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The Protective effects of Vitamin E against alterations of rat testis structure induced by deltamethrin; histological, ultrastructure, and biochemical study 维生素 E 对溴氰菊酯引起的大鼠睾丸结构改变的保护作用;组织学、超微结构和生化研究
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-12-10 DOI: 10.1080/01913123.2023.2292563
Ghada Nady Ouais, Sherif A. Kamar, Ali Ahmed Mousa, Mohamed Mostafa Sonbol
Deltamethrin is a widely used synthetic pyrethroid pesticide. It causes reproductive toxicity. Aim of the work: it evaluates the impact of vitamin E in restoration of the testicular integrity of al...
溴氰菊酯是一种广泛使用的合成拟除虫菊酯杀虫剂。它会导致生殖毒性。工作目的:评估维生素 E 对恢复睾丸完整性的影响。
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引用次数: 0
The possible protective role of selenium on the visual cortex of adult albino rat on exposure to potassium dichromate. 硒对重铬酸钾暴露于成年白化病大鼠视觉皮层的可能保护作用。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-11-02 Epub Date: 2023-11-30 DOI: 10.1080/01913123.2023.2259455
Sally S Anwer, Hala Mohamed Hassanin

The visual cortex is very important in mammals for processing of visual information. Exposure to heavy metals such as potassium dichromate poses serious health threat to human beings. The aim of this work is to study the effect of potassium dichromate on the visual cortex of adult albino rat and also to identify the possibility of selenium as protective agent against toxicity of potassium dichromate. A total number of 40 adult albino rats weighting (200-250) gm were used. They divided into four groups: control group, potassium dichromate received group, potassium dichromate and selenium received group and selenium received group. The rats received treatment for 6 weeks. After 6 weeks, they were sacrificed. The present study showed that potassium dichromate causes degeneration of granular neurons in layer IV and pyramidal neurons in layer V. Morphometric results revealed statistically significant decrease in the number of granule and pyramidal cells in potassium dichromate received group as compared with control group. Most of degenerative changes are improved by selenium.

视觉皮层在哺乳动物处理视觉信息方面非常重要。接触重铬酸钾等重金属对人类健康构成严重威胁。本工作的目的是研究重铬酸钾对成年白化大鼠视觉皮层的影响,并确定硒作为重铬酸钾毒性保护剂的可能性。总共使用了40只体重(200-250)克的成年白化大鼠。他们分为四组:对照组、重铬酸钾治疗组、重铬酸钾加硒治疗组和硒治疗组。大鼠接受6 周。6周后处死。本研究表明,重铬酸钾可导致IV层颗粒神经元和V层锥体神经元变性。形态计量学结果显示,与对照组相比,接受重铬酸钾治疗组的颗粒细胞和锥体细胞数量在统计学上显著减少。硒能改善大多数退行性变化。
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引用次数: 0
Adverse neurological effects after exposure to copper, manganese, and mercury mixtures in a Spraque-Dawley rat model: an ultrastructural investigation. Spraque-Dawley大鼠模型暴露于铜、锰和汞混合物后的神经系统不良反应:超微结构研究。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-11-02 Epub Date: 2023-11-30 DOI: 10.1080/01913123.2023.2270580
Maxine Draper, Megan Jean Bester, Mia-Jeanne Van Rooy, Hester Magdalena Oberholzer

Exposure to environmental metal pollutants is linked to oxidative stress and the subsequent development of neurological disease. In this study, the effects of copper, manganese, and mercury, were evaluated at X100 the World Health Organization safety limits for drinking water. Using a Sprague-Dawley rat model, following exposure for 28 days, the effects of these metals on biochemical blood parameters and tissue and cellular structure of the brain were determined. Biochemical analysis revealed no hepatocellular injury with minor changes associated with the hepatobiliary system. Minimal changes were found for renal function and the Na+/K+ ratio was reduced in the copper and manganese (Cu + Mn) and copper, manganese, and mercury (Cu, Mn + Hg) groups that could affect neurological function. Light microscopy of the brain revealed abnormal histopathology of Purkinje cells in the cerebellum and pyramidal cells in the cerebrum as well as tissue damage and fibrosis of the surface blood vessels. Transmission electron microscopy of the cerebral neurons showed microscopic signs of axonal damage, chromatin condensation, the presence of indistinct nucleoli and mitochondrial damage. Together these cellular features suggest the presence and influence of oxidative stress. Exposure to these metals at X100 the safety limits, as part of mixtures, induces changes to neurological tissue that could adversely influence neurological functioning in the central nervous system.

