硒与苯那普利抑制单侧输尿管梗阻大鼠肾间质纤维化

目的研究亚硒酸钠与苯那普利对单侧输尿管梗阻(UUO)大鼠肾间质纤维化(RIF)的保护作用及其机制。方法将大鼠随机分为假手术组、UUO组(结扎单侧输尿管建立UUO模型)、UUO+硒组(亚硒酸钠0.2 mg/kg·d灌胃)和UUO+苯那普利组(苯那普利10 mg/kg·d灌胃),每组18只。术后第7、14和21天,各组随机处死6只大鼠,肾组织行HE和Masson染色,观察RIF程度;免疫组化法检测结缔组织生长因子(CTGF)、转化生长因子-β1(TGF-β1)、α-平滑肌肌动蛋白(α-SMA)和Ⅲ型胶原(ColⅢ)的表达;Western blot检测CTGF和TGF-β1蛋白表达;比色法检测谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)和丙二醛(MDA)的含量。结果术后第7、14和21天,硒组和苯那普利组RIF较UUO组明显减轻(P<0.05);肾组织CTGF、TGF-β1、α-SMA、ColⅢ表达强度和MDA含量明显低于UUO组(P<0.01或P<0.05);GSH-Px和SOD含量明显高于UUO组(P<0.05)。两干预组之间各项指标无明显差异。UUO组TGF-β1、CTGF、α-SMA、ColⅢ的表达和RIF指数与MDA含量呈正相关(P<0.05),与SOD和GSH-Px含量呈负相关(P<0.05);CTGF与α-SMA、ColⅢ的表达呈正相关(P<0.05),CTGF、α-SMA和ColⅢ表达与RIF病变程度呈正相关(P<0.05)。结论亚硒酸钠与苯那普利均可减轻UUO模型大鼠RIF。     

单侧输尿管梗阻模型小鼠肾脏微血管损伤与肾间质纤维化的关系研究

目的:观察单侧输尿管梗阻(UUO)后小鼠肾脏管周毛细血管(PTC)损伤、继发低氧及肾组织纤维化的变化,进一步探讨管周毛细血管损伤和缺氧对肾间质纤维化的影响。方法:将48只雄性昆明小鼠随机分为UUO组和对照组,采用左侧输尿管结扎术复制UUO模型,于术后1、3、7、14 d分别处死2组小鼠取左肾。采用M asson染色评定肾间质损伤程度;免疫组织化学方法测定血小板反应蛋白-1(TSP-1)、低氧诱导因子-1α(H IF-1α)、血管内皮生长因子(VEGF)表达和PTC密度变化;免疫印迹检查VEGF蛋白表达的变化。结果:假手术组肾组织结构形态正常,无纤维化的表现。UUO术后第1 d TSP-1表达开始升高,第3-14 d时升高更加显著(P0.05);VEGF在第1 d表达升高,第3-14 d表达逐渐降低(P0.05);PTC密度随之逐渐下降,H IF-1α表达逐渐升高,肾间质面积逐渐扩大。相关分析显示,TSP-1与PTC密度呈负相关(r=-0.874),PTC密度与H IF-1α表达呈负相关(r=-0.930),VEGF表达与PTC密度呈正相关(r=0.745),PTC密度与肾纤维化面积呈负相关(r=-0.787),H IF-1α与肾纤维化面积呈正相关(r=0.835),均P0.01。结论:UUO模型小鼠TSP-1表达升高,VEGF表达下降,PTC损伤和组织缺氧加重,肾间质纤维化面积扩大;缺血和缺氧可能是UUO后肾组织病变发生发展的重要原因。     

