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Background: To clarify the role of subclasses of macrophages in chronic glomerulonephritis, we evaluated the relationship between myeloid-related protein 8 (MRP8) and MRP14 expression on macrophages and the progression of membranoproliferative glomerulonephritis (MPGN)., Methods: We enrolled 35 patients with MPGN type 1 who had a normal creatinine clearance at the time of their first renal biopsy and divided them into 2 groups based on clinical status at the time of their most recent examination: 12 patients with normal urine test results and 12 patients with minor urinary abnormalities at the latest observation (group 1) and 7 patients with persistent nephropathy and 4 patients with renal insufficiency (group 2). The first and second renal biopsy findings and MRP8 and MRP14 expression on macrophages were investigated in both groups., Results: Mean scores for positive glomerular and interstitial MRP8 and CD68 staining at the time of the first and second biopsies were significantly higher in group 2 than group 1. At the time of the second biopsy, mean scores for interstitial CD68-positive (CD68 +) staining were higher in group 2 than group 1. Mean scores for glomerular and interstitial MRP8 + and CD68 + staining at the time of the first biopsy correlated with the chronicity index at the time of second biopsy in both groups., Conclusion: Results suggest that MRP8 expression on macrophages in glomeruli and interstitial lesions at the first biopsy can be a useful prognostic marker for renal dysfunction in children with MPGN type 1.

Background: FB21 is reactive with glomerular endothelial cells and distal tubules of the human kidney and is bound to a sialic-acid-dependent cell-surface antigen. We evaluated FB21 staining in fetal kidneys and kidneys of children and adults with normal kidneys and glomerulonephritis and investigated whether FB21 can be used as a marker for endothelial cell injury., Methods: This study was performed on 6 children, 10 adults, and 12 fetuses with normal kidneys and 113 patients diagnosed with primary and secondary glomerulonephritis. We evaluated renal staining for FB21 in children with normal kidneys and glomerulonephritis and measured serum E-selectin concentrations in patients with hemolytic uremic syndrome (HUS) and Henoch-Schönlein purpura nephritis (HSPN)., Results: (1) FB21 was reactive with endothelial cells of normal kidneys and detected on the surface of endothelial cells by immunoelectron microscopy. (2) FB21 was reactive with endothelial cells in kidneys of fetuses older than 32 weeks. (3) Endothelial cell FB21 staining scores in the first renal biopsy specimens of patients with HUS and HSPN were lower than those in normal kidneys of children and correlated negatively with serum E-selectin concentrations. (4) Endothelial cell FB21 staining of crescentic and sclerotic glomerular lesions in patients with immunoglobulin A nephropathy, membranoproliferative glomerulonephritis, and focal glomerulosclerosis was weaker than that in normal kidneys., Conclusion: These results suggest that FB21 can be used as a marker for glomerular endothelial cell injury in various types of glomerulonephritis.

Background: To clarify the mechanism of deposition of immunoglobulin G (IgG) subclasses in glomerulonephritis in children, we investigated IgG subclasses in glomerular deposits and T helper subtype 1 (T(H)1)/T(H)2 cytokine balance in pediatric patients with glomerulonephritis., Methods: We enrolled 95 children in whom glomerulonephritis had been diagnosed in our hospital between 1993 and 2000. Patients were divided into 5 groups according to histological diagnosis: 31 patients with lupus nephritis (LN), 22 patients with membranoproliferative glomerulonephritis (MPGN), 7 patients with membranous glomerulonephritis (MGN), 20 patients with Henoch-Schönlein purpura nephritis, and 20 patients with IgA nephropathy. We compared serum IgG subclass values, serum cytokine (interleukin-2 [IL-2] receptor [IL-2R], IL-2, IL-4) values, and immunofluorescence evidence of glomerular IgG subclasses in the kidney among groups., Results: (1) High serum IgG1 and IgG2 values and glomerular IgG1 and IgG2 deposits were found frequently in the LN group. (2) High serum IgG3 values and glomerular IgG3 deposits were found frequently in the MPGN group. (3) High serum IgG4 values and glomerular IgG4 deposits were found frequently in the MGN group. (4) Conversely, cytokine measurements showed high serum IL-2 and IL-2R values in the LN and MPGN groups, and serum IL-4 values were high in the MGN group., Conclusion: These findings suggest that the pathogenetic mechanism of LN may involve both the T(H)1 and T(H)2 pattern, the pathogenetic mechanism of MPGN may involve the T(H)1 pattern, and the pathogenetic mechanism of MGN may involve the T(H)2 pattern.