Nakajima M, Hewitson T D, Mathews D C, Kincaid-Smith P
Department of Nephrology, Royal Melbourne Hospital, Victoria, Australia.
Nephrol Dial Transplant. 1991;6(1):11-6. doi: 10.1093/ndt/6.1.11.
Platelets may play a role in the pathogenesis of IgA glomerulonephritis (IgAGN). Ultrastructural labelling of platelet antigens might identify activated platelets, and localisation of platelet antigens may assist in understanding the role of platelets in glomerular disease. We examined renal biopsies from eight patients with mesangial IgAGN using protein A-gold immunoelectron microscopy. Serial sections were stained with antisera against platelet-derived growth factor (PDGF), platelet factor 4, beta-thrombolglobulin, platelet glycoprotein IIb-IIIa complex, and fibrinogen, as well as antisera against IgA, IgG, IgM and C3c. Platelets, including activated and degranulated platelets, were detected in capillaries in five of eight biopsies. PDGF was detected in mesangial deposits in five of eight cases. In one case immunolabelling was as intense as IgA labelling. Fibrinogen labelling was present in six of eight. Less intense labelling or negative results were obtained with the other antisera. There was no correlation between intensity of immunolabelling and any clinical or morphological features reflecting severity of glomerular lesions. The role of platelets in the pathogenesis of IgAGN remains unclear. The documentation of frequent deposit of PDGF should stimulate further interest in PDGF participation in this condition.
血小板可能在IgA肾小球肾炎(IgAGN)的发病机制中起作用。血小板抗原的超微结构标记可能识别活化的血小板,血小板抗原的定位可能有助于理解血小板在肾小球疾病中的作用。我们使用蛋白A-金免疫电子显微镜检查了8例系膜IgAGN患者的肾活检组织。连续切片用抗血小板衍生生长因子(PDGF)、血小板第4因子、β-凝血球蛋白、血小板糖蛋白IIb-IIIa复合物和纤维蛋白原的抗血清染色,以及抗IgA、IgG、IgM和C3c的抗血清染色。在8例活检组织中的5例中,在毛细血管中检测到血小板,包括活化和脱颗粒的血小板。在8例中的5例中,在系膜沉积物中检测到PDGF。在1例中,免疫标记与IgA标记一样强烈。8例中有6例存在纤维蛋白原标记。用其他抗血清获得的标记强度较低或结果为阴性。免疫标记强度与反映肾小球病变严重程度的任何临床或形态学特征之间均无相关性。血小板在IgAGN发病机制中的作用仍不清楚。PDGF频繁沉积的记录应激发对PDGF参与这种情况的进一步关注。