Elsevier

Kidney International

Volume 60, Issue 6, December 2001, Pages 2215-2221
Kidney International

Cell Biology – Immunology – Pathology
Tubular lesions and tubular cell adhesion molecules for the prognosis of lupus nephritis

https://doi.org/10.1046/j.1523-1755.2001.00055.xGet rights and content
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Tubular lesions and tubular cell adhesion molecules for the prognosis of lupus nephritis.

Background

To assess the prognostic value of tubular lesions and cell adhesion molecules' expression, a retrospective study with immunohistochemistry was performed on 152 patients presenting lupus nephritis from January 1985 to December 1999.

Methods

The following clinical parameters were recorded: age, sex, race, time of systemic lupus erythematosus (SLE) diagnosis, time of the biopsy, proteinuria, creatininemia, and renal function at the end of follow-up. All biopsies were re-evaluated according to a tubular grading, an inflammatory grading, the percentage of sclerosed glomeruli, the percentage of crescents, and the current WHO classification. Immunohistochemistry was performed with anti-CD40, anti-CD44, and anti-intercellular adhesion molecule-1 (anti-ICAM-1) antibodies.

Results

Patients were 136 women (89.5%) and 16 men with a mean age of 31.2 years ± 12.8 at the time of biopsy. The mean follow-up period was 94.3 months ± 64.1. Eighty-eight biopsies (58%) showed various degrees of tubular atrophy. Males (P = 0.001) and tubular grading (P = 0.0001) were linked with renal survival in univariate and multivariate analysis. CD40 (P = 0.01) and ICAM-1 (P = 0.001) tubular expressions were linked with renal survival. ICAM-1 tubular expression provided additional information for the prognosis of the patients with biopsies showing tubular atrophy (P = 0.005) or not (P = 0.05).

Conclusions

Our study shows that tubular lesions are good indicator of lupus nephritis outcome. Furthermore, tubular expression of cell adhesion molecules like ICAM-1 and CD40 also serves to predict the outcome.

Keywords

CD40
CD44
ICAM-1
glomerulonephritis
tubular atrophy

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