改良构建大鼠单侧输尿管梗阻肾间质纤维化模型

文题释义：肾盂积液：输尿管完全或不完全梗阻时,由于尿液无法正常排出体外而导致肾盂积液。慢性肾盂积液引起的肾脏损伤是不可逆的,可由多种上尿路梗阻性疾病诱发,导致肾盂肾盏扩大,肾小管与肾小球结构与功能丧失,进而肾组织萎缩。 肾间质纤维化：是各种慢性肾病发展至终末期的共同病理特征,以肾小管间质瘢痕硬化为特征,最终导致肾脏组织功能完全丧失。该过程受到转化生长因子β、成纤维细胞生长因子、内分泌等信号通路的调控,肾间质纤维化动物模型是研究相关药物药理机制的重要模型。 背景：传统的大鼠单侧输尿管梗阻手术方法,可以在较短的时间内(一两周)导致动物梗阻侧肾脏发生肾间质纤维化,但具有术后并发症较多、死亡率较高的缺点。 目的：优化并改良大鼠单侧输尿管梗阻手术操作,降低动物术后的并发症发生率,提高存活率,检测改良单侧输尿管梗阻方法建模大鼠的病理生理指标,为功能药理学基础研究提供背景数据支持。 方法：①取20只雄性SD大鼠,随机分为4组,分别进行传统单侧输尿管梗阻方法结扎、改良单侧输尿管梗阻方法结扎、不游离输尿管结扎、开腹腔但不结扎输尿管(假手术组)操作,术后14 d时比较组间大鼠肾间质纤维化成模率、死亡率、术后并发症发生率的差异;②另取28只SD大鼠,雌雄各半,随机分为改良组与假手术组,采用尿液分析、血细胞分析、血液生化分析方法,检测两组大鼠的生理指标,并通过苏木精-伊红染色与Masson染色法,观察改良组大鼠术后14,21 d时的肾脏组织病理学结果。 结果与结论：①与不游离输尿管结扎组大鼠相比,传统单侧输尿管梗阻组和改良单侧输尿管梗阻组大鼠的成模率高;②在单侧输尿管梗阻手术操作过程中,采用输尿管中段双结扎、中间不剪断的改良方法与传统方法相比,操作更简便易行,手术开创更小,肾间质纤维化成模快、成模率较高,动物术后死亡率与并发症发生率均低;③改良组与假手术组相比,术后14 d时的尿素氮、谷草转氨酶、白蛋白等血液生化指标差异有显著性意义(P < 0.05),其梗阻侧肾脏的组织病理切片苏木精-伊红染色与Masson染色结果均可见典型的肾间质纤维化病理特征。 ORCID: 0000-0001-7823-2897(孙杰) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Renal parenchyma impairment characterization in partial unilateral ureteral obstruction in mice with intravoxel incoherent motion‐MRI

Ureteropelvic junction obstruction constitutes a major cause of progressive pediatric renal disease. The biological mechanisms underlying the renal response to obstruction can be investigated using a clinically relevant mouse model of partial unilateral ureteral obstruction (pUUO). Renal function and kidney morphology data can be evaluated using renal ultrasound, scintigraphy and uro‐magnetic resonance imaging (uro‐MRI), but these methods are poorly linked to histological change and not all are quantitative. Here, we propose to investigate pUUO for the first time using an intravoxel incoherent motion diffusion sequence. The aim of this study was to quantitatively characterize impairment of the kidney parenchyma in the pUUO model. This quantitative MRI method was able to assess the perfusion and microstructure of the kidney without requiring the injection of a contrast agent. The results suggest that a perfusion fraction (f) reduction is associated with a decrease in the volume of the renal parenchyma, which could be related to decreased renal vascularization. The latter may occur before impairment by fibrosis and the findings are in accordance with the literature using the UUO mice model and, more specifically, on pUUO. Further investigation is required before this technique can be made available for the diagnosis and management of children with antenatal hydronephrosis and to select the optimal timing of surgery if required.     

IL-17在肾间质纤维化中的作用初探

探讨白细胞介素17(IL-17)在肾间质纤维化发生发展中的作用。采用的体内实验为,以单侧输尿管梗阻(unilateral ureteric obstruction,UUO)启动纤维化病理过程。将C57BL/6小鼠分为假手术组(Sham)和单侧输尿管梗阻(unilateral ureteric obstruction,UUO)组,分别于术后第1、3、7天处死,留取手术侧肾组织。采用HE、PAS、PASM、Masson染色评价肾间质组织病理变化。以免疫组化、实时荧光定量PCR(qRT-PCR)法检测α平滑肌肌动蛋白(α-SMA)表达水平;酶联免疫吸附试验(ELISA)检测IL-17在肾组织中的表达情况。体外实验为,分离培养C57BL/6小鼠肾成纤维细胞,转化生长因子β1(TGF-β1)刺激使其转化为肌成纤维细胞,继而用蛋白免疫印迹法(western blotting)检测IL-17的刺激下α-SMA表达水平。结果显示,组织病理学检查显示随着梗阻时间延长,炎性细胞浸润明显,肾小管萎缩,间质面积增大,Ⅰ型胶原和α-SMA增多。PCR检测显示α-SMA mRNA表达增多。但ELISA结果显示肾组织中IL-17含量呈下降趋势。Western blot结果表明肌成纤维细胞在IL-17的刺激下,α-SMA蛋白水平显著下降。实验说明,单侧输尿管梗阻手术可导致相应侧肾组织发生纤维化病变,但肾组织中IL-17含量与纤维化病变并不一致,在体外实验中IL-17可下调肌成纤维细胞表达的α-SMA。     