暴露于环境金属污染物与氧化应激和随后的神经疾病发展有关。在这项研究中,铜、锰和汞的影响在世界卫生组织饮用水安全限值X100下进行了评估。使用Sprague-Dawley大鼠模型,暴露28 天,测定了这些金属对血液生化参数以及大脑组织和细胞结构的影响。生化分析显示没有肝细胞损伤和与肝胆系统相关的轻微变化。肾功能变化很小,铜和锰(Cu + Mn)和铜、锰和汞(Cu、Mn + Hg)组可能影响神经功能。大脑光学显微镜显示小脑浦肯野细胞和大脑锥体细胞的组织病理学异常,以及表面血管的组织损伤和纤维化。大脑神经元的透射电子显微镜显示轴突损伤、染色质浓缩、核仁模糊和线粒体损伤的微观迹象。这些细胞特征共同表明氧化应激的存在和影响。作为混合物的一部分,在X100安全极限下暴露于这些金属会导致神经组织发生变化,从而对中枢神经系统的神经功能产生不利影响。
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引用次数: 0
The Sonic hedgehog pathway inhibitor GDC0449 induces autophagic death in human Medulloblastoma Daoy cells. Sonic hedgehog通路抑制剂GDC0449诱导人髓母细胞瘤day细胞自噬死亡。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-11-02 Epub Date: 2023-11-30 DOI: 10.1080/01913123.2023.2270676
Qi Zhang, Wanjing Zou, Longtao He, Cuiping Zhang, Ying Wang

Medulloblastoma (MB) is a frequently occurring malignant brain tumor in children, and many of these tumors are identified by the abnormal activation of the Sonic Hedgehog (SHH) pathway. Although the Shh inhibitor GDC0449 initially shows some effectiveness in certain tumors, they eventually recur due to drug resistance mechanisms, highlighting the need for new treatment options. In this study, we explore whether GDC0449 induces autophagy in the human MB cell lines. To investigate the ultrastructural pathology changes of GDC0449-treated Daoy and D283 cells, we employed Transmission Electron Microscopy (TEM) technology to identify the expression of autophagic vacuoles. Our results indicate that GDC0449 only increases autophagy in Daoy cells by increasing the LC3-II/LC3-I ratio and autophagosome formation.We also analyzed Beclin1, LC3, Bax, and Cleaved-caspase3 protein and mRNA expression levels of autophagic and apoptotic markers using fluorescence confocal microscopy, RT-PCR, and Western blot. We found that cell autophagy and apoptosis increased in a dose-dependent manner with GDC0449 treatment. Additionally, we observed increased mammalian target of rapamycin (mTOR) phosphorylation and decreased protein kinase B (AKT/PKB), Ribosomal Protein S6, eIF4E-binding protein (4EBP1) phosphorylation in GDC0449-treated Daoy cells. It was observed that inhibiting autophagy using Beclin1 siRNA significantly blocked the apoptosis-inducing effects of GDC0449, suggesting that GDC0449 mediates its apoptotic effects by inducing autophagy.Our data suggests that GDC0449 inhibits the growth of human MB Daoy cells by autophagy-mediated apoptosis. The mechanism of GDC0449-induced autophagy in Daoy cells may be related to the inhibition of the PI3K/AKT/mTOR signaling pathway.

