Heme-Oxygenase-1 Is Decreased in Circulating Monocytes and Is Associated With Impaired Phagocytosis and ROS Production in Lupus Nephritis.

Lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus (SLE). Based on studies showing the potential role of heme oxygenase-1 (HO-1), an enzyme that catalyzes the degradation of heme and has anti-inflammatory properties in SLE development, we decided to explore HO-1 in LN. Accordingly, we evaluated HO-1 levels and function in circulating and infiltrating monocytes and neutrophils of LN patients. HO-1 levels were assessed in peripheral monocytes of LN patients and controls by flow cytometry and immunofluorescence microscopy. Phagocytosis and the production of reactive oxygen species (ROS) were evaluated to determine the effect of HO-1 in monocyte function. In addition, renal biopsies with proliferative LN were used to identify HO-1 in infiltrating cells and renal tissue by immunofluorescence and immunohistochemistry. Biopsies of healthy controls (HC) and patients who underwent nephrectomy were included as controls. Circulating pro-inflammatory monocytes and activated neutrophils were increased in LN patients. HO-1 levels were decreased in all subsets of monocytes and in activated neutrophils. LN monocytes showed increased phagocytosis and higher production of ROS than those of HC. When HO-1 was induced, phagocytosis and ROS levels became similar to those of HC. HO-1 was mostly expressed in renal tubular epithelial cells (RTEC). Renal tissue of LN patients showed lower levels of HO-1 than HC, whereas infiltrating immune cells of LN showed lower levels of HO-1 than biopsies of patients who had renal surgery. HO-1 is decreased in circulating monocytes and activated neutrophils of LN patients. HO-1 levels modulate the phagocytosis of LN monocytes and ROS production. HO-1 expression in RTEC might be an attempt of self-protection from inflammation.

Frequency of primary glomerular disease in northeastern China

Most frequently reported Chinese renal biopsy data have originated from southeastern China. The present study analyzed the renal biopsy data from northeastern China. The records of 1550 consecutive native patients who were diagnosed with primary glomerular diseases (PGD) after renal biopsy at our hospital during 2005-2009 were used. These patients were divided into four age groups for stratified analysis: <15, 15-44, 45-59, and ≥60 years old. Among PGD, minimal change disease (MCD) was the most common histologically diagnosed disease (30.7 percent), followed by IgA nephropathy (IgAN), mesangial proliferative glomerulonephritis (MsPGN), membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), focal segmental glomerulosclerosis (FSGS), and endocapillary proliferative glomerulonephritis (EnPGN). MCD was the disease most frequently observed (43.7 percent) in the <15-year-old group. MsPGN was the most common disease in the elderly group (38.1 percent). MsPGN was more prevalent in females (27.8 percent), whereas MCD was more prevalent in males (35.3 percent). Primary glomerular diseases constituted the most commonly encountered group of diseases with a high prevalence of MCD, which predominantly affected males and young adults. The prevalence of MCD was high in northeastern China. Further study is necessary to expand the epidemiologic data available for renal disease in China.

Glomerulopatías en el Paraguay. Reporte del registro de biopsias renales en 1072 casos / Glomerulopathies in Paraguay. Report of registry of renal biopsies in 1072 cases

La biopsia renal es el principal método de diagnóstico de las glomerulopatías. El Registro de biopsias renales es importante para conocer la situación epidemiológica y clínico­patológica de las enfermedades renales de un país y las variaciones geográficas entre los países o continentes. Para conocer la situación actual de las glomerulopatías del Paraguay se ha realizado el presente estudio en 1.365 biopsias renales registradas entre agosto de 1989 a junio de 2005 en el Departamento de Patología del IICS, que es el Centro de Referencia y Registro de Biopsias Renales del país, analizando sus aspectos histológicos, demográficos y las diferencias entre periodos quinquenales de estudio. Del total de casos, 1072 (75.5%) fueron glomerulopatías y, a diferencia de la mayoría de los países, se observó un predominio de glomerulonefritis secundarias (GNS) (57.3%) de las cuales 85.9% fueron nefritis lúpica (NL). En las glomerulonefritis primarias (GNP) la GN proliferativa mesangial (GNPM) y la membranoproliferativa (GNMP) fueron las mas frecuentes (39.8% y 28.2%), mientras que la Nefropatía por IgA (NIgA) y la Enfermedad de cambios mínimos (ECM) fueron raras (1.9% y 1.3%). No se observaron cambios significativos de incremento o disminución de tipos histológicos a través de los periodos de estudio tanto en las GNP como en las GNS. La existencia de este registro de biopsias renales fue la base para la creación del Registro de Glomerulopatías del Paraguay en el año 2004, cuyos datos son necesarios para establecer programas de tratamiento y prevención de las enfermedades glomerulares en nuestro país a fin de disminuir su progresión al estadío terminal.

Renal biopsy is the main diagnostic method of glomerulopathies. The registry of renal biopsies is important to know the epidemiological and clinical and pathological situation of renal diseases of a country and the geographic variations between countries or continents. In order to know the current situation of glomerulopathies in our country, we studied 1,365 renal biopsies registered between August 1989 to June 2005 at the Pathology Department of the IICS, the reference center and the Renal Biopsy Registry of the country, analyzing histological and demographic aspects as well as the differences between five­year periods of study. On the total cases, 1,072 (75.5%) were glomerulopathies while secondary glomerulonephritis (SGN) were more frequent (57.3 %) with 85.9% of lupus nephritis (LN) in contrast to most countries. Among primary glomerulonephritis (PGN), mesangioproliferative GN (MPGN) and membranoproliferative GN (MPGN) were predominant (39.8% and 28.2%) while IgA Nephropathy (IgAN) and Minimal Change Disease (ECM) were rare (1.9% and 1.3%). We did not observe significant changes of increases or decreases of histological types through the study periods in PGN as well as in SGN. The existence of this registry of renal biopsy was the base for the creation of the Paraguayan Registry of Glomerulopathies in 2004, which data are necessary to establish treatment and prevention programs of glomerular diseases in our country in order to decrease their progression to end­stage renal disease.