GOLM1基因敲除对单侧输尿管梗阻小鼠肾纤维化的影响

背景:高尔基体膜蛋白1在人体组织中广泛存在,它的异常表达与癌症、病毒感染等多种疾病密切相关.研究表明,高尔基体膜蛋白1可调控一些纤维化细胞因子,但关于其在肾纤维化中的作用尚不清楚.目的:研究高尔基体膜蛋白1对单侧输尿管梗阻小鼠肾纤维化的影响.方法:选取6-8周龄的高尔基体膜蛋白1敲除小鼠(KO小鼠)和C57BL/6野生...     

TNF-alpha deficiency accelerates renal tubular interstitial fibrosis in the late stage of ureteral obstruction

TNF-α and TGF-β1 have a complementary relationship in fibrogenesis. This study was performed to investigate the role of TNF-α in renal tubular interstitial fibrosis. We compared the extent of renal tubular interstitial fibrosis after unilateral ureteral obstruction (UUO) between wild-type and TNF-α-deficient mice by using immunohistochemistry, enzyme-linked immunoassay, and the real-time polymerase chain reaction (PCR). In comparison with wild-type mice, there was no significant difference in the extent of renal fibrosis in the TNF-α-deficient mice at 2 weeks after UUO. By 4 weeks after UUO, however, fibrosis marked an increase in the TNF-α-deficient mice to exceed that in the wild-type mice. Immunohistochemistry, enzyme-linked immunoassay, and real-time PCR demonstrated an increase of extracellular matrix in the kidneys of TNF-α-deficient mice that was caused by upregulation of the expression of TGF-β1 and Snail, which in turn resulted from an increase of infiltrating macrophages. Real-time PCR revealed an increase in expression of the TNF-α type 2 receptor at 4 weeks after UUO, which explained the difference in the extent of renal fibrosis between TNF-α-deficient and wild-type mice. In the chronic stage of renal fibrosis, TNF-α suppresses the infiltration of macrophages by inducing TNF-α type 2 receptor expression, resulting in the amelioration of fibrosis.     

人参皂苷Rh1对UUO大鼠肾纤维化的抑制作用

目的:观察并探讨人参皂苷Rh1(G-Rh1)对单侧输尿管梗阻(UUO)大鼠肾纤维化的抑制作用及其机制。方法:雄性SD大鼠40只,分为假手术组(sham组)、UUO组、G-Rh1低剂量组和G-Rh1高剂量组。手术后第2天开始,G-Rh1低剂量组和G-Rh1高剂量组分别每日灌胃50 mg/kg和100 mg/kg G-Rh1,连续2周。给药2周后,收集24 h尿测定尿蛋白,收集血清测定血清肌酐(SCr)和血尿素氮(BUN)。HE染色观察肾组织病理变化并对肾组织损伤程度评分。利用免疫组化和Western blot法观察肾组织中转化生长因子β_1(TGF-β_1)、α-平滑肌肌动蛋白(α-SMA)、Ⅰ型胶原蛋白和结缔组织生长因子(CTGF)的表达。结果:肾功能检测显示,各组大鼠24 h尿蛋白定量的差异无统计学显著性。UUO组BUN和SCr明显高于sham组(P 0. 05),G-Rh1低剂量组和G-Rh1高剂量组BUN和SCr明显低于UUO组(P 0. 05),同时G-Rh1高剂量组BUN和SCr低于G-Rh1低剂量组(P 0. 05)。光镜下观察,与sham组比较,UUO组病理改变显著,肾组织损伤明显,G-Rh1低剂量组和G-Rh1高剂量组与UUO组比较,肾损伤明显改善,G-Rh1高剂量组改善程度较G-Rh1低剂量组更显著。肾组织免疫组化显示,与sham组比较,UUO组肾小管及肾间质中TGF-β_1表达明显增多,G-Rh1低剂量组和G-Rh1高剂量组与UUO组比较,TGF-β_1表达明显下降,G-Rh1高剂量组较G-Rh1低剂量组降低更明显。Western blot检测显示,与sham组比较,UUO组Ⅰ型胶原蛋白、α-SMA和CTGF蛋白表达明显增多(P 0. 01),G-Rh1低剂量组和G-Rh1高剂量组与UUO组比较,Ⅰ型胶原蛋白、α-SMA表达明显下降(P 0. 05),G-Rh1高剂量组较G-Rh1低剂量组α-SMA和CTGF蛋白表达明显降低(P 0. 05),而Ⅰ型胶原蛋白表达无显著差异。结论:人参皂苷Rh1可缓解UUO大鼠肾组织纤维化,改善肾功能,其主要机制可能是抑制TGF-β_1信号通路中纤维化相关因子的表达。     