髓母细胞瘤(Medulloblastoma, MB)是一种常见于儿童的恶性脑肿瘤,其中许多肿瘤是通过异常激活Sonic Hedgehog (SHH)通路来识别的。尽管Shh抑制剂GDC0449最初在某些肿瘤中显示出一定的有效性,但由于耐药机制,它们最终会复发,这突出了对新治疗方案的需求。在本研究中,我们探讨GDC0449是否诱导人MB细胞系自噬。为了研究gdc0449处理后的day和D283细胞的超微结构病理变化,我们采用透射电镜(TEM)技术检测了自噬空泡的表达。我们的研究结果表明,GDC0449仅通过增加LC3-II/LC3-I比例和自噬体形成来增加day细胞的自噬。我们还使用荧光共聚焦显微镜、RT-PCR和Western blot分析了Beclin1、LC3、Bax和Cleaved-caspase3蛋白和自噬和凋亡标志物的mRNA表达水平。我们发现GDC0449治疗后细胞自噬和凋亡呈剂量依赖性增加。此外,我们观察到在gdc0449处理的day细胞中,哺乳动物雷帕霉素(mTOR)磷酸化靶点增加,蛋白激酶B (AKT/PKB)、核糖体蛋白S6、eif4e结合蛋白(4EBP1)磷酸化降低。我们观察到,使用Beclin1 siRNA抑制自噬可显著阻断GDC0449诱导凋亡的作用,提示GDC0449通过诱导自噬介导其凋亡作用。我们的数据表明,GDC0449通过自噬介导的凋亡抑制人MB day细胞的生长。gdc0449诱导day细胞自噬的机制可能与抑制PI3K/AKT/mTOR信号通路有关。
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引用次数: 0
Involvement of small leucine-rich proteoglycans and telocytes in thin and thick human endometrium: immunohistochemical and ultrastructural examination. 富含亮氨酸的小蛋白多糖和端粒细胞在薄和厚人类子宫内膜中的参与:免疫组织化学和超微结构检查。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-11-02 Epub Date: 2023-11-30 DOI: 10.1080/01913123.2023.2270660
Ozlem Karabay Akgul, Tugba Ekiz-Yilmaz

Thin endometrium, defined as an endometrial thickness of less than 7 mm during the late follicular phase, is a common cause of frequent cancelation of embryo transfers or recurrent implantation failure during assisted reproductive treatment. Small proteoglycans regulate intracellular signaling cascades by bridging other matrix molecules and tissue elements, affecting cell proliferation, adhesion, migration, and cytokine concentration. The aim of the study is to investigate the role of small leucine-rich proteoglycans in the pathogenesis of thin and thick human endometrium and their differences from normal endometrium in terms of fine structure properties. Normal, thin, and thick endometrial samples were collected, and small leucine-rich proteoglycans (SLRPs), decorin, lumican, biglycan, and fibromodulin immunoreactivities were comparatively analyzed immunohistochemically. The data were compared statistically. Moreover, ultrastructural differences among the groups were evaluated by transmission electron microscopy. The immunoreactivities of decorin, lumican, and biglycan were higher in the thin endometrial glandular epithelium and stroma compared to the normal and thick endometrium (p < .001). Fibromodulin immunoreactivity was also higher in the thin endometrial glandular epithelium than in the normal and thick endometrium (p < .001). However, there was no statistical difference in the stroma among the groups. Ultrastructural features were not profoundly different among cases. Telocytes, however, were not seen in the thin endometrium in contrast to normal and thin endometrial tissues. These findings suggest a possible role of changes in proteoglycan levels in the pathogenesis of thin endometrium.

薄子宫内膜,定义为子宫内膜厚度小于7 mm是辅助生殖治疗期间频繁取消胚胎移植或复发性植入失败的常见原因。小蛋白聚糖通过桥接其他基质分子和组织元素来调节细胞内信号级联,影响细胞增殖、粘附、迁移和细胞因子浓度。本研究的目的是研究富含亮氨酸的小蛋白聚糖在薄和厚人类子宫内膜发病机制中的作用,以及它们在精细结构特性方面与正常子宫内膜的差异。收集正常、薄和厚的子宫内膜样本,并用免疫组化方法比较分析富含亮氨酸的小蛋白多糖(SLRP)、decorin、lumican、biglycan和纤维调节蛋白的免疫反应性。对数据进行了统计比较。此外,通过透射电子显微镜评估各组之间的超微结构差异。与正常和厚内膜相比,薄内膜腺上皮和间质中decorin、lumican和biglycan的免疫反应性较高(p p
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引用次数: 0
Lupus nephritis with cryoglobulinemic glomerulonephritis features: a diagnostic conundrum. 狼疮性肾炎伴冷球蛋白血症肾小球肾炎特征:诊断难题。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-11-02 Epub Date: 2023-11-30 DOI: 10.1080/01913123.2023.2270030
George Terinte-Balcan, Simona Cinca, Simona Stancu, Mihaela Gherghiceanu, Gabriel Stefan

