scholarly journals Clinicopathological and prognostic study of IgA-dominant postinfectious glomerulonephritis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ziyuan Huang ◽  
Bo Chen ◽  
Ying Zhou ◽  
Yan Liang ◽  
Wenxian Qiu ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Iga Nephropathy ◽  
Deposition Rate ◽  
Selection Criteria ◽  
Proliferative Glomerulonephritis ◽  
Complement C3 ◽  
Mesangial Area ◽  
Postinfectious Glomerulonephritis ◽  
Endocapillary Proliferative Glomerulonephritis ◽  
Area Deposition

Abstract Background The clinicopathological and prognostic features of IgA-dominant postinfectious glomerulonephritis and its difference from the primary IgA nephropathy remains to be investigated. Methods The clinical and pathological data of 6542 patients who underwent renal biopsy from 2009 to 2020 in our hospital were reviewed and 50 patients who met the selection criteria of IgA-dominant postinfectious glomerulonephritis were enrolled to conduct a retrospective and observational single-center study. The selection criteria were: meet the characteristics of IgA dominance or codominance in immunofluorescence, and conform to 3 of the following 5 criteria: 1.Clinical or laboratory evidence show that there is infection before or at the onset of glomerulonephritis; 2.The level of serum complement decreased; 3.Renal pathology is consistent with endocapillary proliferative glomerulonephritis; 4. Glomerular immunofluorescence staining showed complement C3 dominance or codominance; 5. Hump-like subepithelial immune complex deposition was observed under electron microscopy. According to age, sex, renal function (estimated glomerular filtration rate, eGFR) and follow-up time, the control group was constructed with 1:3 matched cases of primary IgA nephropathy. The clinicopathological and prognostic differences between the two groups were analyzed. Results The most common histological pattern of IgA-dominant postinfectious glomerulonephritis was acute endocapillary proliferative glomerulonephritis and exudative glomerulonephritis. Immunofluorescence showed mainly IgA deposition or IgA deposition only, mainly deposited in the mesangial area (deposition rate 100 %), with typical C3 high-intensity staining (intensity++~+++), mainly deposited in the mesangial area (deposition rate 92.0 %). The fluorescence intensity of kappa is usually not weaker than lambda. The probability of the appearance of typical hump-like electron deposition under electron microscopy is low. Compared to primary IgA nephropathy, patients with IgA-dominant postinfectious glomerulonephritis had higher proportion of crescents (p = 0. 005) and endocapillary hypercellularity (p < 0.001) in pathological manifestations. Using serum creatinine level doubled of the baseline or reached end-stage renal disease as the endpoint, the prognosis of IgA-dominant postinfectious glomerulonephritis patients was worse than that of primary IgA nephropathy patients (p = 0.013). Conclusions The clinicopathological features of patients with IgA-dominant postinfectious glomerulonephritis was different from that of primary IgA nephropathy, and the prognosis was worse.

scholarly journals Urinary sediments could differentiate the endocapillary proliferative lupus nephritis and endocapillary proliferative IgA nephrology

2020 ◽  
Author(s):  
Mo Yuan ◽  
Jing-zi Li ◽  
Xiao-juan Yu ◽  
Hong Zhang ◽  
Ying Tan
Keyword(s):  
Lupus Nephritis ◽  
Disease Activity ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Proliferative Glomerulonephritis ◽  
Renal Outcome ◽  
Pathological Features ◽  
Urinary Sediment ◽  
Proliferative Lupus Nephritis ◽  
Endocapillary Proliferative Glomerulonephritis

