Pathomorphology Comparative Research Of Palatine Tonsils In Chronic Tonsilitis Patients With IgA Nephropathy And Without Nephritis

Objective:Researching the pathomorphology changes andimmunohistology expression for IgA, IgG, CD68, CD21, CD20, CD3of palatine tonsils in chronic tonsilitis patients with IgA nephropathy(IgAN) and without nephritis (non_nephritis for short).Method: Eight patients were diagnosed as IgAN via renal puncture.Eight patients suffering from chronic tonsillitis but without nephritis wereselected as control. Conventional pathological stainning andimmunohistochelnistry were applied respectively in all resected tonsillarsections to observe the pathomorphology changes and expression forIgA, IgG, CD68, CD21, CD20, CD3. All the clinical information of theresearch objects were collected: including age, gender, Urinary sediment,renal function, and renal biopsy report.Results:1. Pathomorphology changes of tonsils stained with H&E.Compared to non_nephritis group, the area of tonsilar lymphaticnodules diminished (P＜0.05), as well as the percentage of germinalcenter area/lymphatic nodule area (P＜0.01) in IgAN group.2. Expression of IgA, IgG in tonsilsCompared to non nephritis group,the number of IgA positive cellseither in germinal center or subepithelial area of tonsils increased (P＜ 0.05), with a reduced number of IgG positive cells (P＜0.05), theratio of IgA/IgG positive cells raised obviously in germinal center (P＜0.01) and subepithelial area (P＜0.05) in IgAN group.3. Expression ofCD68,CD21, CD20, CD3 in tonsilsCompared to non_nephritis group, the expression of CD68 ingerminal center of tonsils increased (P＜0.05),the expression of CD21 ingerminal center of tonsils significantly increased (P＜0.01), theexpression of. CD20 in germinal center of tonsils significantly weakened(P＜0.01),the expression of CD3 in interfollicular zone of tonsilsincreased (P＜0.05) in IgAN group.Conclusion:1. There were pathological morphology changes of tonsils in patientswith IgAN.Both the area of tonsilar lymphatic nodules and the percentageof germinal center area/lymphatic nodule area diminished.2. IgA positive cells either in germinal center or subepithelial areaincreased, whereas, IgG positive cells decreased in tonsils of IgANpatients. There was abnormality in the ratio of IgA/IgG positive cells intonsils of IgAN patients.3. The expression of CD68, CD21 in germinal center, and CD3 ininterfollicular zone increased,while the expression of CD20 in germinalcenter weakened in tonsils of IgAN patients.4. It is proposed for IgAN patients,tonsillectomy may prevent the antigen invasion, eliminate IgA originated from tonsillae, decrease theIgA immunocomplex in circulation, and so decrease the IgAimmunocomplex deposition in the basal membrane of glomeruli andalleviate the impairment of renal function.