Clinical-pathologic significance of CD163 positive macrophage in IgA nephropathy patients with crescents.
Clinical-pathologic significance of CD163 positive macrophage in IgA nephropathy patients with crescents.
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发表时间：
2015-06
影响因子：
0.1
通讯作者：
Jun Li;Chang-hua Liu;Bo Gao;Daoling Xu
中科院分区：
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作者：
Jun Li;Chang-hua Liu;Bo Gao;Daoling Xu
背景CD163是M2巨噬细胞的标志物，表达抗炎特性。本研究旨在探讨伊加肾病伴新月体与不伴新月体患者CD163阳性巨噬细胞表达的差异。方法收集24例IgAN患者的肾组织，包括伴新月体IgAN（n = 10）、不伴新月体IgAN（n = 14）、微小病变组（MCD，n = 8）和正常对照组（阴性对照组，n = 3）。免疫组化和免疫荧光法检测肾组织中CD 163和CD 68的表达。结果与无新月体的IgAN相比，新月体的IgAN患者血清白蛋白降低，肾功能差。CD 163主要表达于急性肾小管间质病变。CD163阳性细胞聚集在肾小管周围的红细胞管型区域。肾小管内可见CD163阳性细胞。CD163阳性细胞可见于肾小球病变，包括毛细血管内细胞增多、细胞新月体和纤维细胞新月体。IgA肾病伴新月体者肾小管间质及肾小球病变中CD163阳性细胞增多。肾小管间质CD163阳性细胞数与新月体百分率、蛋白尿呈正相关，与血清白蛋白、eGFR呈负相关。肾小球CD 163阳性细胞数与新月体百分比呈正相关，与eGFR呈负相关。新月体百分比与血清白蛋白、eGFR呈负相关，与蛋白尿呈正相关。双重染色显示CD163阳性细胞也表达CD68。结论CD 163阳性巨噬细胞参与了IgA肾病伴新月体的活动性新月体病、急性肾小管损伤和肾小球病变。
BACKGROUND CD163, a marker of M2 macrophages, express anti-inflammatory properties. This study aims to investigate the difference of CD163 positive macrophages expression between IgA nephropathy patients with and without crescents. METHODS Renal tissues from IgAN patients (n = 24), including IgAN with crescents (n = 10), IgAN without crescents (n = 14), minimal change disease (MCD, as disease control, n = 8) and normal control kidneys (negative control, n = 3), were included in this study. Expressions of CD163 and CD68 in renal tissues were detected by immunohistochemistry or immunofluorescence. RESULTS Compared with IgAN without crescent, IgAN patients with crescents have lower serum albumin and poor renal function. CD163 was mainly expressed in acute tubulointerstitial lesions. CD163 positive cells accumulate in areas around tubules with RBC casts. CD163 positive cells can also be seen in tubular lumen. CD163 positive cells can be seen in glomerular lesions, including endocapillary hypercellularity, cellular crescent and fibrous-cellular crescent. There were more CD163 positive cells in tubulointerstitial and glomerular lesions in IgAN patients with crescents. CD163 positive cells number in tubulointerstitial tissue was positive correlated with percentage of crescents, proteinuria, and negative correlated with serum albumin, eGFR. CD163 positive cells number in glomeruli was positive correlated with percentage of crescents, and was negative correlated with eGFR. Percentage of crescents was negative correlated with serum albumin, eGFR, and positive correlated with proteinuria. Dual staining showed that CD163 positive cells also expressed CD68. CONCLUSIONS CD163 positive macrophages were involved in active crescent disease, acute tubular injury and glomerular lesions of IgAN with crescents.