GLOMERULOINTERSTITIAL INTERACTION OF ADHESION MOLECULES IN IGA NEPHROPATHY AND MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS

The expression of two adhesion molecules, ICAM1 (CD54) and ICAM3 (CD50 ), infiltrating cells positive for their ligand, LFA1 (CD11a), and the markers of total leukocytes (CD45), T cells (CD3), granulocytes/monoc ytes (CD15), macrophages (CD68) in renal interstitium were examined by an indirect immunoperoxidase method. The study was longitudinally per formed on repeat renal biopsy specimens from 69 patients with two diff erent proliferative glomerulonephritides: 43 with IgA nephropathy (IgA N) and 26 with membranoproliferative glomerulonephritis (MPGN). inters titial ICAM1 (iICAM1) was mainly expressed on endothelium of peritubul ar venules and sometimes on tubular epithelium, and interstitial ICAM3 (ilCAM3) on infiltrating immune cells. In IgAN, IICAM1 was significan tly correlated with glomerular infiltration of LFA1+ cells (gLFA1) and CD68+ cells (gCD68) (r = 0.478/0.500; P < 0.0001) as well as CD3+ cel ls (gCD3) (r = 0.402; P < 0.002). In MPGN, iICAM1 was significantly co rrelated only with gCD68 (r = 0.382; P < 0.05), In both diseases, iICA M1 and ilCAM3 were significantly correlated with interstitial infiltra tion of LFA1+ cells (iLFA1) and CD68+ cells (iCD68) (r = 0.616 to 0.81 5; P < 0.0001) and with interstitial infiltration of CD3+ cells (iCD3) (r = 0.474 to 0.816; P < 0.01). The ilCAM3 was also significantly cor related with interstitial CD45+ cells (iCD45) (r = 0.672 in IgAN and 0 .769 in MPGN; P < 0.00001). Interstitial infiltration of these immune cells was significantly correlated with the histologic parameters indi cating renal injury, such as the index of glomerular lesion and the pe rcent interstitial Volume (r = 0.410 to 692; P ( 0.05). Longitudinal a nalysis revealed that the parameters described above showed correspond ing change with each other at the follow-up biopsy, These findings sug gest that the glomerular infiltration of T cells and macrophages influ ences the ICAM1/ICAM3 expression of the interstitial cells, especially in IgAN, and that ICAM1/LFA1 and ICAM3/LFA1 interactions contribute t o the persistent infiltration of the interstitium by immune cells in b oth diseases. (C) 1997 by the National Kidney Foundation, Inc.