eGFR and urine osmotic pressure clinically (both P<0.05). Index of interstitial fibrosis and tubular atrophy was significantly higher in nocturnal normotensive BP group (P<0.05), while the proportion of glomerular ischemia lesion was not significantly different between two groups. (3) Multivariate logistic regression analysis showed that elevated nocturnal BP was an independent risk factor for severe tubulointerstitial injury of IgAN (OR=1.113, 95％CI 1.038-1.192, P=0.002). (4) Compared with the group of eGFR≥60 ml·min-1·(1.73 m2)-1, 24-hour systolic blood pressure (SBP) and diastolic blood pressure (DBP), daytime SBP and DBP, nocturnal SBP and DBP were significantly higher in group of eGFR<60 ml·min-1·(1.73 m2)-1 (all P<0.05). Conclusion The proportion of non-dipper circadian rhythm of BP in IgAN patients with hypertension is as high as 79.5％. Elevated nocturnal BP is associated with the severity of renal damage, and elevated nocturnal BP is an independent risk factor for severe tubulointerstitial injury in IgAN patients with hypertension. Therefore, 24 h ABPM should be emphasized, and elevated nocturnal BP should be well controlled to slow the progression of IgAN.
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Objective To examine whether aldosterone contribute to obesity related glomerular disease. Methods C57BL/6J mice were randomly divided into three groups: a control group (low?fat?diet, n=10), a model group (high?fat?diet, n=10) and a intervention group (high?fat?diet, n=12). After 8 weeks intervention group were treated with a mineralocorticoid receptor antagonist, spirolactone (SPL).The physicochemical indexes and the renal pathology of the three groups were all detected. The mRNA and protein expressions of podocyte marker protein were determined by real?time PCR and Western blotting, respectively. Results Compared with the control group, body weight, kidney weight, Lee ’s index, fat index, blood cholesterol, blood triglyceride, creatinine clearance rate, urinary protein excretion, glomerular average diameter, glomerular foot process average width were significantly up ? regulated (P<0.05); The mRNA and protein expression of nephrin, podocin, podoplanin and podocalyxin were significantly down?regulated in model group (P<0.05). Meanwhile, these changes were attenuated by SPL. Conclusion Aldosterone can participate in the process of obesity? related renal injury, and these can be attenuated by mineralocorticoid receptor antagonist, spirolactone. This gives us preliminary clues to treat ORG.
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Objective To explore whether the glomerular podocytes can be damaged by aristolochic acid. Methods Thirty-two male SD rats were equally divided into the following 2 groups:model group in which the rats received the extract of Aristolochia manshuriensis Kom (AmK) by gavage; control group only received tap water by gavage.24 h urinary protein excretion was measured at the end of the 1st and 4th week,and SDS-PAGE gel electrophoresis was performed to detect the protein in urine.At the end of the 4th week,all the rats were sacrificed and the glomeruli were isolated by laser capture microdissection technique.The mRNA expression of nephrin,podocin,CDA2P,podocalyxin and podoplanin in isolated glomeruli was determined by RT-PCR,and the average width of glomerular foot process was measured by electron microscopy and image analysis. Results At the end of the 4th week,24 h urinary protein excretion in the model group was significantly higher than that in the control group (P＜0.01) and the urinary albumin content in model group was also obviously increased.The average width of glomerular foot process in the model group was significantly larger than that in control group (P＜0.01).The mRNA expressions of nephrin,podocin,CDA2P,podocalyxin and podoplanin in glomeruli were significantly down-regulated in the model group compared with the control group,which decreased by 34％,62％,56％,50％(P＜0.01) and 27％ (P＜0.05),respectively. Conclusions Aristolochic acid can damage the glomerular podocytes,resulting in the down-regulation of nephrin,podocin,CD2AP,podoplanin and podocalyxin mRNA expression, the segmental widening of foot process, and increased urinary protein excretion.
