Macrophages in Human Immunodeficiency Virus-Associated Kidney Diseases
| Autor: | A. Andrew Abraham, Istvan Bodi, Paul L. Kimmel |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
B-Lymphocytes
Kidney Pathology medicine.medical_specialty medicine.diagnostic_test Glomerulosclerosis Focal Segmental business.industry Macrophages T-Lymphocytes T cell Renal function HIV Infections Immunohistochemistry Glomerulonephritis medicine.anatomical_structure Immune system Nephrology Immunopathology Immunology Biopsy medicine Humans Renal Interstitial Tissue business B cell |
| Zdroj: | American Journal of Kidney Diseases. 24:762-767 |
| ISSN: | 0272-6386 |
| Popis: | Human immunodeficiency virus (HIV)-associated nephropathies are characterized by renal immune cell interstitial infiltration in patients with peripheral T-cell depletion. Since interstitial inflammation may mediate cytokineinduced fibrosis, we evaluated the immune cell population in the interstitium and glomeruli in renal biopsy tissue from 10 HIV-infected patients with focal segmental glomerulosclerosis (HIVFGS), staining renal biopsy specimens for UCHL-1 (a T-cell marker), 013134 (predominantly a T helper-cell marker), PG-M1 (a macrophage marker), and L26 (a B-cell marker), and comparing them with renal tissue specimens from patients with HIV-associated immune complex glomerulonephritis (ICD) and from uninfected patients with FGS. Five fields comprising 0.2 mm 2 were examined at a magnification of ×400, a total area of 1 mm 2 . Total immune cells were estimated as the sum of UCHL-1, L-26, and PG-M1 cells. The T helper to suppressor (HIS) ratio was estimated as OPD4/(UCHL-1 - OPD4) lymphocytes. Tubular interstitial infiltrate was variable but dense in the majority of the infected biopsies, and was mild to moderate in all uninfected cases. The proportion of interstitial macrophages was greater in biopsy specimens from patients with HIVFGS than in those with HIVICD. In contrast, there was a greater percentage of B cells in the infiltrate in HIVICD compared with HIVFGS. Although there were fewer immune cells in whole glomeruli compared with 1 mm 2 interstitium, macrophages were the predominant cells in glomeruli. B lymphocytes were generally absent in glomeruli in infected tissue, a pattern similar to uninfected tissue. The blood H/S ratio in HIVinfected patients was 0.2 ± 0.03. However, the HIS ratio in infected renal interstitial tissue was not different from that in uninfected tissue. Immune cell populations in glomeruli did not correlate with serum creatinine concentration or creatinine clearance in all patients or in any individual subgroup. The total number of glomerular immune cells, T cells, and macrophages correlated with urinary protein excretion in patients with HIVFGS. The glomerular macrophage to T cell ratio correlated with the level of urinary protein excretion in patients with HIVICD. The total number of interstitial immune cells and serum creatinine correlated strongly in the group with HIVICD. Urinary protein excretion correlated with the number of total interstitial immune cells in the entire study population, in all HIV-infected patients, and in patients with HIVICD. In patients with HIVFGS, the interstitial H/S ratio correlated directly with the creatinine clearance. Our data suggest that immune cell sequestration occurs in renal tissue in HIV-infected patients. Increased infiltrating immune cells, and specifically macrophage infiltration, may be associated with the pathogenesis of HIVFGS. |
| Databáze: | OpenAIRE |
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