engleski

Proteins of extracellluar matrix as predictors of glomerulonephritis outcome

Chronic renal insufficiency develops only in those cases of glomerulonephritis in which the lumina of postglomerular capillaries in the renal cortex are narrowed due to expansion of extracellular matrix (ECM). Aim of the study was to compare the composition of interstitial ECM proteins with clinical data in various forms of primary glomerulonephritis (GN). We examined renal biopsies from 55 GN patients, while normal renal tissue was obtained from nephrectomy due to small renal tumour. Specimens fixed in B5 and/or Dubosque fixative were analysed by immunohistochemistry (APPAP-method) using a monoclonal antibodies against tenascin (TN), fibronectin (FN), collagen I, III and IV (COI, COIII, COIV) (DAKO). The same fixatives were used for controle renal tissue. Evaluation of fibrin was performed on frozen sections by immunofluorescence. Clinical data were: proteinuria and creatinine level, obtained by standard laboratory methods, immunotherapy and ACE-genotype. Fifty patients had proteinuria at time of biopsy and 33 of them continued to have one after follow up period. Patients with persistent proteinuria had more often interstitial fibrosis with elevated content of COI and COIV. Only 10% of patients who responded good to immunotherapy had deposits of fibrin. There were 12 patients with elevated creatinine at biopsy with similar composition of ECM as patients with proteinuria. Majority of patients with interstitial fibrosis had ACE-genotyp II although this genotype wasn’ t the most common in the cochort. Our study showed that persistant proteinuria could be linked to interstitial fibrosis and fibrin deposits. Patients with II ACE-genotype are more prone to develop interstitial fibrosis.

glomerulonephritis; interstitum; fibrosis; extracellular matrix proteins

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