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Objective To explore the correlation of anticardiolipin antibody (ACL) and lupus nephritis (LN) glomerular microthrombi (GMT) in patients with systemic lupus erythematosus (SLE) and to analyze their clinical manifestations and renal pathological characteristics.Methods The clinical data of 126 LN patients treated at our hospital between January 2005 and October 2010 were retrospectively reviewed.The factors,including age,gender,the clinical manifestations in and outside of kidney were evaluated by multivariate Logistic regression analysis.Enzyme-linked immunosorbent assay (ELISA) was used to test the serum levels of ACL in all patients.Statistical analysis was conducted using x2 test and Logistic regression.Results ① All 126 patients were investigated.Thirty-eight LN patients had GMT.When compared with the LN-non-GMT group,the SLE disease activity index (SLEDAI),urinary protein quantity (24 h),serum creatinine,serum urea nitrogen,anti-dsDNA antibody (+),the incidence of severe hypertension,anemia,thrombocytopenia,arthritis were higher in the LN-GMT group (P＜0.01).Logistic regression analysis showed that SLEDAI (OR=2.486,95％CI 1.678-3.684,P=0.000),anemia (OR=4.628,95％CI 1.045～20.496,P=0.044) were correlated with GMT; ② The pathologic results of renal biopsy showed that GMT had an incidence of 30.2％ (n=38) in LN.As compared with the LN-non-GMT group,Wilcoxon test showed that the LN-GMT group suffered more severe greater renal pathological injuries (P=0.012).The pathological types of LN-non-GMT and LN-GMT groups were as follows:type Ⅳ (38％ vs 76％) and type Ⅲ (31％ vs 8％); ③ The positive rate of ACL was higher in the LN-GMT group than that in the LN-non-GMT group (n=23,61％ vs n=15,36％).The differences were statistically significant (P=0.018).Conclusion GMT is not rare in LN.SLEDAI,anemia and positive ACL are correlated with GMT,LN patients with concurrent GMT have more severe renal pathological changes.
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Objective To investigate the impact of metabolic syndrome(MS)on clinicopathology of IgA nephropathy(IgAN). Methods A total of 118 IgAN patients complicated with MS were enrolled in the study as IgAN-MS group. Then 118 IgAN patients of same age arrange without MS were randomly selected as IgAN-non-MS group.A comparative analysis of clinical and pathological data between these two groups was performed. Results The urine protein, serum creatinine, body mass index, mean arterial pressure, serum triglyceride, fasting blood glucose and serum uric acid in IgAN-MS group were all significantly higher than those in IgAN-non-MS group(P<0.05 or P<0.01). The serum HDL-C level in IgAN-MS group was significantly lower than that in IgAN-non-MS group(P<0.01). The percentages of patient with hypertension, abnormal glucose metabolism or abnormal lipid metabolism in IgAN-MS group were also significantly higher than those in IgAN-non-MS group(P <0.01). The glomerular and tubulointerstitial pathological changes in IgAN-MS group were significantly more severe than those in IgAN-non-MS group(P<0.01). There were significantly positive correlations between MS and urinary protein quantity, serum creatinine level, and glomerular damage index or tubulointerstitial damage index(P<0.01)by Spearman rank correlation analysis. Conclusion MS may be an important risk factor of IgAN progression.
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Objective To compare the clinicopathological features between two kinds of obesity-related glomerulopathy (ORG). Methods Twenty-three patients with obesity-associated glomerulomegaly (OB-GM) and 22 patients with obesity-associated focal and segmental glomerulosclerosis (OB-FSGS) diagnosed by renal biopsy during 1998 to 2008 in our center were enrolled in this study. A retrospective analysis of clinical and pathological data was carried out. Results (1) All the patients in these two groups were with abdominal obesity. Most of them were middle-aged male. There were no significant differences in gender, age, body mass index and waist circumference between these two groups (P>0.05). The mean course of disease in OB-FSGS group was significantly longer than that in OB-GM group[(21.7±29.7) vs (6.8±9.3) months,P<0.05]. (2) Metabolic syndrome was found in the most patients of these two groups, but there were no significant differences in the levels of serum glucose, triglycerides, HDL-cholesterul, uric acid and blood pressure between them(P>0.05). (3) The 24-hour urinary protein and Ser level in OB-FSGSgroup were significantly higher than those in OB-GM group[(2.49±1.58) vs (0.83±0.87) g/d, P<0.05; (102.09±25.07) vs (87.84±20.63) μmol/L, P<0.05]. The serum albumin level, creatinine clearance and urinary osmotic pressure in the former were significantly lower than those in the latter [(38.67±7.00) vs (44.05±3.55) g/L, P<0.01; (95.78±37.83) vs (128.72±31.20) ml/min, P<0.01; (678.72±91.76) vs (840.69±133.88) mmol/L, P<0.01]. (4) The mean glomerular diameters of both OB-FSGS group and OB-GM group were increased, whose difference was not significant [(204.3±23.1) vs (205.3±14.3) μm, P>0.05]. Conclusion There are significant differences in the mean course of disease, 24-h urinary protein excretion, serum albumin level and renal function between these two different kinds of ORG.
