Saito T, Ootaka T, Sato H, Furuta T, Sato T, Soma J, Abe K, Yoshinaga K
Second Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
J Pathol. 1993 Jun;170(2):179-85. doi: 10.1002/path.1711700214.
We studied infiltrating cells in the glomeruli of eight cases with focal segmental endocapillary proliferation (FSEP) using monoclonal antibodies to leukocyte common antigen, T cells, B cells, and monocytes/macrophages (Mo/M psi). It was demonstrated by sequential biopsies performed in five cases that FSEP preceded focal glomerular sclerosis (FGS). Cell types in FSEP were compared with those in FGS from 17 patients with persistent nephrotic syndrome, ten non-nephrotic patients, and eight patients with nephrotic syndrome which was initially responsive to steroid therapy but relapsed, as well as minimal change specimens from nine nephrotic patients. In the glomeruli, the mean total leukocyte counts increased significantly in the FSEP group (P < 0.01). The serial sections in FSEP revealed that Mo/M psi were the predominant cells and were localized in areas of endocapillary proliferation. T-cell or B-cell infiltration was less marked. The extensive intracapillary distribution of p150,95 antigen belonging to the integrin family and acting as a C3bi receptor suggested that FSEP may be mediated by adhesion molecules expressed on Mo/M psi. These findings indicate that Mo/M psi may play a key role in FGS which shows endocapillary proliferation in the initial stage.
我们使用针对白细胞共同抗原、T细胞、B细胞以及单核细胞/巨噬细胞（Mo/Mψ）的单克隆抗体，研究了8例局灶节段性毛细血管内增生（FSEP）患者肾小球中的浸润细胞。5例患者的序贯活检表明，FSEP先于局灶性肾小球硬化（FGS）出现。将FSEP中的细胞类型与17例持续性肾病综合征患者、10例非肾病患者、8例最初对类固醇治疗有反应但复发的肾病综合征患者以及9例肾病患者的微小病变标本中的FGS细胞类型进行了比较。在肾小球中，FSEP组的平均白细胞总数显著增加（P < 0.01）。FSEP的连续切片显示，Mo/Mψ是主要细胞，且定位于毛细血管内增生区域。T细胞或B细胞浸润不太明显。属于整合素家族并作为C3bi受体的p150,95抗原在毛细血管内广泛分布，提示FSEP可能由Mo/Mψ上表达的黏附分子介导。这些发现表明，Mo/Mψ可能在初始阶段表现为毛细血管内增生的FGS中起关键作用。
