(RS) S U M M A R Y In vitro and in vivo experimental studies suggest that the transcription factor NF-kB plays a role in tubulointerstitial injury. We investigated possible cellular and molecular mechanisms involving NF-kB activation in the progression of tubulointerstitial lesions in human lupus nephritis (LN). Paraffin-embedded renal biopsies from 50 patients with LN and six control patients with minimal change disease (MCD) were examined by Southwestern histochemistry for in situ detection of active NF-kB and AP-1. Immunohistochemistry was performed to examine the expression of NF-kB, AP-1, and NF-kB regulatory proteins (IkB-a, p-IkB-a, and IKK-a proteins), as well as NF-kB and AP-1 downstream target proinflammatory molecules (ICAM-1, TNF-a, IL-1b, IL-6, and GM-CSF) and NF-kB upstream signaling molecules (CD40 and CD40L). We observed extensive upregulation of activated NF-kB in renal tubular cells and interstitial cells, in parallel with overactivation of transcription factor AP-1 in LN, as compared with normal controls and MCD. Tubular expression of activated NF-kB correlated well with the degree of tubulointerstitial histopathological indices and/or renal function. Tubulointerstitial IKK-a expression was specifically upregulated in LN. IkB-a and p-IkB-a were detected only in interstitial cells in LN. Tubulointerstitial expression levels of NF-kB and AP-1 downstream inflammatory molecules and NF-kB upstream signaling molecules CD40 and CD40L were markedly enhanced in LN as compared with MCD or normal controls and were associated with tubulointerstitial histopathological indices and/or renal function. The results suggest that altered IKK-a expression and NF-kB activation along with AP-1 overexpression may play a pathogenic role in tubulointerstitial injury in human LN mediated through a network of downstream proinflammatory molecules. (J Histochem Cytochem 56:517-529, 2008)