Morphometric and immunohistochemical insigh tinto focal segmental glomerulosclerosis in obese and non-obese patients
- Autores: M. Danilewicz, M. Wagrowska Danilewicz
- Localización: Nefrología: publicación oficial de la Sociedad Española de Nefrología, ISSN 0211-6995, Vol. 29, Nº. 1, 2009, págs. 35-41
- Idioma: inglés
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Resumen
A number of studies have reported an alarming increase in the incidence of obesity related-glomerulopathy.
Focal segmental glomerulosclerosis has recently been shown to be key lesion leading to end-stage renal disease in these cases. Methods: Nineteen patients with obesity-related focal segmental glomerulosclerosis (O-FSGS) and 16 with idiopathic focal segmental glomerulosclerosis (I-FSGS) were examined by percutaneous renal biopsy. Glomerular and interstitial parameters in O-FSGS and I-FSGS were compared morphometrically as well as immunomorphological study was done to evaluate immunohistochemical profile of TGFbeta- 1, monocytes/macrophages, T lymphocytes and a-SMA in these groups. Results: The total glomerular cells, mesangial areas, glomerular a-SMA staining, glomerular monocytes/macrophages and glomerular T-cells were in IFSGS increased in comparison with O-FSGS, most of them significantly, whereas total glomerular area was significantly greater in O-FSGS patients. The tubular immunoexpression of TGF-b-1, interstitial volume and interstitial a-SMA staining were significantly increased in I-FSGS cases in comparison with O-FSGS group, but interstitial CD68+ and CD3+ cells did not differ significantly. Moreover, we found in both O-FSGS and I-FSGS groups significant positive correlations between glomerular immunoexpression of a-SMA and glomerular CD 68+ cells, tubular immunoexpression of TGF-b-1 and interstitial immunoexpression of a-SMA as well as tubular immunoexpression of TGF-b-1 and interstitial volume.
Negative correlation between tubular immunoexpression of TGF-b-1 and interstitial CD3+ cells was significant only in IFSGS group. Conclusions: Our morphometric and immunohistochemical study suggests that O-FSGS and I-FSGS are separate morphological entities whereas mechanisms of glomerular and interstitial injury in these cases seem to be rather similar.
