CLINICOPATHOLOGICAL SIGNIFICANCE OF INTRATUBULAR GIANT MACROPHAGES INPROGRESSIVE GLOMERULONEPHRITIS

Citation
T. Oda et al., CLINICOPATHOLOGICAL SIGNIFICANCE OF INTRATUBULAR GIANT MACROPHAGES INPROGRESSIVE GLOMERULONEPHRITIS, Kidney international, 53(5), 1998, pp. 1190-1200
Citations number
32
Categorie Soggetti
Urology & Nephrology
Journal title
ISSN journal
00852538
Volume
53
Issue
5
Year of publication
1998
Pages
1190 - 1200
Database
ISI
SICI code
0085-2538(1998)53:5<1190:CSOIGM>2.0.ZU;2-Y
Abstract
Very large macrophages, which we have termed ''giant macrophages'' (G- M phi), have been found in renal tubules, some containing cytoplasmic vacuoles. To elucidate their pathophysiological roles, we examined ren al biopsy tissues from various primary glomerulonephritis (GN) and tub ulointerstitial nephritis (TIN) using immuno-histochemistry; with mono clonal antibodies against M phi and other cell surface markers. Giant macrophages were absent or rare in TIN, minimal change nephrotic syndr ome, and minor glomerular abnormalities, but G-M phi was plentiful in progressive glomerulonephrides such as IgA nephropathy with crescents, membranoproliferative GN, focal segmnental glomerulosclerosis, and es pecially in crescentic GN. These G-M phi were usually seen in the lume n of renal tubules, but occasionally were found in the Bowman's spaces and glomerular tufts, and similar cells were also found in urine. Mor eover, they frequently made contact with tubular epithelial cells expr essing intercellular adhesion molecule-1, and the tubular epithelial c ells in such lesions often had dt generative changes. Giant M phi may damage tubular epithelial cells from the luminal side. Phenotypically, G-M phi showed activated (CD71(+)) and mature (25F9(+)) characteristi cs along with features of M phi (CD68(+)), and the cytoplasm contained a great deal of lipids. The numbers of G-M phi, in renal tissues clos ely correlated with the degree of hematuria (rho = 0.5, P < 0.001), se rum creatinine value (r = 0,63, P < 0.001) in GN patients (N = 96) and with proteinuria in IgA nephropathy patients (r = 0.89, P < 0.001, N = 27). These data suggest that G-M phi are M phi that were activated a nd matured in certain active inflammatory: sites. which flowed into tu bules and then into urine. Thus, the existence of G-M phi in biopsy ti ssue or urine reflect the activity of GN and may have a predictive val ue for the progression of GN.