Differential Roles of Beta2 Integrins in Human Crescentic Glomerulonephritis

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  • 半月体性腎炎におけるbeta2 integrin 関与の病型間の相違について

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An immunohistochemical study was performed to investigate the involvement of beta2 integrins in the glomerular infiltration of leukocytes in different types of human crescentic glomerulonephritis (CrGN). On 51 ethanol-fixed paraffin embedded renal biopsy specimens (34 cases of pauci-immune type and 17 cases of immune-mediated type), the following antigens were evaluated by immunoperoxidase method ; the glomerular (intra-capillary and extra-capillary) expression of ICAM-1, deposition of FRA and infiltration of leukocytes bearing beta2 integrins (LFA-1, CR3 and CR4). ICAM-1 was expressed both in extra-capillary and intra-capillary areas in very early stage of crescent formation and was rapidly decreased with the progression of the stage of crescent. Similarly, infiltration of leukocytes bearing beta2 integrins were observed both in extra-capillary and intra-capillary areas in early stage of crescent formation and were rapidly decreased with the progression of the stage of crescent. In pauci-immune type, the extra-capillary expression of ICAM-1 was significantly correlated with extra-capillary infiltration of LFA-1+cells (γ=0.800, p<0.0001) and CR3+cells (γ=0.791, p<0.0001). The extra-capillary deposition of FRA was also significantly correlated with extra-capillary infiltration of CR3+cells (γ=0.685, p<0.001) and CR4+cells (γ=0. 741, p<0.0001). In both types, the intra-capillary expression of ICAM-1 was significantly correlated with intra-capillary infiltration of LFA-1+cells (γ=0.618, p<0.01 and γ=0.754, p<0.05 respectively). These results suggested that ICAM-1/LFA-1 and ICAM-1/CR3 interaction might be involved in both the extra- and intra-capillary infiltration of leukocytes in pauci-immune CrGN. CR3 and CR4 might also function as fibrin/fibrinogen receptors in extra-capillary lesions in this type. On the other hand, only ICAM-1/LFA-1 interaction might be involved only in the intra-capillary infiltration of leukocytes in immune mediated CrGN.

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