Clinicopathological significance of intratubular giant macrophages in progressive glomerulonephritis

Clinicopathological significance of intratubular giant macrophages in progressive glomerulonephritis. Very large macrophages, which we have termed “giant macrophages” (G-Mφ), have been found in renal tubules, some containing cytoplasmic vacuoles. To elucidate their pathophysiological roles, we exami...

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Published in:	Kidney international Vol. 53; no. 5; pp. 1190 - 1200
Main Authors:	Oda, Takashi, Hotta, Osamu, Taguma, Yoshio, Kitamura, Hiroshi, Sugai, Hisako, Onodera, Shin, Horigome, Ikuo, Suzuki, Kazuyuki, Shouji, Yoshiharu, Furuta, Takashi, Chiba, Shigemi, Yoshizawa, Nobuyuki, Nagura, Hiroshi
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-05-1998 Nature Publishing
Subjects:	Antibodies, Monoclonal Biological and medical sciences crescentic glomerulonephritis focal segmental glomerulosclerosis Giant Cells - immunology Giant Cells - pathology giant macrophages Glomerulonephritis - immunology Glomerulonephritis - pathology Glomerulonephritis - urine Glomerulonephritis, IGA - immunology Glomerulonephritis, IGA - pathology Glomerulonephritis, Membranous - immunology Glomerulonephritis, Membranous - pathology Humans IgA nephropathy Immunohistochemistry Immunophenotyping Investigative techniques, diagnostic techniques (general aspects) Kidney Tubules - immunology Kidney Tubules - pathology Macrophages - immunology Macrophages - pathology Medical sciences membranoproliferative glomerulonephritis Nephritis, Interstitial - immunology Nephritis, Interstitial - pathology Nephrosis, Lipoid - immunology Nephrosis, Lipoid - pathology Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Polymerase Chain Reaction Receptors, Immunologic - genetics Receptors, Scavenger RNA, Messenger - genetics RNA, Messenger - metabolism RNA, Messenger - urine tubulointerstitial nephritis Urinary system Urine - cytology membranoproliferative glomerulonephritis IgA nephropathy crescentic glomerulonephritis focal segmental glomerulosclerosis tubulointerstitial nephritis giant macrophages Kidney disease Human Immunohistochemistry Pathology Proliferative glomerulonephritis Renal tubule Urinary system disease Prognosis Exploration Macrophage
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Summary:	Clinicopathological significance of intratubular giant macrophages in progressive glomerulonephritis. Very large macrophages, which we have termed “giant macrophages” (G-Mφ), have been found in renal tubules, some containing cytoplasmic vacuoles. To elucidate their pathophysiological roles, we examined renal biopsy tissues from various primary glomerulonephritis (GN) and tubulointerstitial nephritis (TIN) using immunohistochemistry with monoclonal antibodies against Mφ and other cell surface markers. Giant macrophages were absent or rare in TIN, minimal change nephrotic syndrome, and minor glomerular abnormalities, but G-Mφ was plentiful in progressive glomerulonephrides such as IgA nephropathy with crescents, membranoproliferative GN, focal segmental glomerulosclerosis, and especially in crescentic GN. These G-Mφ were usually seen in the lumen of renal tubules, but occasionally were found in the Bowman's spaces and glomerular tufts, and similar cells were also found in urine. Moreover, they frequently made contact with tubular epithelial cells expressing intercellular adhesion molecule-1, and the tubular epithelial cells in such lesions often had degenerative changes. Giant Mφ may damage tubular epithelial cells from the luminal side. Phenotypically, G-Mφ showed activated (CD71+) and mature (25F9+) characteristics along with features of Mφ (CD68+), and the cytoplasm contained a great deal of lipids. The numbers of G-Mφ in renal tissues closely correlated with the degree of hematuria (ρ = 0.5, P < 0.001), serum creatinine value (r = 0.63, P < 0.001) in GN patients (N = 96) and with proteinuria in IgA nephropathy patients (r = 0.89, P < 0.001, N = 27). These data suggest that G-Mφ are Mφ that were activated and matured in certain active inflammatory sites, which flowed into tubules and then into urine. Thus, the existence of G-Mφ in biopsy tissue or urine reflect the activity of GN and may have a predictive value for the progression of GN.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0085-2538 1523-1755
DOI:	10.1046/j.1523-1755.1998.00886.x