Interstitial immune complex nephritis in patients with systemic lupus erythematosus

Abstract

Interstitial immune complex nephritis in patients with systemic lupus erythematosus (SLE). Renal tissues from 45 patients with SLE nephritis, 34 patients with idiopathic membranous nephropathy (IMN) and 77 patients with minimal glomerular disease (MGD) were studied by light, immunofluorescence and electron microscopy. Interstitial nephritis characterized by focal or diffuse infiltration of inflammatory cells, tubular damage and interstitial fibrosis was observed in 66% of SLE patients. Fluorescein-conjugated antibodies to immunoglobulins or complement or both were bound to peritubular capillaries, interstitium and tubular basement membranes (TBM) in 53% of patients with a granular pattern corresponding to opaque deposits seen by light or electron microscopy or both. Antibodies reactive with thymidine or cytosine or both were bound to interstitial structures in 19% of patients tested and showed the same granular distribution. Interstitial cellular infiltration was rare and deposits of immunoglobulins and complement were rare or absent in IMN and MGD, whereas deposits of DNA products were never observed. The findings are consistent with the interpretation that in patients with SLE nephritis immune deposits, presumably containing DNA-anti-DNA complexes, localize in peritublular capillaries, TBM and interstitum, thereby producing an inflammatory reaction which contributes to development and evolution of renal diseases.

Imaging morphological details and pathological differences of red blood cells using tapping-mode AFM

“…The holes and corrugations observed might be responsible for the reduced binding capability and pre-saturated binding kinetics of DNA to the cell surface, as observed by Huss et al employing macroscopic binding assays of RBCs derived from SLE patients (Huss et al, 2000). In addition, similar pathological changes on macroscopic cell tissues from humans with SLE were found using immuno-fluorescence studies (Brentjens et al, 1975), which might be associated with already described functional deficiencies of red blood cells in SLE (Cohen et al, 1999;RichaudPatin et al, 2003).…”

“…RBCs derived from SLE patients show an overall reduced binding capability and pre-saturated binding kinetics of DNA to the cell surface (Huss et al, 2000). Autoantibodies and DNA bound to the surface of Bereitgestellt von | Universitaetsbibliothek der LMU Muenchen Angemeldet | 129.187.254.47 Heruntergeladen am | 18.11.13 11:33 erythrocytes lead to the activation of the macrophage system, and macrophage-mediated erythro-phagocytosis has been observed (Brentjens et al, 1975;Weidner and Lorentz, 1986;Huss et al, 2000).…”

Immunology and the diagnosis of lupus nephritis

“…This routinely leads to a recruitment of infiltrating cells into the kidney interstitium, which can be found in approximately 70% of all LN biopsies, especially in class IV nephritis. 8,9 The 'true' occurrence of interstitial infiltration in LN might be even higher, since the infiltrate is often distributed in a patchy fashion. This is supported by studies in the NZB/W F1 mouse model for SLE, which develops a nephritis closely resembling class IV human LN, in which the infiltrating T and B cells are often found in circumscribed areas.…”

Urinary Excretion of Albumin and Retinol Binding Protein in Systemic Lupus Erythematosus

“…Similarly, Brentjens et af. 31 demonstrated interstitial abnormalities in 50-70% of patients with lupus nephritis. Other workers have reported specific tubular abnormalities in patients with SLE and glomerulonephritis, such as impaired ability of the kidney to concentrate and acidify urine.F defects in hydrogen ion and electrolyte handling,33.34 and increases in the fractional excretion of fhm.…”