依那普利对大鼠早期肾间质纤维化的影响

目的：观察依那普利对早期肾间质纤维化形成大鼠的疗效,并探讨其作用机制。方法：将60只雄性SD 大鼠随机分为假手术组、单侧输尿管梗阻模型组和依那普利治疗组（每组20只）,治疗组于手术后第4天开始以依那普利灌胃,术后第14天取各组大鼠肾组织分别行HE染色和Masson染色,免疫组织化学检测Ⅰ型胶原、III型胶原在肾组织的蛋白表达。应用Real-time PCR方法检测肾组织中Ⅰ型胶原、III型胶原、血小板源生长因子(platelet drived growth factor,PDGF)-B、转化生长因子（transforming growth factor,TGF）-β1、结缔组织生长因子（cennective tissue growth factor,CTGF）mRNA的水平。应用Western免疫印迹方法检测PDGF-B蛋白的表达。结果：依那普利治疗组大鼠肾脏的肾间质损伤指数、肾间质胶原评分、Ⅰ型胶原、Ⅲ型胶原,以及细胞因子PDGF-B,TGF-β1,CTGF的表达均比模型组明显下降（均P<0.05）。结论：依那普利可通过下调细胞因子PDGF-B,TGF-β1,CTGF的表达而起到治疗单侧输尿管梗阻大鼠肾间质纤维化的作用。     

Renal recruitment of B lymphocytes exacerbates tubulointerstitial fibrosis by promoting monocyte mobilization and infiltration after unilateral ureteral obstruction

Renal fibrosis is a significant threat to public health globally. Diverse primary aetiologies eventually result in chronic kidney disease (CKD) and immune cells influence this process. The roles of monocytes/macrophages, T cells, and mast cells have been carefully examined, whilst only a few studies have focused on the effect of B cells. We investigated B‐cell function in tubulointerstitial fibrosis induced by unilateral ureteral obstruction (UUO), using genetic B‐cell‐deficient μMT mice or CD20 antibody‐mediated B‐cell‐depleted mice. Obstructed kidneys of μMT and anti‐CD20‐treated mice showed lower levels of monocyte/macrophage infiltration and collagen deposition compared to wild‐type mice. Mechanistically, anti‐CD20 attenuated UUO‐induced alterations of renal tumour necrosis factor‐α (TNF‐α), vascular cell adhesion molecule 1 (VCAM‐1) pro‐inflammatory genes, and CC chemokine ligand‐2 (CCL2) essential for monocyte recruitment; B cells were one of the main sources of CCL2 in post‐UUO kidneys. Neutralization of CCL2 reduced monocyte/macrophage influx and fibrotic changes in obstructed kidneys. Therefore, early‐stage accumulation of B cells in the kidney accelerated monocyte/macrophage mobilization and infiltration, aggravating the fibrosis resulting from acutely induced kidney nephropathy. © 2016 The Authors. Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.     

结缔组织生长因子在单侧输尿管梗阻大鼠肾脏中的表达及其意义

目的： 观察结缔组织生长因子（CTGF）在单侧输尿管梗阻（UUO）大鼠模型中的动态表达，探讨CTGF在肾小管间质纤维化中的作用机制。方法： 将48 只Wistar大鼠随机分为UUO组和假手术（SO）组，采用左输尿管结扎术复制UUO模型，于术后1、3、7、14 d分别处死2组大鼠取左肾。采用Masson染色评定肾小管间质损伤程度；逆转录-聚合酶链式反应(RT-PCR) 方法检测肾组织转化生长因子-β₁（TGF-β₁）、CTGF、Ⅰ型胶原（ColⅠ）和纤溶酶原激活物抑制物-1（PAI-1）mRNA表达；免疫组织化学方法测定TGF-β₁、CTGF、ColⅠ、PAI-1表达；Western blotting方法检测CTGF蛋白表达量的变化。结果: UUO术后1d，梗阻肾TGF-β₁ mRNA表达开始升高，第3-14d时升高更显著（P<0.01），CTGF、ColⅠ、PAI-1 mRNA水平随之逐渐升高。免疫组织化学染色发现，UUO大鼠肾小管和间质区域CTGF表达随病程进展逐渐增强；相关分析显示，UUO术后第7d，CTGF表达量与肾小管间质损伤指数、肾小管间质TGF-β₁、ColⅠ、PAI-1表达强度均呈正相关，相关系数（r）分别为0.62、0.85、0.78和0.76（均P<0.01）。Western blotting结果显示，CTGF蛋白水平在术后第3d开始上升，随病程进展更显著。结论: CTGF可通过促进细胞外基质产生和抑制细胞外基质降解双重途径诱导肾小管间质纤维化的发生和进展。     

