Nephrol Dial Transplant (2003) 18: 285-292
© 2003 European Renal Association-European Dialysis and Transplant Association
Upregulation of MHC class II, interferon-
and interferon-
receptor protein expression in HIV-associated nephropathy
Departments of Medicine and Pathology, George Washington University Medical Center, Washington, DC and Department of Medicine, West Palm Beach Veteran's Administration Medical Center, West Palm Beach, FL, USA
Background. Renal cellular HIV infection has been linked to the pathogenesis of HIV-associated nephropathy (HIVAN), but mediators of its development are unknown. HIV infection is associated with disordered cytokine metabolism, and chemokine receptors are coreceptors for HIV immune cellular infection. Chemokines such as interleukin (IL)-8, monocyte chemoattractant protein-1 (MCP-1) and RANTES, and interferons (IFNs) have been implicated in the progression of nephropathy. Renal major histocompatibility complex (MHC) protein expression is involved in antigen presentation and modulating tissue cellular immune responses. Their relative importance in HIVAN pathogenesis is unknown.
Methods. We measured levels of chemokines, IFN-
, IFN-
receptor and non-polymorphic MHC Class II protein by high performance capillary electrophoresis, and incubation with antibodies for quantification by chemiluminesce in renal tissue of patients with HIVAN, compared with tissue without HIV infection, in the presence and absence of nephropathy. Renal biopsy tissue protein levels were correlated with the number and type of infiltrating tissue immune cells.
Results. Mean renal interstitial and glomerular MCP-1, RANTES and IL-8 tissue levels were higher in patients with HIV infection compared with tissue without HIV infection, regardless of the presence of renal disease. In contrast, mean renal interstitial and glomerular non-polymorphic MHC Class II, IFN- and IFN- receptor protein were higher in patients with HIVAN compared with all other groups. Tissue MHC Class II and IFN- receptor protein levels did not correlate with immune cellular infiltration in patients with HIV infection and renal disease.
Conclusions. The data suggest an upregulated renal immune microenvironment, capable of antigen presentation, exists in HIVAN. MHC Class II proteins and IFNs, and the capacity to present antigen may be crucial in HIVAN pathogenesis.
Keywords: chemokines; interferon ; interferon ; interleukin-8; major histocompatibility II protein; monocyte chemoattractant protein-1; RANTES
Correspondence and offprint requests to: Paul L. Kimmel, Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, 2150 Pennsylvania Avenue NW, Washington, DC 20037, USA. Email: pkimmel{at}mfa.gwu.edu
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