Significance of leukocyte infiltration in membranous nephropathy with segmental glomerulosclerosis

Aim: To clarify the role of leukocyte subsets in the development of glomeru losclerosis (GS) and interstitial lesions which may contribute to the progn osis of membranous nephropathy (MN), we investigated infiltrating cells in both glomeruli and interstitium in biopsy specimens. Methods: Forty-one cas es of MN were divided into two groups: MN with segmental GS (MN+GS; n = 21) and MN without GS (MN-GS; n = 20). There was no significant difference bet ween both groups regarding clinical data at the time of the renal biopsy. T he cells were analyzed with a three-layer indirect immunoperoxidase method using monoclonal antibodies against leukocyte common antigen, T cells, B ce lls, and monocytes/macrophages (Mo/M phi). Results: Renal function tended t o deteriorate during the final follow-up period in group MN+GS, but not in group MN-GS. The number of glomerular and interstitial leukocytes in group MN+GS were significantly higher than those in group MN-GS. Leukocytes were mostly Mo/M phi in the glomerulus, while T cells and Mo/M phi were predomin ant in the interstitium. in group MN+GS, there was a significant correlatio n in number of M phi (CD68+) between glomeruli and interstitium, but not in group MN-GS. Conclusion: The results suggest that Mo/M phi may play an imp ortant role in the development of segmental GS and interstitial lesions in MN which may be responsible for the incurability and poor prognosis.