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  • Title: Dysregulation of apoptosis: a possible mechanism leading to chronic progressive renal histological changes in lupus nephritis.
    Author: Lu F, Shen W, Zhang X, Guo M, Lin S.
    Journal: Chin Med J (Engl); 2000 Dec; 113(12):1082-6. PubMed ID: 11776141.
    Abstract:
    OBJECTIVE: To evaluate apoptosis in lupus nephritis and the relationship between the existence of apoptotic cells in renal tissue and histopathological or clinical changes. METHODS: Apoptosis was detected by in situ nick-end labeling techniques (TUNEL) in renal biopsies from 25 patients with type IV lupus nephritis (LN), 12 patients with IgA nephropathy IgAN, 4 patients with idiopathic mesangioproliferative glomerulonephritis (MsPGN) and 3 patients with acute poststreptococcal glomerulonephritis (APGN). Normal renal tissue obtained at nephrectomy for hypernephroma in 4 adults was used as control. Proliferating cells were identified by proliferating cell nuclear antigen (PCNA) in these patients. RESULTS: Compared to other proliferative glomerulonephritis and controls, the patients with lupus nephritis had less apoptotic cells, a higher ratio of PCNA + cells/TdT + cells (P/T) in renal tissues; and their P/T ratio in glomeruli and tubulointerstitium correlated with the chronicity index, r = 0.4983 (P = 0.0132), r = 0.8399 (P < 0.001), r = 0.6614 (P = 0.0033), respectively. P/T ratios in the glomerulus and tubule had a positive correlation with 24-hour urinary protein, r = 0.8554 (P < 0.001) and r = 0.7134 (P = 0.001); and a negative correlation with creatinine clearance (Ccr), r = -0.4880 (P = 0.0133) and r = -0.7229 (P = 0.001), which in tubules positively correlated with serum creatinine (Scr), r = 0.4107 (P = 0.0414). CONCLUSIONS: Apoptosis is reduced in proliferative lupus nephritis. Intense proliferation without a commensurate increase in apoptosis is a possible mechanism that leads to chronic progressive renal histopathological changes.
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