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Objective To investigate whether low-protein diet has protective effect on the progression of renal interstitial fibrosis in rats with cyclosporine A (CsA)-induced nephropathy. Methods Eighteen male Sprague-Dawley rats were randomly divided into three groups (6 rats in each group). The rats in control group (C group) received common diet; in model group (M group) low-salt diet; in intervention group (Ⅰ group) low-salt and low-protein diet. After diet adaptation period of one week, the rats in C group received subcutaneous injection of olive oil 1 mg/kg daily for 5 weeks, while M group and Ⅰ group subcutaneous injection of CsA (diluted into 25 g/L with olive oil) 1 ml/kg for 5 weeks. All the rats were sacrificed at the end of the 5th week. The food-intake and body weight were measured daily. The creatinine clearance (Ccr) was examined before rats were sacrificed. The semi-quantitative pathological analysis on kidney sections was performed. The mRNA and protein expression of transforming growth factor-β1 (TGF-βI) and type Ⅰ collagen (Col Ⅰ) in kidney tissue was determined with real time PCR and immunohistochemical staining, respectively. Results The food-intake and body weight of rats in M and I groups were significantly lower than those in C group (P<0.05). Compared with C group, the Ccr levels in M and Ⅰ groups were significantly reduced [(0.65±0.15) ml/min, (0.40+0.13) ml/min vs (1.55±0.29) ml/min, P<0.05], the relative fibrosis areas of kidney interstitium in M and I groups were significantly increased (3.60%±0.46%, 3.26%±0.75% vs 0.44%±0.24%, P<0.05), the mRNA and protein expression of TGF-β1 in M and I group was significantly up-regulated (by 2.6 and 3.1 times in mRNA and by 1.5 and 1.6 times in protein, respectively, P<0.05), and the mRNA and protein expression of Col Ⅰ in M and I groups was also significantly up-regulated (by 3.0 and 3.5 times in mRNA and by 2.3 and 2.1 times in protein, respectively, P<0.05). There were no significant differences between M and I groups in every parameters above-mentioned except the rat body weight and Ccr. Both the body weight and Ccr in Ⅰ group were significantly lower than those in M group (P<0.05). Compared with C group, the urine osmotic pressure in M group and in I group were deceased (for M group, P>0.05; for I group, P<0.05). Compared with C group, the serum cholesterol levels in M and I groups were significantly increased (P<0.05), and the serum phosphorus level in I group was significantly decreased (P<0.05). The levels of serum albumin and serum calcium of all three groups had no statistical differences (P>0.05). Conclusion Low-protein diet has no renoprutective effects on the rat model of cyclosporin A nephropathy, on the contrary, may induce body weight loss.
