The Proliferation-associated Antigen Ki-67 is a Useful Marker for Evaluating Disease Activity in Human IgA Nephropathy
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Abstract:
We used immunohistochemistry to study glomerular expression of the proliferation-associated antigen Ki-67 and α-smooth muscle actin (αSMA) in kidney biopsies from IgA nephropathy (IgAN), a type of proliferative glomerulonephritis. The non-proliferative glomerular disease, diabetic glomerulosclerosis (DGS) and idiopathic membranous nephropathy (MN) were also examined. Quantitative evaluation of the immunostaining results showed a significant increase in the number of Ki-67-positive (Ki-67+) cells in IgAN as compared to both DGS and MN, while glomerular αSMA expression was significantly higher in DGS and IgAN compared to MN. There was a significantly positive correlation between the number of Ki-67+ cells and αSMA expression in the glomerulus in IgAN ; however, there was no correlation between the expression of these factors in DGS or MN. Furthermore, in IgAN, the number of Ki-67+ cells in the glomerulus was significantly correlated to both urinary protein excretion and serum creatinine levels, but there was no relationship between the glomerular expression of αSMA and these clinical features. In addition, neither DGS nor MN exhibited a correlation between the number of Ki-67+ cells or αSMA expression and clinical findings. The estimation of urinary protein excretion is one of the most important laboratory measures for human glomerular diseases. Therefore, using Ki-67 expression to evaluate the proliferative activity of mesangial cells in renal biopsies may be useful for evaluation of both disease severity and activity in IgA nephropathy.Keywords:
Mesangial proliferative glomerulonephritis
Glomerulosclerosis
Immunostaining
Membranous Nephropathy
Immunostaining
Immunoglobulin A
Mesangial proliferative glomerulonephritis
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The combination of antigens with antibodies to form immune complexes and their localization within the glomerulus have aided the study of immune mechanisms of tissue damage and provided a cornerstone for the clinical classification and treatment of many glomerular diseases. The concept that the pathogenesis of many common forms of idiopathic glomerulonephritis, such as membranous nephropathy and IgA nephropathy, is related to immune complexes is widely accepted. Since the antigenic component of the immune complex in these diseases remains unknown, they are classified morphologically rather than etiologically. Thus, the subepithelial location of the deposits defines idiopathic membranous nephropathy, whereas the . . .
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Rapidly progressive glomerulonephritis is a group of clinical syndromes, in which renal function of patient progressively deteriorates with pathological manifestation of extensive glomerular crescent formation. Among which, anti-glomerular basement membrane antibody glomerulonephritis is the rarest but the most aggressive subtype. This paper discusses a case of rapidly progressive glomerulonephritis combined with membranous nephropathy. There were posterior reversible encephalopathy syndromes during diagnosis and treatment. Diagnosis was confirmed in time by laboratory examination and renal pathology. Condition of the patient was alleviated through close work between all departments. This allowed us to further understand the case characteristics of rapidly progressive glomerulonephritis combined with membranous nephropathy, importance of effective prevention, and significance of various complications during treatment, so as to alleviate pain and improve prognosis in patient.
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