ADHESION MOLECULES EXPRESSION IN NONCRESCENTIC ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS

Clinicomorphological features of 11 cases of noncrescentic acute post- streptococcal glomerulonephritis (APSGN) were reviewed. Intraglomerula r and interstitial leukocytes and their possible correlation with the adhesion molecules intercellular adhesion molecule-1 (ICAM-1), vascula r cell adhesion molecule-1 (VCAM-1), and endothelial-leukocyte adhesio n molecule-1 (ELAM-1/E-selectin) were investigated by an immunohistoch emical method. Intraglomerular leukocytes were primarily granulocytes (11.4 +/- 10 cells/glomerular cross-section) and monocytes-macrophages (13.4 +/- 19.4 cells/glomerular cross-section). The granulocytes outn umbered monocytes-macrophages in 7 of 11 specimens. The number of intr aglomerular leukocytes correlated with proteinuria at the time of rena l biopsy. Intraglomerular ICAM-1 staining was strongly positive in all biopsies, especially when intraglomerular monocytes-macrophages preva iled. Expression of intraglomerular VCAM-1 and E-selectin in diseased kidneys did not differ from that in normal kidneys. Interstitial leuko cytes were primarily monocytes-macrophages (158.9 +/- 96.8 cells/mm(2) ) and T lymphocytes (102.2 +/- 63.9 cells/mm(2)). The number of inters titial leukocytes, especially monocytes-macrophages, correlated with s erum creatinine level at the time of biopsy. Interstitial ICAM-1 stain ing was strongly positive on tubules, peritubular capillaries, and sma ll vessels. The tubular positivity for ICAM-1 correlated with the numb er of interstitial monocytes-macrophages. Interstitial VCAM-1 and E-se lectin were expressed as in normal kidney tissues. The data from this study demonstrate that APSGN is characterized by the presence of both intraglomerular and interstitial leukocyte infiltration, correlating r espectively with proteinuria and serum creatinine at the time of renal biopsy. Among the adhesion molecules studied, ICAM-1 seems the most i nvolved in leukocyte recruitment, especially in that of monocytes-macr ophages.