Immunohistological localization of apolipoproteins in the glomeruli in renal disease: specifically apoB and apoE.

: Recently it has become clear that abnormalities of the lipid metabolism may play a large role in the progression of renal diseases. To investigate the relationship between lipids and kidney tissues, the authors employed an immunofluorescent technique to determine the presence of apolipoprotein (apo) B and E in kidney tissue, particularly the glomeruli, and analyzed the relationship between their deposition and the clinical and histological findings of a total of 49 patients with persistent proteinuria and/or hematuria (age range: 10 to 62 years). The patients were divided into 4 groups, as follows: both apoB and apoE negative cases (Group 1; 17 cases), apoB alone positive (Group 2; 7 cases), apoE alone positive (Group 3; 10 cases) and both apoB and apoE positive cases (Group 4; 15 cases). Group 2 had more severe proteinuria and a higher level of total cholesterol than Group 1. Group 3 exhibited a higher incidence of glomerular adhesion and interstitial changes than Group 1. Group 4, on the other hand, exhibited more severe mesangial hypercellularity and a higher incidence of glomerular sclerosis and interstitial scarrings than Group 1, a higher incidence of glomerular sclerosis than Group 2, more severe proteinuria, higher serum levels of total cholesterol, and lower serum levels of total protein than Groups 1 and 3 and higher level of uric acid than Group 1. These results suggest that the deposition of apoB and apoE accelerates the progression of mesangial lesions, resulting in greater proteinuria and glomerular sclerosis.