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NDT Advance Access originally published online on January 5, 2007
Nephrology Dialysis Transplantation 2007 22(3):740-748; doi:10.1093/ndt/gfl712
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Significance of glomerular cell apoptosis in the resolution of acute post-streptococcal glomerulonephritis

Takashi Oda1, Nobuyuki Yoshizawa2, Kazuo Yamakami2, Aki Ishida3, Osamu Hotta3, Shigenobu Suzuki1 and Soichiro Miura1

1Department of Medicine and 2Department of Public Health, National Defense Medical College, Saitama and 3Department of Nephrology, Sendai Shakaihoken Hospital, Sendai, Japan

Correspondence and offprint requests to: Takashi Oda, MD, Department of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama 359-8513, Japan. Email: takashio{at}ndmc.ac.jp



  Abstract

Background. Glomerular hypercellularity due to resident glomerular cell proliferation and leucocyte infiltration has been described in acute post-streptococcal glomerulonephritis (APSGN). APSGN usually resolves without progression. However, the mechanism of resolution remains to be determined.

Methods. Renal biopsy tissues from 15 patients with APSGN (obtained 1–31 days after disease onset) and five control patients with minor glomerular abnormality were evaluated with respect to glomerular resolution. Apoptotic cells were assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling (TUNEL) as well as by immunostaining of single-stranded DNA (ssDNA).

Results. The number of glomerular cells was high in the early-phase of APSGN and decreased over time. No TUNEL+ glomerular cells were found in control subjects, whereas prominent glomerular TUNEL+ cells were observed in APSGN patients, particularly in the early phase of the disease. The number of glomerular TUNEL+ cells decreased exponentially but was still prominent in renal tissue biopsied at 31 days after disease onset. Double staining for ssDNA and glomerular cell markers showed that glomerular apoptotic cells were predominantly mesangium and endothelial cells, with some neutrophils and macrophages.

Conclusions. These results suggest that apoptosis exists in the glomerulus in patients with APSGN from the early to the late stages of the disease and contributes to the resolution of glomerular hypercellularity.

Keywords: acute post-streptococcal glomerulonephritis (APSGN); apoptosis; nephritis-associated plasmin receptor (NAPlr); single-stranded DNA (ssDNA); terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling (TUNEL)

Received for publication: 13. 7.06
Accepted in revised form: 2.11.06


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[Abstract] [Full Text] [PDF]


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