- 作者：Cristina Gluhovschi ; Gheorghe Gluhovschi ; Elena Potencz ; Elena Lazar ; Ligia Petrica ; Gheorghe Bozdog ; Florica Gadalean ; Flaviu Bob ; Daniel Cioca ; Silvia Velciov
- 刊名：Human Immunology
- 出版年：2012
- 出版时间：November, 2012
- 年：2012
- 卷：73
- 期：11
- 页码：1098-1101
- 全文大小：1027 K
Introduction and Aims
The HLA-DR antigen is a HLA class II molecule involved in the presentation of antigenic peptides to the T cell receptor, thus regulating the immune response. Renal expression of the HLA-DR antigen may indicate specific sites of immunologically-mediated kidney injury in glomerulonephritis (GN). The aim of our study was to assess the presence of the HLA-DR antigen along the nephron including the extraglomerular mesangium in GN.Methods
A cross-sectional study of 22 patients with glomerulonephritis, mean age: 46.59 ¡À 10.77 years, 14 male and 8 female, was conducted. Conventional stains, as well as immunohistochemistry for the HLA-DR Antigen Alpha-Chain were employed on kidney biopsies. Immunohistochemistry was assessed using a semi-quantitative score: 0-absent, 1-mild, 2-moderate, 3-intense. Statistical analysis was performed using SPSS17.
Results
Four patients presented Focal and Segmental Glomerulosclerosis (FSGS), 5 patients: membranoproliferative GN, 7 patients: membranous nephropathy, 3 patients: mesangial proliferative GN, 2 patients: minimal change disease (MCD), and 1 patient: crescentic GN. Regarding the percentage of cases with HLA-DR positive cells along the nephron out of 22 patients: glomerular endothelial cells were 100 % positive, intraglomerular mesangium cells were 81.8 % positive, podocytes were 36.4 % positive, extraglomerular mesangium cells were 31.8 % positive, proximal tubule cells were 95.5 % positive, distal tubule cells were 68.2 % positive, interstitial capillaries were 77.3 % positive, and cells of interstitial infiltrates were 27.3 % positive. The percentage of cases staining positively for the HLA-DR antigen in the extraglomerular mesangium was 25 % in FSGS, 60 % in membranoproliferative GN, 0 % in membranous nephropathy, 33.3 % in mesangial proliferative GN, 100 % in minimal change disease and 0 % in crescentic GN.
Conclusions
A prominent HLA-DR antigen distribution was found on glomerular endothelial cells, intraglomerular mesangium cells and proximal and distal tubular cells. Extraglomerular mesangium cells and podocytes stained variably for the HLA-DR antigen, as did the cells of the interstitial infiltrates. The extraglomerular mesangium which serves as a portal of entry into the intraglomerular mesangium is endowed with antigen-presenting capabilities and is a region where induction of immune reactions could take place.