The Expression of Apoptosis in Lupus Nephritis / 대한내과학회지

ABSTRACT

BACKGROUND: A few researches on apoptosis in proliferative glomerulonephritis including lupus nephritis, have been reported on the basis of animal experimental models and human renal biopsy tissues. Systemic lupus erythematosus has been reported as a disease with an apoptosis defect of lymphocyte, so that it leads to the decreased immunologic tolerance and activated autoimmunity. The lupus nephritis is frequently accompanied with a interstitial fibrosis and tubuloepithelial change, as compared to other nephitis. In addition to that, the pathologic evolution from one class to other class is also feasible and these things make us to think that the lupus nephritis is tightly linked to the apoptosis. METHOD: We evaluated the relationship between the apoptosis and pathologic characteristics, which was focused on class IV, in 22 patients with clinically and biopsy proven lupus nephritis by comparing with control specimens. The study on the apoptosis was observed through in situ DNA nick end-labeling method and the review on the medical history. RESULTS: 1) An apoptosis in glomerulus was observed in only five patients (zero in Class II, 50% in Class IV) of proliferative glomerulonephritis. But 14 patients (50% in Class II, 75% in Class IV) were detected on the site of tubulo-interstitium. 2) The apoptosis detected in tubulo-interstitial area was significantly correlated with nephrotic syndrome (P<0.025), but correlations with the complement serum level, renal function and the used amount of steroid was not determined. CONCLUSION: The apoptosis of glomerulus in the lupus nephritis was observed in 50% of proliferative cases (especially, in class IV), but in the area of tubulointerstitium, the higher rate (more than 50%) of apoptotic expressions were observed in class II and class IV. The observation on apoptosis in renal tissue could be another prognostic factor.