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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (4): 723-727. doi: 10.19723/j.issn.1671-167X.2019.04.022

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Relationship between podocyte injury and macrophage infiltration in renal tissues of patients with lupus nephritis

Ying WANG,Ming-hui LI,Yan ZHANG,Xiao-yan HU,Rui-xia MA()   

  1. Department of Nephrology, the Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China
  • Received:2018-09-04 Online:2019-08-18 Published:2019-09-03
  • Contact: Rui-xia MA E-mail:anita1685@163.com
  • Supported by:
    Supported by the Science and Technology Fundation of Qingdao City(2012-1-3-2-(2)-nsh)

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Abstract:

Objective: To investigate the relationship between the expression of nephrin and the infiltration of macrophages in renal tissues in patients with lupus nephritis (LN), and to provide the evidence of potential mechanism of podocyte injury in LN.Methods: In the study, 60 patients who were first diagnosed with LN by pathology were selected including 38 active LN patients with r-SLEDAI≥4, and another 10 patients of normal renal tissue were excised as a normal control group. The renal tissue and podocyte injury were observed through light and transmission electron microscope. The expression of nephrin and the infiltration of macrophages (CD68 +cells) in the renal tissue of the 60 LN patients and 10 normal cases were detected by immunohistochemical and immunofluorescence method. Different statistical analysis methods were used to analyze the correlation between the variables. Variance analysis was used for comparison among the groups, while LSD test was used for comparison between every two groups. Pearson correlation analysis was used to analyze the correlation between the variables.Results: (1)Of all the LN patients, 24 h urinary protein [(3.94±1.76) vs. (1.56±0.68), P<0.05], erythrocyte sedimentation rate (ESR) [(79.83±6.3) vs. (40.1±10.5), P<0.05] and serum creatinine [(106.58±14.9) vs. (79.1±9.89), P<0.05] were significantly increased in active group than those in inactive group, while C3 [(0.34±0.12) vs. (0.78±0.11), P<0.05], C4 [(0.07±0.04) vs. (0.17±0.10), P<0.05] and eGFR [(62.42±5.16) vs. (81.33±4.53), P<0.05] were significantly decreased in active group. (2)Compared with the normal control group, the expression of nephrin in renal tissue of the LN patients was significantly decreased, and the expression of nephrin in the active patients was significantly lower than that in inactive group (P<0.05). (3)Compared with the normal control group, the number of infiltrated macrophages in the LN patients was significantly increased, especially in the active patients (P<0.05). Macrophages were mainly found in glomeruli. (4)There was a significant negative correlation between the expression of nephrin and macrophage infiltration in renal tissues of the LN patients (r=0.761, P<0.001).Conclusion: Macrophage infiltration in renal tissues may be one of the potential mechanisms of podocyte injury in lupus nephritis.

Key words: Podocyte, Macrophage, Lupus nephritis

CLC Number: 

  • R593.24 +2

Table 1

Comparison of clinical data among different patients"

Characteristics NC group
(n=10)		 LN group
Inactive(n=22) Active (n=38)
Age/years 34.80±2.00 33.50±2.20 34.50±3.10
24 h UP/g 0.10±0.22 1.56±0.68 3.94±1.76*
Hb/(g/L) 129.00±3.30 112.00±7.70 82.00±6.30*
Serum albumin/(g/L) 42.80±1.48 34.65±2.49 24.51±4.11*
TG/(mmol/L) 0.85±0.22 2.59±0.60 3.81±0.14*
TC/(mmol/L) 3.38±0.29 5.80±0.39 7.46±0.12*
CRP/(mg/L) 1.70±1.09 15.62±2.21 57.28±5.16*
ESR/(mm/1h) 6.12±2.60 40.10±10.50 79.83±6.30*
SCr/(μmol/L) 86.50±9.36 79.10±9.89 106.58±14.90*
C3/(g/L) 1.24±0.21 0.78±0.11 0.34±0.12*
C4/(g/L) 0.37±0.07 0.17±0.10 0.07±0.04*
eGFR/(mL/min) 97.37±3.23 81.33±4.53 62.42±5.16*

Figure 1

Renal tissue pathology A, normal control group (HE ×200); B, inactive LN group (HE×200); C, active LN group (HE ×200)."

Figure 2

Transmission electron microscope images A, normal control group; B, inactive LN group; C, active LN group."

Figure 3

Macrophage infiltration in renal tissue A, macrophages of normal group, LN inactive group and active group by immunohistochemical method; B, CD68+ cell counting, *P < 0.05."

Figure 4

Expression of nephrin by immunofluorescence method A, normal control group; B, inactive LN group; C, active LN group."

Figure 5

Semiquantitative integral value of nephrin in the patients *P < 0.05."

Figure 6

Correlation between macrophage infiltration in renal tissues and expression of nephrin"

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