Origin of hyperplastic epithelial cells in idiopathic collapsing glomerulopathy
| Autor: | Itaru Kihara, K. Kawasaki, M Hara, Toshio Yanagihara, Tadashi Yamamoto, Eishin Yaoita |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Histology Biology Immunophenotyping Pathology and Forensic Medicine Podocyte Adherens junction Cytokeratin Focal segmental glomerulosclerosis medicine Humans Child Hyperplasia Glomerulosclerosis Focal Segmental CD68 Cell Differentiation Epithelial Cells General Medicine Middle Aged medicine.disease Epithelium Microscopy Electron medicine.anatomical_structure Antigens Surface Female Synaptopodin |
| Zdroj: | Histopathology. 34:537-547 |
| ISSN: | 1365-2559 0309-0167 |
| Popis: | Aims Glomerular epithelial cell hypertrophy and hyperplasia are listed as the primary criteria for the diagnosis of collapsing glomerulopathy (CG), a distinct variant of focal segmental glomerulosclerosis. However, the extent of podocyte phenotypic alterations that occur in CG, and the origin of the hyperplastic epithelial cells remain to be established. Methods and results Renal biopsy materials from seven out of three patients with CG were studied by serial section analysis for immunohistochemistry and electron microscopy. Markers for podocytes (PHM5 and synaptopodin), parietal epithelial cells (PECs: cytokeratin) and macrophages (CD68) were used for the immunohistochemistry. Multiple ultrathin sections from a total of 15 glomeruli, including some from patients with CG, were examined by electron microscopy. Glomerular adhesions occurred in 71% of the serially sectioned glomeruli taken from patients with CG. Hyperplastic epithelial cells were immunonegative for podocyte markers and CD68, but invariably immunopositive for cytokeratin. Electron microscopy revealed that detachment of the podocytes from involved glomerular capillary walls was extensive. Many of the detached podocytes appeared to be necrotic and apoptotic. In contrast, junctional complexes of desmosomes and zonula adherens connected hyperplastic epithelial cells to each other. Cilia were also often observed. Conclusions The results of our ultrastructural and immunohistochemical study suggest that the hyperplastic epithelial cells observed in cases of CG are derived from PECs. Our results raise the possibility that PECs play a general role in covering glomerular tufts from which the podocytes have disappeared. |
| Databáze: | OpenAIRE |
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