Protective role of JAK/STAT signaling against renal fibrosis in mice with unilateral ureteral obstruction

Inflammation is involved in renal fibrosis, a final common pathway for kidney diseases. To clarify how JAK/STAT/SOCS system was involved in renal fibrosis, UUO was induced in BALB/c or SOCS3^+/− mice in the presence or absence of JAK inhibitor-incorporated nanoparticle (pyridine6–PGLA). UUO increased pSTAT3 and subsequently elevated SOCS3 levels in the obstructed kidneys. pSTAT3 levels were further increased in SOCS3^+/− mice. UUO-induced renal fibrosis was markedly suppressed in SOCS3^+/− mice, while it was aggravated by pre-treatment with pyridine6–PGLA. Although there were no differences in renal mRNA levels of TGF-β and collagens between wild and SOCS3^+/− mice, MMP-2 activity was enhanced in SOCS3^+/− UUO mice. Activated MMP-2 was completely suppressed by pyridine6–PGLA-pre-treatment. TNF-α one of JAK/STAT activators, increased pSTAT3 levels and subsequently induced MMP-2 activation in proximal tubular cells. These results suggest that JAK/STAT3 signaling may play a role in repair process of renal fibrosis in UUO partly via MMP-2 activation.     

The value of alpha-SMA in the evaluation of hepatic fibrosis severity in hepatitis B infection and cirrhosis development: a histopathological and immunohistochemical study

AIMS: To investigate the value of alpha-smooth muscle actin (alpha-SMA), an indicator of stellate cell activation, in predicting fibrosis in chronic hepatitis B (CHB) patients. METHODS AND RESULTS: The liver biopsy specimens of 30 patients with a clinical diagnosis of CHB were obtained before treatment and scored by Knodell's histological activity index. The specimens were then immunohistochemically stained with alpha-SMA and semiquantitatively evaluated. Fibrosis and the immunoreactivity of alpha-SMA in the periportal, perisinusoidal and pericentral areas were compared. Fibrosis and necroinflammatory activity in CHB patients were significantly correlated (P =0.022). Furthermore, the degree of alpha-SMA expression and the scores of fibrosis (in periportal, perisinusoidal and pericentral areas) were highly correlated (P =0.000, 0.001, 0.000, respectively). CONCLUSIONS: In liver biopsy samples, alpha-SMA may prove to be a valuable marker in the evaluation of stellate cell activation and fibrosis progression and an early indicator of the development of fibrosis.     

霉酚酸酯对糖尿病大鼠肾小管-间质损伤的保护作用及机制

研究霉酚酸酯(MMF)对糖尿病大鼠肾小管-间质损伤的保护作用,并探讨其可能机制。应用链脲佐菌素诱导大鼠糖尿病模型,随机分三组:对照组、模型组与MMF给药组。8周后观察尿白蛋白排泄率(AER)、肾小管-间质病理形态学变化,应用免疫组化方法检测肾小管-间质骨桥蛋白(OPN)与α-平滑肌肌动蛋白(-αSMA)蛋白表达,Western印迹检测肾组织IL-1与TNF-α蛋白表达。结果表明,糖尿病大鼠AER与肾小管-间质损伤指数(TII)明显高于对照组(P<0.01),MMF给药组AER与TII明显低于模型组(P<0.05);免疫组化显示模型组肾小管-间质OPN与-αSMA表达阳性面积明显高于对照组(P<0.01),MMF给药组肾小管OPN与与-αSMA表达阳性面积明显低于模型组(P<0.01);Western印迹显示模型组肾组织IL-1与TNF-α表达较对照组分别增加2.8倍与3.8倍,MMF给药组IL-1与TNF-α表达分别下降73%与70%(P<0.01)。研究显示MMF对糖尿病肾小管-间质损伤有明显保护作用,其机制可能部分与抑制肾小管-间质OPN与-αSMA表达有关。     

