Value of immunohistochemical expression of podocalyxin in active lupus nephritis / Valor de la expresión inmunohistoquímica de la podocalixina en la nefritis lúpica activa

Podocalyxin is an electronegative sialoglycoprotein that prevents the podocyte foot process from collapsing. The aim of this study was to detect an association between the glomerular immunohistochemical (IHC) expression of podocalyxin and the degree of podocyte effacement detected by electron microscopy, and to evaluate the role of podocalyxin IHC expression as a novel marker for disease activity in lupus nephritis (LN). Methods: Thirty-two renal biopsies of active lupus nephritis patients were studied. Clinical assessment by the systemic lupus activity measure (SLAM-R) score and laboratory data were included [serum creatinine, 24-h urinary protein, antinuclear antibodies (ANA), anti-double-strand DNA antibodies (anti-dsDNA), C3 and C4]. Light (L/M) and electron microscopic (E/M) examination was conducted. Podocyte loss was evaluated by immunohistochemistry with monoclonal anti-podocalyxin antibodies by means of a semiquantitative score that was graded from 0 to 4+ according to the percentage of glomerular involvement. Results: 22 cases (68.8%) with LN class IV, 6 (18.8%) with class III and 4 (12.5%) with class V. The mean age was (25.41±10.13) years. There was a significant negative correlation between IHC podocalyxin score and LN class, and NIH activity parameters such as leukocyte infiltration, endocapillary proliferation, fibrinoid necrosis and cellular crescent and disease activity index but not chronicity index. There was a highly significant negative correlation between IHC podocalyxin and podocyte effacement by E/M (rs=−0.903, P=0.000), and E/M immune deposits (r=−0.53, P=0.001), and a significant association with degree of proteinuria, ANA and SLAM score (P<0.05). Conclusions: Podocyte loss indicated by podocalyxin immunohistochemical expression reflects the degree of activity and severity of LN and the degree of podocyte effacement by E/M (AU)

La podocalixina es una sialoglicoproteína electronegativa que evita el colapso del proceso podocitario. Nuestro objetivo fue detectar una asociación entre la expresión inmunohistoquímica (IHQ) glomerular de la podocalixina y el grado de borramiento podocitario detectado mediante microscopia electrónica, además de evaluar la función de la expresión IHQ de la podocalixina como un nuevo marcador de la actividad de la enfermedad en la nefritis lúpica (NL). Métodos: Se evaluaron 32 biopsias renales de pacientes con NL activa. Se incluyeron la evaluación clínica mediante la puntuación de la determinación de la actividad del lupus sistémico (systemic lupus activity measure, SLAM-R) y datos analíticos (creatinina sérica, proteína en la orina de 24h, anticuerpos antinucleares [AAN], anticuerpos anti-ADN de doble cadena [anti-ADNdc], C3 y C4). Evaluación mediante microscopio de luz (M/L) y microscopio electrónico (M/E). La evaluación de la pérdida podocitaria se realizó mediante inmunohistoquímica con anticuerpos antipodocalixina monoclonales, por medio de una puntuación semicuantitativa que se clasificó de 0 a 4+ en función del porcentaje de afectación glomerular. Resultados: Encontramos 22 (68,8%) casos con clase IV de NL, 6 (18,8%) con clase III y 4 (12,5%) con clase V. La media de edad fue de 25,41±10,13 años. Se observó una asociación negativa significativa entre la puntuación de la podocalixina en la IHQ con la clase de NL y los parámetros de actividad del NIH, como la infiltración leucocitaria, la proliferación endocapilar, la necrosis fibrinoide y los drepanocitos y el índice de actividad de la enfermedad, pero no el índice de cronicidad. Se observó una correlación negativa muy significativa entre la podocalixina en la IHQ y el borramiento podocitario mediante M/E (rs=−0,903; p=0,000), depósitos inmunes mediante M/E (r=−0,53; p=0,001) y una asociación significativa con el grado de proteinuria, AAN y puntuación en el índice SLAM (p<0,05). Conclusiones: La pérdida podocitaria indicada mediante la expresión IQH de la podocalixina refleja el grado de actividad y la intensidad de la NL, así como el grado de borramiento podocitario mediante M/E (AU)

Nucleated cells response to protein electroinsertion.

Application of an electrical pulse field at a strength slightly below the value required for electroporation to a suspension of red blood cells in the presence of membrane xenoproteins leads to the insertion of those proteins in the erythrocyte plasma membrane. This observation is extended to nucleated cells. In the presence of glycophorin A, application of such pulses leads to the insertion of 10(4)-10(5) molecules of glycophorin A per cell in CEM-CM3, Hela S3, and bovine CD8+ T cells. Electroinserted glycophorin A is detected by flow cytometry using anti-glycophorin monoclonal antibodies. The survival of the cells subjected to electroinsertion was 55% for CEM-CM3 cells, 69% for Hela S3 cells, and 65% for CD8+ T cells. Cells cultured after electroinsertion lost the electroinserted glycophorin A, with two different rates, by a temperature and cell type-dependent mechanism. During the first 2 h after electroinsertion, the CD8+ T cells lost 12.5% of the inserted glycophorin A per h, the CEM-CM3 cells lost 7.7% per h, whereas the Hela S3 cells lost only 0.8% of the inserted protein per h. After 2 h, the rate increased substantially, to 41.7% per h for the CD8+ T cells, 13.5% for the CEM-CM3 cells, and 8.9% for the Hela S3 cells. Cytochalasin D efficiently inhibited the disappearance of electroinserted glycophorin A during the first 2 h after electroinsertion only.