In this clinical case, we report an atypical and unique presentation of systemic lupus erythematosus (SLE) in a 39-year-old female with nephrotic syndrome. The patient exhibited class IV plus V lupus nephritis and extensive immune complex deposition within the intracapillary and arteriolar regions suggestive of cryoglobulinemic glomerulonephritis, despite no detectable circulating cryoglobulins. Electron microscopy revealed cryoglobulin-like deposit distribution in all glomerular examined compartments, namely subendothelial, intramembranous, subepithelial, and mesangial, apparently extending from the capillary hyaline thrombi. The case highlights the possibility of severe renal injury in SLE without circulating cryoglobulins and the diverse kidney manifestations associated with the disease. However, the impact on patient outcome was minimal, as classical treatment (id est National Institute of Health regimen) remained effective.

在这个临床病例中,我们报告了一例39岁的肾病综合征女性系统性红斑狼疮(SLE)的非典型和独特表现。该患者表现为IV级加V级狼疮性肾炎,毛细血管内和小动脉内广泛的免疫复合物沉积,提示冷球蛋白血症性肾小球肾炎,尽管没有检测到循环冷球蛋白。电子显微镜显示,冷冻球蛋白样沉积物分布在所有肾小球检查区,即内皮下、膜内、上皮下和系膜,明显从毛细血管透明血栓延伸。该病例强调了SLE在没有循环冷球蛋白的情况下发生严重肾损伤的可能性,以及与该疾病相关的各种肾脏表现。然而,由于经典治疗(美国国立卫生研究所的方案)仍然有效,对患者结果的影响很小。
{"title":"Lupus nephritis with cryoglobulinemic glomerulonephritis features: a diagnostic conundrum.","authors":"George Terinte-Balcan, Simona Cinca, Simona Stancu, Mihaela Gherghiceanu, Gabriel Stefan","doi":"10.1080/01913123.2023.2270030","DOIUrl":"10.1080/01913123.2023.2270030","url":null,"abstract":"<p><p>In this clinical case, we report an atypical and unique presentation of systemic lupus erythematosus (SLE) in a 39-year-old female with nephrotic syndrome. The patient exhibited class IV plus V lupus nephritis and extensive immune complex deposition within the intracapillary and arteriolar regions suggestive of cryoglobulinemic glomerulonephritis, despite no detectable circulating cryoglobulins. Electron microscopy revealed cryoglobulin-like deposit distribution in all glomerular examined compartments, namely subendothelial, intramembranous, subepithelial, and mesangial, apparently extending from the capillary hyaline thrombi. The case highlights the possibility of severe renal injury in SLE without circulating cryoglobulins and the diverse kidney manifestations associated with the disease. However, the impact on patient outcome was minimal, as classical treatment (<i>id est</i> National Institute of Health regimen) remained effective.</p>","PeriodicalId":23430,"journal":{"name":"Ultrastructural Pathology","volume":" ","pages":"478-483"},"PeriodicalIF":1.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction. 修正。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-11-02 Epub Date: 2023-09-06 DOI: 10.1080/01913123.2023.2248823
{"title":"Correction.","authors":"","doi":"10.1080/01913123.2023.2248823","DOIUrl":"10.1080/01913123.2023.2248823","url":null,"abstract":"","PeriodicalId":23430,"journal":{"name":"Ultrastructural Pathology","volume":" ","pages":"540-541"},"PeriodicalIF":1.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10159755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Morphologically and karyotypically atypical cells of 'normal' human bronchial epithelial cell line (Beas-2B). “正常”人支气管上皮细胞系(Beas-2B)的形态学和核型非典型细胞。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-11-02 Epub Date: 2023-11-30 DOI: 10.1080/01913123.2023.2262561
Younsu Lee, Young-Joon Ryu

