Proliferative gknerulonephritis: the profiles of proliferation and apoptosis / 中华肾脏病杂志

ABSTRACT

Objective Hypercellularity in proliferan've glomerulonephritis can result from either increased proliferation or the failure of cells to undergo apoptosis in response to stimuli. Increasing evidence supports that alterations in the control of cell survival are important in the pathogenesis of proliferative glomerulonephritis. Methods Apoptotic cells in the glomeruli have been analyzed by the in situ end labeling (ISEL) of TdT from patients diagnosed with membranoproliferative glomerulonephritis (MPGN, n = 12), type IV lupus nephritis (LN, n = 15) and acute postinfectious glomerulonephritis (APGN, n = 13) in the present study. In addition, the proliferating cell nuclear antigen (PCNA)-positive proliferating glomerular cells were observed by immunochemical 4 layer PAP method in these patients. Results The ratio of proliferating and apoptotic cells was the highest one in patients with MPGN (3.91) as compared to APGN (1.28) and LN(1 .02). The extends of increasing apoptotic cells in the glomeruli were different among patients with MPGN,, APGN and LN, although all of them showed extremely glomerular hypercellularity. The number of apoptotic glomemlar cells was significantly higher in patients with APGN (1.16?0.35) than those with MPGN (0.12?0.16) as well as LN patients (0.35 ? 0.20). Conclusion Apoptosis is essential in the resolution of glomerular cellularity together with the remodeling processes. Intense proliferations without increment in apoptosis are the characterisitics of MPGN and LN associated with their renal histological changes and prognosis.