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Objective To study the pathogenesis of anemia in chronic aristolochic acid nephmpathy(CAAN) rats. Methods The hemoglobin(Hb)values of sixty-two male SD rats were assayed to determine its normal range.Among them,24 rats with normal Hb value were randomly divided into 2 groups:model group (MG)in which rats received the extract of Aristololochia manshuriensis Kom (AmK) by gavage,and control group (CG) received tap water only by gavage.Body weisht(BW),Hb,24 h urinary protein excretion(UP)and creatinine clearance (Ccr)of 6 rats in each group were measured before administration and at the end of the 8th week, respeetively.then these rats were sacrificed.The relative area of renal interstitial fibrosis was measured by microscopy.The mRNA expression of erythropoietin (EPO)in kidney tissue Was determined by real-time RT-PCR;protein expression of type I collagen(Coll),aminopeptidase P (APP),hypoxia indHeible factor let and 2α(HIF-1α and HIF-2α)in kidney tissue Was examined by immunohistochemistry staining. Results Hb values of normal rats presented normal distribution. The normal Hb was (155.9±16.5) g/L. Rat anemia was diagnosed when Hb was below 123.6 g/L. There was no difference in all the examination results between CG and MG before administration (P>0.05). Compared with CG, the Hb and Cer in MG were significantly decreased [(121.66±15.68) g/L vs (169.00±12.89) g/L, (0.63±0.13) ml/min vs (1.27±0.18) ml/min, P< 0.01], and the UP in MG was significantly increased at the end of the 8th week [(27.04±9.40) mg/d vs (6.11±0.84) mg/d, P<0.01]; the relative areas of fibrosis and Col l in renal interstitium of MG were significantly enlarged [(12.89±2.33)% vs (0.55±0.10)%, (13.92±2.92)% vs (1.32±0.84)%, P<0.01]; the protein expression of APP and the mRNA expression of EPO in the kidney tissue of MG were significantly down-regulated [(0.55±0.23)% vs (3.77±1.06)%, 0.005±0.001 vs 0.032±0.013, P<0.01]; the protein expression of HIF-lα and HIF-2α in the kidney tissue of MG was significantly up-regulated (2.55±0.16 vs 1.12±0.46, 2.33±0.33 vs 1.15±0.27, P<0.01), at the end of the 8th week. Conclusions The pathogenesis of anemia in CAAN may be due to the decreased production of EPO caused by the destruction of peritubular capillary. The compensatory up-regulation of HIF-lα and HIF-2α expression can not prevent the anemia development.
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Objective To introduce a case of varicella.zoster virus(VZV)-related glomerulonephritis and encephalitis. Methods The clinical data and renal pathology were analyzed.Associated literatures were reviewed. Results A 15 years old male patient presented nephritic syndrome,nephrotic syndrome and renal dysfunction with reduced serum complement C3 level from the 5th day after he suffered from varicella.The pathological diagnosis of his kidney tissue was endocapillary proliferative glomerulonephritis with podocyte proliferation and severe renal tubular injury by light microscopy.Immunofluorescent and electron microscopic examinations showed "full-house"staining and granular electron-dense deposits in multiple sites.respectively. Furthermore.virus-like particles or/and inclusions could also be seen by electron microscopy and Mann staining light microscopy.Positive varicella-zoster virus (VZV) specific lgM antibody was detected by serum virological test.VZV antigen and RNA transcript were found in glomerular and tubular cells by immunohistochemical staining and in situ hybridization of renal tissues,respectively. The patient had epileptic episodes for many times in his disease course and his brain MRI and electroencephalogram findings accorded with viml encephalitis with secondary epilepsy.So,the diagnosis of VZV-related glomerulonephritis and encephalitis was established. Conclusion This is the first report of VZV-related glomerulonephritis and encephalitis confirmed by serum virology and tissue virology.
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<p><b>OBJECTIVE</b>To study the protective effects of Yishen Ruanjian Power (YRP) on renal interstitial fibrosis in rats with chronic aristolochic acid induced nephropathy (CAAN).</p><p><b>METHODS</b>Eighteen male SD rats were divided into 3 groups, 6 in each group. Water solution of Caulis Aristolochia Manshuriensis (CAM) Liquid Extract were given to the mice in the model group by gastrogavage to make CAAN animal model. For those in the TCM group, decocted water solution of YRP was given by gastrogavage after the mice being modeled with the above-mentioned method. Tap water was given by gastrogavage to the mice in the control group. Body weight, 24-hr urinary protein excretion and beta2 microglobulin (beta2-MG), and serum creatinine (r) were determined at the end of the 1st, 4th, 8th, 12th and 16th week. At the end of the 16th week, the rats were sacrificed and the pathological figure of their kidneys were observed by Masson staining. Transforming growth factor-beta1 (TGF-beta1), connective tissue growth factor (CTGF), plasminogen activator inhibitor-1 (PAI-1), tissue inhibitor of metalloproteinase-1 (TIMP-1) and type I collagen (Col I ) in kidney tissue were determined by RT-PCR and immunohistochemical method, respectively.