The Effects Of Glucocorticoids On Intrarenal Arteriole Lesions In Patients With Primary Glomerulonephritis

Objetive To investigate the effects of glucocorticoids on intrarenal arteriolelesions as well as its potential mechanisms in patients with primaryglomerulonephritis.Methods We retrospectively collected39patients with primaryglomerulonephritis including both IgAN and non-IgA nephropathy. Patients weredivided into three groups:：group A with corticosteroid therapy less than ninemonths(n=14), group B more than nine months(n=13), and group C withoutcorticosteroid therapy(n=12). The average treatment courses of group A and B were5.7months and12.4months respectively. Both clinical and pathological indexes werematched among the three groups．Cross section images of arterioles in the slides weretaken after PASM staining of renal biopsy tissues．The wall thickness／outer diameterratio, the wall area/cross section area ratio of the arterioles were then measured.Vascular smooth muscle cells (VSMC) were indicated by immunohistochemichalstaining of a-SMA to observe the morphology of arterioles. Vascular endothelialgrowth factor (VEGF) in slides were detected by immunohistochemistry． Results The wall thickness／outer diameter ratio, the wall area/cross sectionarea ratio of the arterioles, the percentage of arterioles with vacuolar changes, theexpression of VEGF in renal tissues were all significantly lower in groups B than ingroup C. Except that the percentage of arterioles with vacuolar changes wassignificantly lower in groups A than in group C, all of the other indexes wereindifferent between them. All of the above indexes were indifferent between group Aand group B.Conclusions Glucocorticoids can reduce intrarenal arteriole lesions in patientswith primary glomerulonephritis, the mechanism of which might be related withinhibition of the expression of VEGF in renal tissues.