Clinical implications of DNA-topoisomerases examination in renal biopsies from nephritis patients
Autor: | L V Ivanovа, E M Shilov, A A Ivanov, L V Kozlovskaya, P Rudolph, D Proppe |
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Jazyk: | ruština |
Rok vydání: | 2003 |
Předmět: | |
Zdroj: | Терапевтический архив, Vol 78, Iss 6, Pp 11-17 (2003) |
Druh dokumentu: | article |
ISSN: | 0040-3660 2309-5342 |
Popis: | Aim. To study expression of topoisomerases (TI) I and Ha (DNA-bound enzymes involved in transcription and replication) in renal tissue as markers of activity and prognosis of glomerulonephritis (GN) decisive for choice of immunodepressive therapy. Material and methods. TI expression was studied immunohistochemically in renal biopsies from 177 patients with different morphological variants of GN and in the samples of unaffected kidney tissue removed in 12 patients for local tumors. Results. There are definite differences between proliferative and поп-proliferative GN variants - elevation of TI levels and monocytic infiltration in proliferative GN. Focal-segmental glomerulosclerosis is characterized by a high TI Ila level in mesangial cells and monocytic infiltration of the glomeruli which are typical for inflammation. A statistical relationship between TI levels in mesangial cells and glomerular epithelium suggests a pathogenetic relation between these links of the pathological process. Molecular markers of activation and proliferation of cells and direct inductors of the inflammatory process (cells of monocytic infiltrate) closely correlated with the activity index - an integral indicator of inflammatory activity, as well as with the integral indicator of sclerotic processes in renal tissuesclerosis index. Monocytic infiltration in the interstitium correlated both with morphological manifestations of activity, progression of nephritis and their clinical equivalents. In high TI expression GN resistance to immunodepressive therapy rose. To overcome the resistance, immunodepressive therapy must be more active - large doses and duration of treatment. In patients with lupus nephritis and merenal GN prognosis was worse in the presence of high TI expression in mesangial cells and epithelium of the renal canaliculi. Conclusion. The authors are the first to demonstrate TI expression in renal tissue of GN patients, correlation of its level with activity of renal process as well as its role in prediction of response to treatsangiocapillary ment and the rate of renal failure progression. It is suggested that high TI expression entails a progressive course of GN. |
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