Increased excretion of urinary podocytes in lupus nephritis.

Podocytes are highly specialized epithelial cells that form part of the filtration barrier in the kidney, and their loss reflects a malfunction in glomerular filtration, which is usually associated with the progression of the disease. Glomerulonephritis is a serious complication that develops in about 50% of the lupus patients and is characterized by proteinuria arising from direct or indirect podocyte injury. To assess the possible role of podocytes in the pathogenesis of lupus nephritis (LN). Urinary and glomerular podocytes were detected in the kidney biopsies of patients (n = 17) with lupus nephritis, and from control biopsies obtained during autopsies. The WT-1 protein was used as a podocyte marker. The cumulative excretion of urinary podocytes was detected in the urinary sediments of LN patients and normal healthy controls, and the specimens were analyzed by immunohistochemistry, immunofluorescence, and enzyme-linked immunosorbent assay. The apoptotic index was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling. Gross proteinuria in lupus patients was determined via 24-hour urine samples, and the results were analyzed by Student t test. Biopsy specimens from 17 patients with class-III or IV LN had lower levels of glomerular WT-1 expression than the levels found in normal kidneys (P < 0.0001). The reduction of glomerular podocytes in patients with lupus nephritis correlated with the cumulative excretion of urinary podocytes (P < 0.0001) and proteinuria. There was no correlation between the urinary podocytes and the apoptotic index in the LN urinary sediments. A decrease in glomerular podocytes is associated with their cumulative excretion in urinary sediments; therefore, such findings correlate with proteinuria in lupus nephritis patients.

Caspase 3 blocking avoids the expression of autoantigens triggered by apoptosis in neonatal Balb/c mice skin.

OBJECTIVE: To assess the effect of caspase 3 inhibition, in the expression of intracellular antigens induced by apoptosis. MATERIAL AND METHODS: Skin explants of neonatal Balb/c mice were used to assess the autoantigen expression. Skin was obtained by punch biopsies, tissues were cultured in DMEM; cell death was induced by chemicals and assessed by TUNEL. The expression of La, Ro, Sm, RNP, Cajal Bodies and NuMa antigens were monitored by immunohistochemistry using autoantibodies or monoclonal antibodies against these antigens. RESULTS: Chemicals used to induce cell death, successfully produced apoptosis or necrosis in more than 60% of keratinocytes, and viability was significantly decreased when it was compared with those in controls. An increased expression of all skin intracellular antigens in skin biopsies treated with chemicals, major antigenic expression was detected with anti-La and anti-Ro antibodies. The caspase 3 inhibitor DEVD-CMK significantly decreased the expression of antigens induced by chemicals. CONCLUSION: By this result we can infer that caspase inhibitors modify apoptosis and decrease the autoantigens associated to cell death.

The final destiny of acantholytic cells in pemphigus is Fas mediated.

BACKGROUND: Pemphigus is an autoimmune disease characterized by the formation of intra-epidermal blisters. Patients develop auto-antibodies against desmoglein 1 and 3 proteins and induce acantholysis. OBJECTIVE: This work addresses the issue of whether the Fas pathway mediates acantholysis. Furthermore, the possible suppliers of the Fas pathway were investigated. METHODS: Seventeen biopsies of pemphigus patients were studied by haematoxylin and eosin staining, and apoptosis was defined by TUNEL. The expression of Fas, FasL and caspase 3 was studied by in situ hybridization and immunohistochemistry. Cell infiltrates were studied by immunofluorescence with monoclonal anti-CD3, CD4, CD8, CD19 and CD69. RESULTS: All of the biopsies showed intra-epidermal blisters, acantholytic cells and inflammatory infiltrates. The blisters expressed Fas, FasL and caspase 3. Cell infiltrates were composed of CD8 and a few CD4(+)CD69(+) cells. Additionally, CD19(+) cells were detected. Interestingly, the Fas expression was increased in acantholytic cells and perilesional keratinocytes. Incidentally, these cells exhibited apoptotic features. Interestingly, the CD8 cells expressed FasL. CONCLUSION: This paper presents the morphological evidence that apoptosis and acantholysis are linked. Therefore, the Fas pathway is associated with CD8 cells in pemphigus lesions.

Widespread expression of inducible NOS and citrulline in lupus nephritis tissues.

OBJECTIVE: Examine the presence of functional inducible nitric oxide synthase (iNOS) in lupus nephritis lesions. METHODS: Seventeen kidney biopsies from patients with lupus nephritis and an equal number of normal control kidney biopsies were examined for the presence of iNOS and endothelial nitric oxide synthase (eNOS) and citrulline by using immunohistochemical methods. Additionally, iNOS and eNOS mRNAs were examined by reverse transcription -PCR amplification of total renal RNA. RESULTS: All biopsies expressed constitutive eNOS, but in contrast to normal kidney biopsies, 70% of the lupus biopsies also expressed iNOS mRNA and the cognate protein. Eight positive biopsies corresponded to class IV lupus nephritis, which also had a high degree of citrullination. CONCLUSIONS: The data indicate that functional iNOS activity is present in glomeruli as part of the inflammatory process in the kidney; therefore the products of iNOS could play a role in the pathogenesis of lupus nephritis.

Fas ligand and Bax gene transcription contributes to Ro60 ribonucleoprotein redistribution in UV-A irradiated human keratinocytes.

OBJECTIVES: Ro ribonucleoproteins are of particular interest because they are serologic markers of photosensitive variants of lupus such as the subacute cutaneous lupus erythematosus (SCLE), in which the polycyclic skin lesions are triggered by exposure to the sun. We study the role of apoptosis in the expression of Ro antigen. METHODS: We used UV-A irradiated keratinocytes. RESULTS: We demonstrate in cultured human UVA-irradiated keratinocytes that the enhanced expression of Ro60 ribonucleoprotein is caused by antigenic redistribution consecutive to Fas-L and Bax gene activation.