| Background Henoch-Sch(¨|o)nlein purpura nephritis was a kind ofsecondary glomerulonephritis in children which could be seen frequently,while the etiology and pathogenesis haven't been fully understood up tonow. The types of pathological changes in kidney varied, which mainlypresented mesangial proliferative glomerulonephritis accompanied bycrescent formation.The prognosis of the disease was considered to becorrelated with the damage of renal glomeruli as well as the damage levelof interstitial substance of renal tubule. The recent studies indicated thatthe mast cell might play a key role in the development of renal interstitialfibrosis, but rare reseaches had been done to ascertain whether mast cellsand mast cell-derived tryptase and transforming growth factor-β1 affectedthe development of renal interstitial fibrosis of Henoch-Schonlein purpuranephritis in children, either.Objective To investigate the probable mechanism of tryptase andTGF-β1 secreted by mast cells and the function of mast cell on thedevelopment of renal interstitial fibrosis of Henoch-Schonlein purpuranephritis in children with Henoch-Schonlein purpura nephritis.Methods Paraffin-embedded renal biopsy tissue sections from 20children with Henoch-Schonlein purpura nephritis were examined byimmunohistochemical staining by anti-tryptaseβmonoclonal antibody andanti-TGF-β1 monoclonal antibody. Mast cells were counted by stainingwith toluidine blue. Masson staining was used to judge the level offibrosis and to evaluat histopathological score. Normal renal tissuesections from 5 nephrectomized children for nephroma were selected ascontrol group. Possible correlation among the percentage of tryptase-β, toluidine blue positive cells, the expression level of TGF-β1, thepathologic type, and histopathological score were evaluated separately.All data has been analyzed by SPSS 10.0.Results The pathologic grade of 20 patients with Henoch-Schonleinpurpura nephritis was 3 in gradeⅡ, 5 in gradeⅢ,7 in gradeⅣ,3 in gradeⅤand 2 in gradeⅥaccording to Pothology Standard by Pediatrics thebranch of Chinese Medical Assosiation in Zhuhai Conference in 2000.The histopathological score of glomeruli was 7 in gradeⅠ(35%), 8 ingradeⅡ(40%),5 in gradeⅢ(25%);and for renal tubule interstitium, 2 ingrade 0(10%), 5 in gradeⅠ(25%), 8 in gradeⅡ(40%), 5 in gradeⅢ(25%). The score analysis of fibrosis level for tubule interstitium in 20children with Henoch-Schonlein purpura nephritis were 4 in score 0(20%),6 in score 1(30%), 7 in score 2(35%), 3 in score 3(15%). Theglomerulus histopathological score was positively correlated with that ofthe renal tubule interstitium (r=0.936, P＜0.05). The score of glomeruliand renal tubule interstitium histopathological are positively correlatedwith that of fibrosis level in the renal tubule interstitium (r=0.864,0.906,P＜0.05),as well as the percentages of tryptase-β, mast cells and theexpression level of TGF-β1 in nephridial tissue (r=0.940,0.920,0.937; r'=0.903,0.859,0.948 P＜0.05). The postitive correlation is presentpositively between the percentages of tryptase-βpositive cells①, mast cellpositive cells②and the expression level of TGF-β1③(①/②r=0.7900.766,0.858,①/③r=0.766,②/③r=0.858, P＜0.05). Thehistopathological score of the renal interstitial fibrosis are positivelycorrelated with the percentages of tryptase-β, mast cell positive cells andthe expression level of TGF-β1 in nephridial tissue (r=0.941,0.942,0.897P＜0.05) Conclusion The mast cells and mast cells-derived tryptase andTGF-β1 secreted were probably involved in development of the renalinterstitial fibrosis in children with Henoch-Schonlein purpura nephritis.
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