CYTOKINES, ADHESION MOLECULES, AND CELLULAR INFILTRATION IN NEPHROPATHIA-EPIDEMICA KIDNEYS - AN IMMUNOHISTOCHEMICAL STUDY

Puumala hantavirus-induced nephropathia epidemica (NE) is an important cause for an acute reversible renal failure in Scandinavia, European Russia, and the Balkans. The characteristic histopathological renal fi nding is an acute tubulointerstitial nephritis. Mild to massive protei nuria, hematuria, and a rise in the serum creatinine level are typical ly seen. The pathogenetic mechanisms of NE kidney failure are incomple tely understood. Therefore we studied the infiltrating cell population s and local expression of cytokines and growth factors in the kidney d uring the acute disease. Results of the histological and immunohistolo gical studies of eight kidney biopsies show mild to moderate interstit ial infiltration of lymphocytes, plasma cells, monocytes/macrophages, and polymorphonuclear leukocytes, mainly eosinophilic granulocytes and neutrophils. An increased expression of the cytokines tumor necrosis factor-alpha transforming growth factor-beta, and platelet-derived gro wth factor was seen at the same sites mainly in the peritubular area o f the distal nephron. Concomitantly also at the same locations express ion of the endothelial adhesion molecules ICAM-1, VCAM, and PECAM was seen. Light microscopic changes in tubuli were common. Interestingly, despite the often massive transient proteinuria, no marked changes wer e seen in the glomeruli of NE kidneys. No evidence of Puumala virus wa s found in the kidney biopsies. (C) 1996 Academic Press Inc.