CD44 Expression In IgA Nephropathy And Its Clinical Implications

Objective To research the effects of CD44 on the pathogenesis of IgA nephropathy and clinical implications of CD44, CD44 expression was determined in patients with IgA nephropathy in different stages.Method CD44 expression was detected by immunohistochemical S-P method in 34 specimens from patients with IgA nephropathy, and 6 from controls with normal renal biopsy specimens. Serum creatinine , blood pressure and urinary protein excretion at the time of the renal biopsy were analyzed. SPSS8.0 statistics software were applied to analyze the data.Result Expression of CD44 in renal biopsy of controls was negative in the glomeruli and weakly positive in renal interstitium . In IgA nephropathy, CD44 is expressed in the area of severe mesangial proliferation , cellular crescents and tubulointerstitial inflammatory infiltrate . CD44 is strongly positive in cellular crescents . In IgA nephropathy subclass I , the pattern of CD44 expression is similar to the normal biopsy specism(p > 0.05) .The significant relationship was observed between subclass II , III or Vand subclass I (P<0.05) , between subclass IV and subclass I (P<0.01) . CD44 expression is almost negative in the global sclerotic glomeruli . No significant correlation was found between the expression ofCD44 and the serum creatinine level (r = -0.722, P>0.05). The incidences of CD44 in patientes with high blood pressure were significantly different from those without high blood pressure . CD44 expression correlated significantly with the degree of proteinuria (r =0. 55, P<0. 05 ) .Conclusion Expression of CD44 in normal renal biopsy was negative in the glomeruli and weakly positive in renal interstitium .The glomerular and tubulointerstitial expression of CD44 correlated with the degree of renal damage in IgA nephropathy . No significant correlation was found between the expression of CD44 and the serum creatinine level .The incidences of CD44 in patientes with high blood pressure were significantly different from those without high blood pressure . CD44 expression correlated significantly with the degree of proteinuria .Therefore CD44 could be a reliable marker of the progression of IgA nephropathy . CD44 may have a important role in the cascade of renal inflammation and fibrosis .Postgraduate: ZHANG Yan (Department of nephrology) Directed by: LIU Liqiu...