Li H L, Hancock W W, Hooke D H, Dowling J P, Atkins R C
Department of Nephrology, Prince Henry's Hospital, Melbourne, Victoria, Australia.
Kidney Int. 1990 Jun;37(6):1552-6. doi: 10.1038/ki.1990.148.
Our previous immunohistologic studies with monoclonal antibodies (mAb) showed that glomerular and interstitial accumulations of mononuclear cells (MNC) were common features of many types of proliferative glomerulonephritis, especially crescentic glomerulonephritis. The current study examined a series of patients with crescentic IgA disease, since IgA disease in general has a highly variable course and the presence of crescents is one indicator of likely progression to end-stage renal failure. We compared the intraglomerular and interstitial infiltrates within biopsies from patients with crescentic IgA nephropathy (N = 5) versus those with noncrescentic IgA (N = 18), or normal controls (N = 10). Few leucocytes were found within glomeruli of normal (2.4 +/- 0.7 cells/glomerular cross section) (mean +/- SEM) or noncrescentic IgA disease biopsies (3.8 +/- 0.7), and no activated MNC bearing receptors for interleukin-2 (IL-2R) were detected. By contrast, in crescentic IgA disease, glomerular leucocytes were increased (5.1 +/- 0.6, P less than 0.01), due to increased monocyte (3.1 +/- 0.9, P less than 0.01) and T cell (1.4 +/- 0.4, P less than 0.01) infiltration, and IL-2R + MNC were then observed (1.2 +/- 0.5, P less than 0.05). Studies of interstitial cells showed small numbers of leucocytes within normal kidneys (101 +/- 16/mm2). Biopsies from noncrescentic IgA disease showed a fivefold increase in interstitial MNC infiltration (total leucocytes 565 +/- 105/mm2, P less than 0.01), due to an influx of T cells (283 +/- 59/mm2, P less than 0.01) and monocytes (120 +/- 32/mm2, P less than 0.01), and including a mean of 20% IL-2R+ MNC (114 +/- 29/mm2, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
我们之前使用单克隆抗体（mAb）进行的免疫组织学研究表明，单核细胞（MNC）在肾小球和间质中的积聚是多种类型增生性肾小球肾炎的常见特征，尤其是新月体性肾小球肾炎。当前研究对一系列新月体性IgA肾病患者进行了检查，因为一般而言IgA肾病病程高度多变，而新月体的存在是可能进展至终末期肾衰竭的一个指标。我们比较了新月体性IgA肾病患者（N = 5）与非新月体性IgA患者（N = 18）或正常对照（N = 10）活检组织中的肾小球内和间质浸润情况。在正常（2.4±0.7个细胞/肾小球横截面）（均值±标准误）或非新月体性IgA疾病活检组织的肾小球中发现的白细胞很少（3.8±0.7），且未检测到带有白细胞介素-2受体（IL-2R）的活化MNC。相比之下，在新月体性IgA疾病中，肾小球白细胞增多（5.1±0.6，P<0.01），这是由于单核细胞（3.1±0.9，P<0.01）和T细胞（1.4±0.4，P<0.01）浸润增加所致，随后观察到IL-2R + MNC（1.2±0.5，P<0.05）。间质细胞研究显示正常肾脏中有少量白细胞（101±16/mm²）。非新月体性IgA疾病活检组织显示间质MNC浸润增加了五倍（总白细胞565±105/mm²，P<0.01），这是由于T细胞（283±59/mm²，P<0.01）和单核细胞（120±32/mm²，P<0.01）的流入，且平均包括20%的IL-2R + MNC（114±29/mm²，P<0.01）。（摘要截取自250词）
