荚膜细胞损伤对四级狼疮性肾炎发展的影响

IF 2.1 Q2 UROLOGY & NEPHROLOGY International Journal of Nephrology and Renovascular Disease Pub Date : 2024-10-04 eCollection Date: 2024-01-01 DOI:10.2147/IJNRD.S473616
Cyntia Camilo Franco Borges Zago, Bruna de Freitas Oliveira, Giovanna Uehara, Ana Laura Carvalho da Silva, Laura Penna Rocha, Fabiano Bichuette Custódio, Liliane Silvano Araújo, Crislaine Aparecida da Silva, Marlene Antônia Reis, Juliana Reis Machado
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引用次数: 0

摘要

目的:在肾脏中,系统性红斑狼疮会导致狼疮性肾炎(LN),这是一种肾小球肾炎。有证据表明,狼疮肾炎患者可能会出现荚膜细胞损伤的特定途径激活。这种损伤可通过不同的机制发生,如荚膜细胞失去与肾小球基底膜的粘附力、细胞死亡或脱分化。一些肾病(如淋巴结核)中出现了荚膜细胞尿和随之而来的荚膜细胞减少症,这凸显了研究这种情况下荚膜细胞损伤的重要性。评估荚膜细胞的原位形态特征有助于更好地了解其发病过程。本研究调查了 Triângulo Mineiro 联邦大学肾脏研究中心进行的肾活检中不同类型 LN 中的荚膜细胞:研究选择了 20 例对照病例和 29 例确诊为 LN 的活检病例,并根据疾病的组织病理学分类进行了划分。通过Wilms肿瘤1蛋白的免疫组织化学方法评估荚膜细胞密度,并通过透射电子显微镜评估足突脱出情况:结果:与对照组相比,淋巴结核患者的荚膜细胞密度较低,而且在所有分析级别中都能观察到这种降低。与对照组相比,LN 组观察到更多的足突脱出,I/II 级和 IV 级脱出更多。与 I/II 级组相比,IV 级组比 III 级组有更多的足突脱出,蛋白尿水平也更高。在 IV 级组,观察到活动指数和足突脱出之间存在较强的正相关性:结论:荚膜细胞在 LN 的形成过程中起着重要作用,这些细胞的损伤可能与 IV 级 LN 的炎症/弥漫性增生细胞过程有更密切的关系。
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Influence of Podocyte Injury on the Development of Class IV Lupus Nephritis.

Purpose: In the kidneys, Systemic Lupus Erythematosus leads to Lupus Nephritis (LN), a form of glomerulonephritis. There is evidence that patients with LN may present activation of specific pathways for podocyte injury. This injury can occur through different mechanisms such as loss of podocyte adhesion to the glomerular basement membrane, cell death or dedifferentiation. Podocyturia with consequent podocytopenia has been described in some nephropathies such as LN, highlighting the importance of studying podocyte injuries in this condition. Evaluating in situ morphological characteristics of podocytes becomes relevant for a better understanding of the processes involved in their pathogenesis. This study investigated podocytes in different classes of LN in renal biopsies performed by the Kidney Research Center at the Federal University of Triângulo Mineiro.

Patients and methods: Twenty control cases and 29 biopsy cases diagnosed with LN were selected, divided according to the histopathological classes of the disease. Podocyte density was assessed through immunohistochemistry for Wilms tumor 1 protein and the evaluation of foot process effacement was performed by transmission electron microscopy.

Results: Podocyte density was lower in the LN and this reduction was observed in all analyzed classes when compared to the control group. More foot process effacement was observed in the LN group, with more effacement in classes I/II and class IV compared to the control group. The class IV group showed more foot process effacement than the class III group and presented higher proteinuria levels compared to the classes I/II group. A strong, positive, and significant correlation was observed between the activity index and foot process effacement in the class IV group.

Conclusion: Podocytes play an important role in the development of LN, and possibly, injuries to these cells are more closely related to the inflammatory/diffuse proliferative cellular process developed in class IV LN.

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来源期刊
CiteScore
3.90
自引率
5.00%
发文量
40
审稿时长
16 weeks
期刊介绍: International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.
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