Abstract Background: The role of manual urine sediment examination in the diagnosis and prognostication of endocapillary proliferative glomerulonephritis remains to be elucidated. This study aims to investigated the differences of urinary sediment findings between lupus nephritis and IgA nephropathy with endocapillary proliferative glomerulonephritis and further evaluated associations of leukocyturia with disease activity, pathological features and prognosis.Methods: The urinary sediment of 126 patients, including 92 patients with lupus nephritis and 34 patients with IgA nephropathy, with a renal biopsy-proven endocapillary proliferative glomerulonephritis were examined in the morning before renal biopsy according to a standardized method. The urinary elements investigated including various cells, casts and crystals. The associations of the level of leukocyturia and disease activity, pathological features and prognosis were further analyzed.Results: In the patients with endocapillary proliferative glomerulonephritis, normal to mild leukocyturia (≤12/HPF), and moderate to severe leukocyturia (>12/HPF) were found in 52(41.27%) and 74 (58.73%) patients, respectively. The proportion of moderate to severe leukocyturia, the frequency of urinary white blood cells casts and waxy casts were significantly higher in endocapillary proliferative lupus nephritis patients compared with endocapillary proliferative IgA nephropathy patients (P<0.001, P=0.020, P=0.010, respectively). In the proliferative lupus nephritis group, the levels of leukocyturia was significantly correlated with serum creatinine (r=0.288, P=0.005), eGFR (r=-0.284, P= 0.006), serum C3 (r=-0.275, P= 0.009) , SLEDAI scores (r=0.383, P=＜0.001) and glomerular leukocyte infiltration (r=0.285, P= 0.002). A multivariate analysis showed that leukocyturia was identified as an independent risk factor for renal outcome in proliferative lupus nephritis (HR: 1.456, 95% CI: 1.083-1.957, P=0.013) but not in IgA nephropathy (HR: 1.069, 95% CI: 0.494-2.312, P=0.866).Conclusions: Urinary sediments of the endocapillary proliferative lupus nephritis and endocapillary proliferative IgA nephrology differed in many aspects. Leukocyturia could reflect the disease activity and prognosis of endocapillary proliferative glomerulonephritis, especially in lupus nephritis.

Soluble fibrin formation in the mesangial area of IgA nephropathy

2007 ◽  
Vol 11 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Ning Liu ◽  
Noriko Mori ◽  
Noriyuki Iehara ◽  
Kazuhide Uemura ◽  
Atsushi Fukastu ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Soluble Fibrin ◽  
Fibrin Formation ◽  
Mesangial Area

scholarly journals Activated complement C3: A potentially novel predictor of progressive IgA nephropathy

1997 ◽  
Vol 51 (4) ◽  
pp. 1257-1264 ◽  
Author(s):  
Jörg Zwirner ◽  
Michael Burg ◽  
Matthias Schulze ◽  
Reinhard Brunkhorst ◽  
Otto Götze ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Complement C3

scholarly journals Correlates of hematuria on glomerular histology and electron microscopy in IgA nephropathy

2016 ◽  
Vol 72 (2) ◽  
pp. 120-124
Author(s):  
Rohit Tewari ◽  
Ritambhra Nada ◽  
Maninder Kaur ◽  
Puja Dudeja ◽  
Charan Singh Rayat ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Iga Nephropathy

Immunoglobulin A-dominant post-infectious glomerulonephritis

2018 ◽  
Author(s):  
Bernardo Rodriguez-Iturbe ◽  
Mark Haas
Keyword(s):  
Electron Microscopy ◽  
Staphylococcus Aureus ◽  
Nephrotic Syndrome ◽  
Risk Factor ◽  
Iga Nephropathy ◽  
Immunoglobulin A ◽  
Renal Lesion ◽  
Crescent Formation ◽  
Histological Features ◽  
Post Infectious

Immunoglobulin A (IgA)-dominant post-infectious glomerulonephritis is usually associated with infections with Staphylococcus aureus. It is most commonly seen in patients over 60, and particularly in men. The renal lesion is acute and severe, and commonly includes crescent formation, although the described histological features vary widely. IgA is the dominant immunoglobulin and in later phases when capillary deposits are resolving it may be impossible to distinguish the condition from IgA nephropathy without the use of electron microscopy. Diabetes appears to be a risk factor. Complement levels are frequently low but may be normal. Clinically there is often severe nephrotic syndrome and hypertension may be less prominent.

scholarly journals microRNA-630 Regulates Underglycosylated IgA1 Production in the Tonsils by Targeting TLR4 in IgA Nephropathy

