Expression And Significance Of CD34 And CD45 In Tublointerstitial Lesion Of IgA Nephropathy

Objectives: Renal interstitial fibrosis(RIF) can be considered the final common passageway of resulting end-stage renal failure(ESRF). The degree of RIF is extracellular matrix (ECM) protein organized accumulate such as collagen(I,III and IV), fibronectin (FN), laminins (LN) and so on. By inhibiting many kind of catabolic enzymes of ECM eg. matrix metalloproteinase(MMP), activator of plasminogen, stimulating activity of inhibitor MMP and activator of plasminogen inhibitor (PAI), thereby inhibits ECM degradation.The nature of pathology histology form is deletion of renal filtration and forecasting degree of ESRD in chronic renal diseases(CKD). Pathogenesy of RIF is unclear. It involved damage of tubulus epithelar and interstitial, activation of tubulointerstitial cell, epithelial-mesenchymal transition (EMT) tomyofibroblast (MyoFb), inflammatory cell (leukomonocyte and mononuclear macrophage) infiltrating, proliferation of fibroblast (FBS), increasing of interstitial cell; likewise by other factors of releasing cytokine and generation of mediators of inflammation, or vasoactive substance and resulting ECM increasing and so on. Accordingly participate indirectly to form interstitial fibrosis.These cells and cytokines interaction co-play key part in forming and developing of RIF in common. Recently years the role of promoting inflammatory factor leucocyte differentiation antigen CD34 and CD45 be thinked more and more highly. this text intend to study expression of CD34 and CD45 in tubulointerstitial lesions and clinic, pathological manifestation.Methods: Collect pathological and clinical data in 40 cases IgAN diagnosed by clinic and renal biopsy. In which male 22 and female 18. All patients exclude Henoch-Sch?nlein purpura nephritis (HSPN), liver cirrhosis glomerulosclerosis, Hepatitis-B virus-associated glomerulonephritis, lupus nephritis, rheumatoid arthritis et al. secondary IgA nephropathy changes. And exclude obesity, pregnancy, diabetes, liver disease, medicine et al. result in renal injury and acute interstitial nephritides and so on. All patients unuse glucocorticosteroid, immunodepressant, angiotensin-converting enzyme inhibitor(ACEI), low molecular heparin et al. drugs before biopsy.The patients, collected blood sample and urine aliquot ,free from infection (including infective symptom and signs; temperature, blood routine, erythrocyte sedimentation rate, sternite and C- reactive protein CRP are normal).According to histological characteristics of tubulo- interstitial lesions (TIL), the degree of tubulointerstitial lesions (TIL) were semi-quantitatively scored by light microscope. Clinical, laboratory and histological Characteristics were compared in different groups of the renal histologic grading. TIL devided into 0-9: inflammatory cell infiltrate 0-3, RIF 0-3, nephric tubule atrophy 0-3. According to accumulated points, RIF can be devided into control group(n=3) , light group(n=16), mild group(n=12) and sever group (n=9) to compare clinical manifestation, laboratory examination, renal biopsy change in different type RIF of IgAN.Using immunohistochemistry tests expression of CD34 and CD45 in kidney tissue. And analysis results by IMS-2000 type high definition color analytical system. According to A value ratio in areas in every renal interstitium slice. Observe expression of CD34 and CD45 in renal tissue by semiquantitative analysis under×200 and×400 high power field. Then calculate average value as index of every case. Statistical treatment undertake statistics analysis by SPSS 11.0 software analytical system. Numeration data by X士S. P<0. 05 have obviously statistics significance.Results: CD34 can express in normal kidney tissue. In the patients of IgAN, CD34 and CD45 immunohistochemical stain shows that expression of CD34 in light and mild group increases, with the degree of TIL changing worse, CD34 gradually increased. But expression of CD34 in sever group decreases. P<0.05 shows statistical significance. CD34 manifests fine grain dendrite and focal segmental distribution in morphologically. CD34 shows polynucleation distribution along capillary wall in glomeruli of IgAN. But negativeexpression of CD34 in endothelial cell(EC), epithelial cell(EC) and intercapillary cells(IC). It obviously different from CD45. The expression of CD45 indicates that it increases in light, mild and sever group . P<0.05 displays statistical significance. But has no difference in three groups with the degree of TIL changing worse. Meanwhile, the expression level of CD34 and CD45 in tubulointerstitial areas has direct correlation with albuminuria, renal function level in patients of IgAN(P<0.05).Conclusions: This study demonstrates that the expression of CD34 has obviously dependablity with the degree of TIL changing worse. CD34 in light and mild group is higher than that in sever group. But CD34 in sever group is lower than that in light and mild group(P<0.05). But CD45 has no obviously difference. The expression level of CD34 and CD45 in tubulointerstitial areas has direct correlation with albuminuria, renal function level in patients of IgAN(P<0.05).