</p><p><b>RESULTS</b>At end of the 1st week, urinary protein excretion, urinary beta2-MG and SCr in the model group were significantly increased to the levels higher than those in the control group (P < 0.01 or 0.05). Relative area of interstitial fibrosis was significantly enlarged in the model group at the end of the 16th week (P<0.01), and at the same time, the mRNA and protein expression of TCF-beta1, CTGF, PAI-1, TIMP-1 and Col I in kidney tissue were significant up-regulated (P<0.01). After intervention with YRP, the above-mentioned up-regulated parameters, except 24-hr urinary protein excretion, were all significantly inhibited (P <0.01 or 0.05).</p><p><b>CONCLUSION</b>YRP could inhibit the accumulation of extracellular matrix in renal interstitial tissue, so as to alleviate the renal interstitial fibrosis and improve the renal function.</p>
Assuntos
Animais , Masculino , Ratos , Ácidos Aristolóquicos , Creatinina , Sangue , Medicamentos de Ervas Chinesas , Usos Terapêuticos , Fibrose , Nefropatias , Tratamento Farmacológico , Patologia , Fitoterapia , Pós , Ratos Sprague-Dawley , Microglobulina beta-2 , SangueRESUMO
Objective To explore the potential relationship between the mast cells (MCs) in renal interstitium and the renal interstitial fibrosis in lupus nephritis (LN). Methods Renal biopsy specimens from patients with types Ⅲ,Ⅳand Vof LN (n=10, respectively), and with minimal change diseases (n=11,as control) were evaluated. Immunohistochemistry staining and immunofluorescence double-staining were used to detect the amount of MCs, the expression of proteinase-activated receptor-2 (PAR-2), transforming growth factor-?1 (TGF-?1) and collagen type I (Col I ) in the renal tissues. Results The amount of MCs in renal interstitium, the positive areas of PAR-2 and TGF-?1 in the renal tubular epithelial cells (RTECs), the amount of PAR-2-positive cells and TGF-?1-positive cells in renal interstitium, and the positive areas of Col I in the renal inter stitium were all higher in three LN groups compared with those in control. Furthermore, among the three LN groups, the above-mentioned parameters were the highest in type Ⅳ and second in type Ⅲ.There were significant positive correlations between the amount of MCs in renal interstitium and the positive areas of PAR-2, TGF-?1 in RTECs as well as the positive areas of Col I in renal interstitium (r=0.513, 0.508, 0.611, respectively, P
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Objective To explore the potential relationship between tryplase-positive mast cells (MCs) infiltration and renal interstitial fibrosis in acute interstitial nephritis (AIN) and chronic interstitial nephritis (CIN). Methods Renal biopsy specimens from patients with AIN (n=11) and CIN (n=16) were studied and 11 patients in minimal change diseases (MM)were as controls. Histochemistry and immunohistochemistry staining assay were applied to delect the expression of tryptase, proteinase-activated receptor-2 (PAR-2), TGF-?1 and collagen type I (Col I )in the renal tissues. Immunofluo-rescence double-staining assay was used to assess the relationship among MCs, PAR-2-positive cells, and TGF-?1-positive cells in the renal interstitium respectively. Results MCs in AIN and CIN were significantly increased compared with those in controls and were mainly scattered in the fibrotic areas of renal interstitium. The relative immunostaining areas for PAR-2, TGF-?1 in the renal tubular epithelial cells (RTECs) and Col I were significantly larger in AIN and CIN than those in controls respectively (P
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Objective To establish a model of chronic aristolochic acid nephropathy (CAAN) in rats and to investigate the pathogenesis of its renal interstitial fibrosis.Methods Male Sprague-Dawley rats were randomly divided into two groups. One group received extract of Aristolochia manshuriensis Kom by gavage intermittently as model group. Another group received only tap water by gavage as controls. Six rats in each group were sacrificed at the end of 4th, 8th and 12th week respectively and the kidneys of each rat were separately harvested. The mRNA and protein expression of type I collagen (Col I ), transforming growth factor-?1 (TGF-?1), connective tissue growth factor (CTGF), plasminogen activator inhibitor-1 (PAI-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) was detected by real-time quantitative RT-PCR and immunohistochemical staining respectively. Results The mRNA expression of Col I, TGF-?1, CTGF, PAI-1 and TIMP-1 in kidney tissue of the rats in model group was significantly upregulated compared to that in controls at the end of 4th week (9.31-, 5.16-, 1.79-, 8.66- and 2.54-fold, respectively) (P