2020 ◽  
Vol 11 ◽  
Author(s):  
Chan Liu ◽  
Mu-Yao Ye ◽  
Wen-Zhe Yan ◽  
Xiao-Fei Peng ◽  
Li-Yu He ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Molecular Mechanisms ◽  
Mononuclear Cells ◽  
Immunohistochemical Analysis ◽  
Bioinformatic Analysis ◽  
Cell Culture Supernatant ◽  
Mechanism Study ◽  
Complement Components ◽  
Mesangial Area ◽  
Primary Glomerular Disease

IgA nephropathy (IgAN) is the most common primary glomerular disease. The characteristic pathology involves immune complexes formed by the deposition of IgA1 and underglycosylated IgA1 aggregates in the mesangial area, which may be accompanied by the deposition of IgG and/or IgM and complement components. However, the molecular mechanisms of IgAN remain unclear. In the present study, microarray analysis showed that the expression of microRNA-630 (miR-630) was significantly reduced in palatal tonsils from IgAN patients compared with chronic tonsillitis. Additionally, bioinformatic analysis showed that Toll-like receptor 4 (TLR4) was the predicted target gene of miR-630 and was regulated by miR-630. When miR-630 was overexpressed in palatal tonsil mononuclear cells from IgAN patients, the expression of TLR4 was reduced and the content of IgA1 in the cell culture supernatant was decreased, and the level of galactosylation in the IgA1 hinge region was increased. Moreover, immunohistochemical analysis showed that the expression of TLR4 in IgAN patients was significantly increased. After knocking down the expression of TLR4, both the concentration of IgA1 and the binding force of IgA1 with broad bean lectin were significantly reduced in IgAN. Furthermore, the mechanism study demonstrated that TLR4 might regulate the expression of IL-1β and IL-8 through NF-κB signaling pathway to modulate the concentration of IgA1 and the glycosylation level of IgA1. This interesting finding may offer new insight into the molecular mechanism of IgAN.

scholarly journals The TLR4-MyD88-NF-κB pathway is involved in sIgA-mediated IgA nephropathy

2020 ◽  
Vol 33 (6) ◽  
pp. 1251-1261 ◽  
Author(s):  
Junjun Zhang ◽  
Yiming Mi ◽  
Ruwen Zhou ◽  
Zhangsuo Liu ◽  
Bo Huang ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Mesangial Cells ◽  
Immunofluorescence Assay ◽  
Kidney Damage ◽  
Secretory Iga ◽  
Tnf Α ◽  
Mesangial Area ◽  
Enhanced Expression ◽  
Better Than

AbstractPrevious studies have shown that secretory IgA (sIgA) was critically involved in IgA nephropathy (IgAN) immune responses. Toll-like receptors (TLRs), especially TLR4 which participates in mucosal immunity, may be involved in the pathogenesis of IgAN. The purpose of this study was to investigate whether sIgA and TLR4 interact to mediate kidney damage in IgAN patients. IgAN patients with positive sIgA deposition in renal tissues were screened by immunofluorescence assay. Patient salivary sIgA (P-sIgA) was collected and purified by jacalin affinity chromatography. Salivary sIgA from healthy volunteers was used as a control (N-sIgA). Expression of TLR4, MyD88, NF-κB, TNF-α, IL-6, and MCP-1 were detected in the mesangial area of IgAN patients by immunohistochemistry, the expression levels in patients with positive sIgA deposition were higher than that with negative sIgA deposition. Human renal mesangial cells (HRMCs) were cultured in vitro, flow cytometry showed that P-sIgA bound HRMCs significantly better than N-sIgA. HRMCs were cultured in the presence of sIgA (400 μg/mL) for 24 h, compared with cells cultured with N-sIgA, HRMCs cultured in vitro with P-sIgA showed enhanced expression of TLR4, increased secretion of TNF-α, IL-6, and MCP-1, and increased expression of MyD88/NF-κB. TLR4 shRNA silencing and NF-κB inhibition both reduced the ability of HRMCs to synthesize TNF-α, IL-6, and MCP-1. Our results indicate that sIgA may induce high expression of TLR4 in HRMCs and further activate downstream signalling pathways, prompting HRMCs to secrete multiple cytokines and thereby mediating kidney damage in IgAN patients.

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