Beas-2B is an adenovirus 12-SV40-transfected cell line of "normal" human bronchial epithelial cells. This cell line was able to replace normal human bronchial epithelial cells, which are currently unavailable, and served as a model for related studies in numerous toxicology and cancer transformation experiments. In any experiment involving toxins or carcinogens, the basic morphology of Beas-2B should be well characterized prior to exposure, but this has never been properly reported. In this study, atypical cells of the Beas-2B cell line in early passage culture were observed using light and electron microscopy, and the cells were further investigated for abnormal karyotypes by flow cytometry. This Beas-2B cell line could be morphologically categorized into two cell types, A and B. Type A contains a large nucleus and abundant cytoplasm (type A > 95%) and type B contains a small nucleus with dense and scarce cytoplasm (type B < 5%). Both atypical cell types had atypical and multilobed/multinucleated cells, including a high percentage (>30%) of mitotic figures, and were Ki-67 positive (100%). Karyotyping also revealed that 40.4% of the cells had atypical karyotyped chromosomes. In light of these findings, this cell line is no longer a "normal" cell, and experiments performed using this cell line can be questioned for non-default results. Experimenters should consider this error in future experiments.

Beas-2B是一种腺病毒12-SV40转染的“正常”人支气管上皮细胞的细胞系。该细胞系能够取代目前无法获得的正常人支气管上皮细胞,并在许多毒理学和癌症转化实验中作为相关研究的模型。在任何涉及毒素或致癌物的实验中,Beas-2B的基本形态都应该在暴露前得到很好的表征,但这从未得到适当的报道。在本研究中,使用光学和电子显微镜观察了Beas-2B细胞系在早期传代培养中的非典型细胞,并通过流式细胞术进一步研究了细胞的异常核型。该Beas-2B细胞系在形态学上可分为两种细胞类型,A型和B型。A型含有大的细胞核和丰富的细胞质(A型 > 95%),B型含有一个小细胞核,细胞质致密而稀少(B型 Ki-67阳性(100%)。核型分析还显示,40.4%的细胞具有非典型核型染色体。根据这些发现,该细胞系不再是“正常”细胞,使用该细胞系进行的实验可能会受到非默认结果的质疑。实验人员应该在未来的实验中考虑这个错误。
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引用次数: 0
A closer look: ultrastructural evaluation of high-risk progression IgA nephropathy. 进一步观察:IgA肾病高危进展的超微结构评价。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-11-02 Epub Date: 2023-09-12 DOI: 10.1080/01913123.2023.2256836
George Terinte-Balcan, Gabriel Stefan

This retrospective, cross-sectional study sought to examine the ultrastructural characteristics of glomerular lesions using Transmission Electron Microscopy (TEM) in IgA nephropathy (IgAN) and their relationship with the high risk of progression phenotype defined by KDIGO guideline as proteinuria ≥1 g/24 hours despite 3 months of optimized supportive care. We analyzed 81 IgAN patients (median age 41 years, 67% male, eGFR 43.8 mL/min, proteinuria 1.04 g/day); 42 (52%) of them had high risk of progression. There were no differences in terms of age, sex, comorbidities, eGFR, and hematuria between the two groups. High-risk patients more often had segmental glomerulosclerosis (29% vs 8%, p 0.01) in optical microscopy, while in TEM had more frequent podocyte hypertrophy (62% vs 26%, p 0.001) and podocyte foot process detachment from the glomerular basement membrane (19% vs 8%, p 0.05), more often thicker (19% vs 5%, p 0.05) and duplicated (26% vs 10%, p 0.05) glomerular basement membrane, and the presence of subendothelial and subepithelial deposits (31% vs 13%, p 0.05). However, in multivariate binary logistic regression analysis, only podocyte hypertrophy (OR 3.14; 95%CI 1.12, 8.79) was an independent risk factor for high-risk progression in IgAN. These findings highlight the importance of podocytopathy in IgAN progression.

