Complement deposition in renal histopathology of patients with ANCA-associated pauci-immune glomerulonephritis
Complement deposition in renal histopathology of patients with ANCA-associated pauci-immune glomerulonephritis
复制标题
DOI：
10.1093/ndt/gfn586
复制
发表时间：
2009-04-01
影响因子：
6.1
通讯作者：
Zhao, Ming-Hui
中科院分区：
文献类型：
--
作者：
Chen, Min;Xing, Guang-Qun;Zhao, Ming-Hui
背景。 ANCA 相关的寡免疫性肾小球肾炎的发病机制尚未完全阐明。一些研究表明补体沉积可以在肾脏组织病理学中检测到。本研究探讨了 ANCA 相关寡免疫性肾小球肾炎患者肾脏组织病理学中补体沉积的临床和病理意义。方法。使用直接免疫荧光、光学和电子显微镜对 112 名 ANCA 相关寡免疫性肾小球肾炎患者的肾活检标本进行了研究。对于直接免疫荧光，通常在肾活检后立即对新鲜冷冻肾组织进行 IgG、IgA、IgM、C3c 和 C1q 染色。补体沉积定义为 C3c 或 C1q 的存在，在 0-4+ 等级中至少为 1+。比较有和没有补体沉积的患者之间的临床和组织病理学数据。结果。在直接免疫荧光显微镜下，分别有37/112（33.0％）和7/112（6.3％）患者的标本中的肾小球毛细血管壁和/或系膜中检测到C3c和C1q。与无C3c沉积的患者相比，有C3c沉积的患者尿蛋白水平较高（P < 0.01），初始肾功能较差（P < 0.05）。结论。补体沉积在人类 ANCA 相关寡免疫性肾小球肾炎的肾脏组织病理学中并不罕见，这与更严重的肾损伤相关。
Background. The pathogenesis of ANCA-associated pauci-immune glomerulonephritis has not been fully elucidated. Several studies had suggested that complement deposition could be detected in renal histopathology. The current study investigated the clinical and pathological significance of complement deposition in renal histopathology of patients with ANCA-associated pauci-immune glomerulonephritis.Methods. Renal biopsy specimens from 112 patients with ANCA-associated pauci-immune glomerulonephritis were investigated using direct immunofluorescence, light and electron microscopy. For direct immunofluorescence, IgG, IgA, IgM, C3c and C1q staining on fresh frozen renal tissue were routinely performed immediately after a renal biopsy. Complement deposition was defined as the presence of C3c or C1q for at least 1+ in a 0-4+ scale. Clinical and histopathological data between patients with and without complement deposition were compared.Results. In direct immunofluorescence microscopy, C3c and C1q could be detected in glomerular capillary wall and/or mesangium in the specimens of 37/112 (33.0%), 7/112 (6.3%) patients, respectively. Compared with patients without C3c deposition, patients with C3c deposition had a higher level of urinary protein (P < 0.01) and poorer initial renal function (P < 0.05).Conclusion. Complement deposition was not rare in renal histopathology of human ANCA-associated pauci-immune glomerulonephritis, which was associated with more severe renal injury.