Department of Internal Medicine, National Defense Medical College, Saitama 359-8513, Japan.
Hum Pathol. 2010 Sep;41(9):1276-85. doi: 10.1016/j.humpath.2010.02.006. Epub 2010 Jun 17.
The nephritis-associated plasmin receptor is a recently identified nephritogenic antigen associated with acute poststreptococcal glomerulonephritis and proposed to play a pathogenic role, but its precise glomerular localization in acute poststreptococcal glomerulonephritis has not been elucidated. We therefore analyzed renal biopsy sections from 10 acute poststreptococcal glomerulonephritis patients by using immunofluorescence staining with anti-nephritis-associated plasmin receptor antibody and various markers of glomerular components. Nephritis-associated plasmin receptor was detected in the glomeruli of all patients, and double staining for nephritis-associated plasmin receptor and collagen IV showed nephritis-associated plasmin receptor to be predominantly on the inner side of the glomerular tufts. Nephritis-associated plasmin receptor-positive areas within glomerular tufts were further characterized with markers for neutrophils, mesangial cells, endothelial cells, and macrophages. In 6 of the patients, nephritis-associated plasmin receptor staining was seen mainly in neutrophils and to a lesser degree in mesangial and endothelial cells. In the other 4 patients, nephritis-associated plasmin receptor staining was seen mainly in mesangial cells and to a lesser degree in neutrophils and endothelial cells. In all patients, macrophages showed little staining. Elevated plasmin activity in glomerular neutrophils was identified by combining in situ zymography staining for plasmin activity and immunofluorescence staining for neutrophils. The glomerular localizations of nephritis-associated plasmin receptor and another nephritogenic antigen, streptococcal pyrogenic exotoxin B, were compared by double immunofluorescence staining and found to be similar. These findings indicate the nephritogenic potential of nephritis-associated plasmin receptor and offer valuable information with respect to the pathogenic mechanism of acute poststreptococcal glomerulonephritis.
肾炎相关纤溶酶受体是一种新近发现的与急性链球菌后肾小球肾炎相关的致病抗原，被认为在发病机制中起作用，但它在急性链球菌后肾小球肾炎中的确切肾小球定位尚未阐明。因此，我们用抗肾炎相关纤溶酶受体抗体和各种肾小球成分的标记物通过免疫荧光染色分析了 10 例急性链球菌后肾小球肾炎患者的肾活检标本。肾炎相关纤溶酶受体在所有患者的肾小球中均被检测到，肾炎相关纤溶酶受体和胶原 IV 的双重染色显示肾炎相关纤溶酶受体主要位于肾小球丛的内侧。肾小球丛内肾炎相关纤溶酶受体阳性区域用标记物进一步表征中性粒细胞、系膜细胞、内皮细胞和巨噬细胞。在 6 例患者中，肾炎相关纤溶酶受体染色主要见于中性粒细胞，其次见于系膜细胞和内皮细胞。在另外 4 例患者中，肾炎相关纤溶酶受体染色主要见于系膜细胞，其次见于中性粒细胞和内皮细胞。所有患者的巨噬细胞染色都很少。通过结合原位酶谱染色检测纤溶酶活性和中性粒细胞免疫荧光染色，鉴定出肾小球中性粒细胞中纤溶酶活性升高。用双重免疫荧光染色比较肾炎相关纤溶酶受体和另一种致肾炎抗原链球菌致热外毒素 B 的肾小球定位，发现它们的定位相似。这些发现表明肾炎相关纤溶酶受体具有致肾炎潜能，并为急性链球菌后肾小球肾炎的发病机制提供了有价值的信息。
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