这项回顾性横断面研究旨在通过透射电镜(TEM)检查IgA肾病(IgAN)肾小球病变的超微结构特征及其与KDIGO指南定义的高风险进展表型的关系,KDIGO指南定义为尽管进行了3个月的优化支持治疗,但蛋白尿≥1 g/24小时。我们分析了81例IgAN患者(中位年龄41岁,67%为男性,eGFR 43.8 mL/min,蛋白尿1.04 g/天);42例(52%)有进展高危。两组在年龄、性别、合并症、eGFR和血尿方面没有差异。在光学显微镜下,高危患者更常出现节段性肾小球硬化(29%比8%,p 0.01),而在TEM下,更常见的是足细胞肥大(62%比26%,p 0.001)和足细胞足突脱离肾小球基底膜(19%比8%,p 0.05),更常见的是肾小球基底膜增厚(19%比5%,p 0.05)和重复(26%比10%,p 0.05),内皮下和上皮下沉积(31%比13%,p 0.05)。然而,在多元二元logistic回归分析中,只有足细胞肥大(OR 3.14;95%CI 1.12, 8.79)是IgAN高危进展的独立危险因素。这些发现强调了足细胞病在IgAN进展中的重要性。
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引用次数: 0
Anti-phospholipase A2 receptor positive membranous nephropathy: investigating the link between electron microscopy stages and clinical outcome. 抗磷脂酶A2受体阳性膜性肾病:探讨电镜分期与临床预后之间的联系。
IF 1 4区 医学 Q4 MICROSCOPY Pub Date : 2023-09-03 DOI: 10.1080/01913123.2023.2236225
Gabriel Stefan, George Terinte Balcan, Nicoleta Petre, Simona Cinca, Adrian Zugravu, Simona Stancu

This retrospective, observational study sought to examine the relationship between Ehrenreich-Churg electron microscopy (EM) stages and long-term outcomes in anti-PLA2R membranous nephropathy (MN). Seventy-one patients with anti-PLA2R MN (median titer 185.7RU/mL) were followed for a median of 46 months, with end-stage kidney disease (ESKD) as the primary endpoint, and response to treatment as a secondary endpoint. Patients were grouped into stages I-II (41 patients) and stages III-IV (30 patients) for analytical purposes. Notably, the III-IV group demonstrated a lower eGFR, lower anti-PLA2R titer, but a higher chronicity score. Kaplan-Meier analysis showed shorter mean kidney survival time in stages III-IV compared to I-II (p 0.03). However, multivariate analysis using Cox regression indicated that Ehrenreich-Churg stages did not significantly influence kidney survival, but lower eGFR at diagnosis and higher histopathological chronicity score did. Remission was achieved by 64% of patients and no relationship between Ehrenreich-Churg stages and treatment response was found. The only identified risk factor for not achieving remission was the severity of hyposerinemia at diagnosis. In conclusion, while EM stages III-IV are associated with more chronic lesions and stages I-II with more active immunologic disease, the histological chronicity score seems to be a stronger predictor of long-term outcomes.

这项回顾性观察性研究旨在研究抗pla2r膜性肾病(MN)的Ehrenreich-Churg电子显微镜(EM)分期与长期预后之间的关系。71例抗pla2r MN患者(中位滴度为185.7RU/mL)随访中位时间为46个月,以终末期肾病(ESKD)为主要终点,对治疗的反应为次要终点。为了分析目的,将患者分为I-II期(41例)和III-IV期(30例)。值得注意的是,III-IV组表现出较低的eGFR,较低的抗pla2r滴度,但较高的慢性评分。Kaplan-Meier分析显示,与I-II期相比,III-IV期的平均肾脏生存时间更短(p < 0.03)。然而,采用Cox回归的多变量分析表明,Ehrenreich-Churg分期对肾脏生存没有显著影响,但诊断时较低的eGFR和较高的组织病理学慢性评分对肾脏生存有显著影响。64%的患者获得缓解,Ehrenreich-Churg分期与治疗反应没有关系。唯一确定的未达到缓解的危险因素是诊断时低丝氨酸血症的严重程度。总之,虽然EM III-IV期与更多的慢性病变相关,而I-II期与更多的活动性免疫疾病相关,但组织学慢性评分似乎更能预测长期预后。
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引用次数: 1
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Ultrastructural Pathology
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