Khan T N, Sinniah R
Department of Pathology, National University of Singapore.
Histopathology. 1995 Apr;26(4):351-6. doi: 10.1111/j.1365-2559.1995.tb00197.x.
Deposition of immunoglobulins, complement proteins C1q, C3c, C3d, C4, C5, C6, C7, C8, C9, and terminal complement complex neoantigens in the renal tubulointerstitium was studied in serial sections by immunofluorescence microscopy. Renal tissue from 45 cases with various glomerular diseases, including 8 controls, was studied. The patients were divided into groups; one with tubulointerstitial lesions (24 cases) and the other without (13 cases). The immunoproteins were deposited mainly in the tubular basement membrane and blood vessels. Compared with controls there was a significantly increased staining score for C5 to C9 in the tubular basement membrane in both disease groups. However, the increase in terminal complement complex neoantigens score was significant only in the disease group with tubulo interstitial lesions. The changes in C3d score were not significant. Serial sections showed consistent and heavy ribbon-like deposits of complement proteins C3d, C5 to C9, and terminal complement complex neoantigens in corresponding locations of the segments of tubular basement membrane, mainly in the disease group with tubulointerstitial lesions and especially in the damaged tubules. These findings suggest that in situ activation of the complement cascade leads to the deposition of terminal complement complex neoantigens. Complement activation in the basal area of the tubules may, therefore, be an important pathogenetic mechanism in tubulointerstitial damage.
通过免疫荧光显微镜对连续切片中肾小管间质内免疫球蛋白、补体蛋白C1q、C3c、C3d、C4、C5、C6、C7、C8、C9以及末端补体复合物新抗原的沉积情况进行了研究。对45例患有各种肾小球疾病的患者的肾组织进行了研究，其中包括8例对照。患者被分为两组，一组有肾小管间质病变（24例），另一组无病变（13例）。免疫蛋白主要沉积在肾小管基底膜和血管中。与对照组相比，两个疾病组肾小管基底膜中C5至C9的染色评分均显著增加。然而，末端补体复合物新抗原评分的增加仅在有肾小管间质病变的疾病组中显著。C3d评分的变化不显著。连续切片显示，补体蛋白C3d、C5至C9以及末端补体复合物新抗原在肾小管基底膜各段的相应位置呈一致且大量的带状沉积，主要见于有肾小管间质病变的疾病组，尤其是受损肾小管。这些发现表明补体级联反应的原位激活导致末端补体复合物新抗原的沉积。因此，肾小管基底区域的补体激活可能是肾小管间质损伤的一个重要发病机制。