Early induction of osteoactivin expression in rat renal tubular epithelial cells after unilateral ureteral obstruction

In this study, we examined the expression of osteoactivin in the rat kidney after unilateral ureteral obstruction. Male Wistar rats were sacrificed at 6h, and on days 1, 2, 3 and 7 after the obstruction. The renal tubular lumens gradually dilated, and marked interstitial fibrosis was confirmed histologically on day 3 after the obstruction. The expressions of osteoactivin and collagen type III were examined by quantitative real-time RT-PCR. An 8-fold increase in osteoactivin mRNA expression as compared with that in the sham-operated group was observed at 6h after the obstruction, whereas no elevation of collagen type III mRNA expression was observed at this early stage. Furthermore, semi-quantitative RT-PCR was performed to identify upregulation of expression of matrix metalloproteinase-13 mRNA relative to that in the sham-operated control, and normalized to the expression level of beta-actin. Intense osteoactivin expression localized in the dilated tubular epithelium and interstitial fibroblasts in the obstructive kidney was detected by immunohistochemistry and by in situ hybridization. These results suggested that the early-phase upregulation of osteoactivin expression in the tubular epithelium in response to renal injury might play a role in triggering renal interstitial fibrosis via activation of matrix metalloproteinase expression and collagen remodeling in rats.     

Evaluation of renal function in sickle cell disease patients in Brazil

The objective of this study was to investigate renal function in a cohort of 98 patients with sickle cell disease (SCD) followed up at a tertiary hospital in Brazil. Clinical and laboratory characteristics at the time of the most recent medical examination were analyzed. Renal function was evaluated by the estimation of glomerular filtration rate (GFR) by the criteria of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). We compared patients with normal GFR to patients with decreased GFR (<60 mL·min⁻¹·(1.73 m²)⁻¹) and hyperfiltration (>120 mL·min⁻¹·(1.73 m²)⁻¹). Comparison between patients according to the use of hydroxyurea and comparison of clinical and laboratory parameters according to GFR were also carried out. Average patient age was 33.8 ± 13.3 years (range 19-67 years), and 57 (58.1%) patients were females. The comparison of patients according to GFR showed that patients with decreased GFR (<60 mL·min⁻¹·(1.73 m²)⁻¹) were older, had lower levels of hematocrit, hemoglobin and platelets and higher levels of urea and creatinine. Independent risk factors for decreased GFR were advanced age (OR = 21.6, P < 0.0001) and anemia (OR = 39.6, P < 0.0001). Patients with glomerular hyperfiltration tended to be younger, had higher levels of hematocrit, hemoglobin and platelets and lower levels of urea and creatinine, with less frequent urinary abnormalities. Hydroxyurea, at the dosage of 500-1000 mg/day, was being administered to 28.5% of the patients, and there was no significant difference regarding renal function between the two groups. Further studies are required to establish the best therapeutic approach to renal abnormalities in SCD.     

Histological, immunohistochemical and biological data in assessing interstitial fibrosis in patients with chronic glomerulonephritis

The aim of this study was to determine the relationship between histological, immunohistochemical (IHC) and biological data in the assessment of interstitial fibrosis in patients with glomerular diseases. A group of 41 patients with primary and secondary glomerulonephritis was studied. In order to quantify the histological changes and to assess the extent of active-inflammatory and chronic-sclerotic/fibrotic interstitial lesions, we adapted a scoring system, initially used for lupus nephritis, and ANCA-associated vasculitis. IHC labeling procedures with monoclonal antibodies anti-smooth muscle actin (SMA), anti-vimentin and anti-transforming growth factor beta (TGFbeta) were assessed using a semi-quantitative score, correlated with the histological and biological data. Our results showed that interstitial labeling of SMA correlated with scores for sclerotic/fibrotic lesions (chronicity index) and with active-inflammatory lesions (interstitial infiltrate, activity index). Interstitial vimentin correlated with the score for interstitial infiltrate. Both interstitial vimentin and TGFbeta immunopositivity correlated with sclerotic/fibrotic lesions (interstitial fibrosis, tubular atrophies, vascular hyalinosis/fibrosis, chronicity index), and negatively with glomerular filtration rate. An important correlation was found between the interstitial labeling of the two IHC markers of myofibroblasts (SMA and vimentin). We conclude that IHC studies related to clinico-biological and histological data can have an important role in the evaluation of the glomerular diseases, but the classical histological investigation assessed through quantification has still not lost its importance.