PubMed · 5905952
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D D Gellman, G Hoog. 1966-03-19. Glomerulonephritis.. https://pubmed.ncbi.nlm.nih.gov/5905952/
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UNLABELLED: Osteopontin expression in human crescentic glomerulonephritis. BACKGROUND: Osteopontin is a molecule with diverse biological functions, including cell adhesion, migration, and signaling. The expression of osteopontin has been demonstrated in a number of models of renal injury in association with accumulations of monocyte/macrophages, including recent reports of osteopontin expression in glomerular crescents in a rat model of anti-glomerular basement membrane glomerulonephritis. METHODS: Glomerular expression of osteopontin in biopsies of human crescentic glomerulonephritis (N = 25), IgA nephropathy with crescents (N = 2), and diffuse proliferative lupus glomerulonephropathy with crescents (N = 1) was studied by immunohistochemistry, in situ hybridization, and combined immunohistochemistry/in situ hybridization. Additionally, antibodies to cell-specific phenotypic markers were used to identify cellular components of the glomerular crescent, which express osteopontin protein and mRNA. RESULTS: All of the crescents present in the biopsies studied contained a significant number of cells that expressed osteopontin protein and mRNA, demonstrated by immunohistochemistry and in situ hybridization, respectively. Using replicate tissue sections and combined immunohistochemistry/in situ hybridization, we showed that the majority of the strongly osteopontin-positive cells are monocyte/macrophages. In addition to the very strong and cell-associated localization, a weaker and more diffuse pattern of osteopontin protein and mRNA expression could be seen in a number of crescents. None of the osteopontin mRNA-expressing cells could be identified as parietal epithelial cells, CD3-positive T cells, or alpha-smooth muscle actin-positive myofibroblasts. Interstitial monocyte/macrophages did not express osteopontin, except when located in a periglomerular inflammatory infiltrate. CONCLUSIONS: Macrophages present in the human glomerular crescent express osteopontin protein and mRNA at a high level. This expression supports a role for osteopontin in the formation and progression of the crescentic lesion via chemotactic and signaling properties of the molecule.
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Glomerulonephritis is a major cause of end-stage renal disease (ESRD) and is the primary disease in over a third of patients undergoing renal transplantation. An understanding of the incidence and clinical significance of recurrent glomerulonephritis posttransplantation is therefore essential. Indeed, all forms of glomerulonephritis have been reported to recur histologically after renal transplantation, but the incidence and severity of clinical recurrence varies greatly according to the type of glomerular disease. Large registries report that between 5% to 10% of allografts fail secondary to recurrence of primary disease. This review attempts to clarify some of the salient clinical features of recurrent glomerulonephritis from a body of literature full of anecdotal reports and retrospective studies. There are several excellent reviews on recurrent glomerulonephritis; this review aims to complement these by focusing on more recent developments in the field. Development of de novo glomerulonephritis in the transplant will also be discussed. The recurrence of metabolic diseases such as diabetes mellitus, cystinosis, Fabry's disease, and primary hyperoxaluria will not be discussed.