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Renal Expression of Adhesion Molecules in Anca-Associated Disease

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Abstract

Introduction

Anti-neutrophil cytoplasmic autoantibodies (ANCA)-associated disease among other manifestations can underlie rapidly progressive glomerulonephritis (RPGN), with crescentic and necrotizing GN. Differences in pathogenic immune mechanisms in RPGN may provide differences in the renal expression of adhesion molecules mediating these lesions.

Methods

Renal intercellular adhesion molecule 1 (ICAM-1; CD54) and vascular cell adhesion molecule 1 (VCAM-1; CD106) were assessed in 40 patients with type I RPGN (anti-glomerular basement membrane antibodies, n = 4), type II (immune complexes, n = 17), and type III (ANCA, n = 19). Enzyme-linked immunosorbent assay (ELISA) for detection of immunoglobulin G antibodies against the Goodpasture’s antigen and indirect immunofluorescence and ELISA for myeloperoxidase (MPO) and proteinase 3 (PR3) were performed for ANCA testing. Ten normal renal tissues were used as controls. Relationships between ICAM-1 and VCAM-1, histopathologic features, and CD18, CD14, and CD3 cells were analyzed.

Results

Abnormal ICAM-1 and VCAM-1 in tubule was seen in >80% of biopsies with RPGN. Abnormal VCAM-1 in glomerular tuft was seen in >60% of biopsies with RPGN. Glomerular ICAM-1 was associated with less glomerulosclerosis (χ 2 = 6.719, p = 0.01), less interstitial fibrosis (χ 2 = 4.322, p < 0.05), and less tubular atrophy (χ 2 = 8.547, p < 0.005). Glomerular VCAM-1 was associated with glomerular leukocyte infiltration (χ 2 = 4.698, p < 0.05). Glomerular tuft stains of ++/+++ for VCAM-1 was observed in 10% from MPO-ANCA-GN patients but in 60% from PR3-ANCA-GN (Fi = 8.538, p = 0.03).

Conclusions

The following conclusions can be made from this study. (1) The renal expression of ICAM-1 and VCAM-1 is upregulated in RPGN, and this is associated with the histological activity. (2) De novo expression of VCAM-1 on glomerular tuft suggests that endothelial cells play a role in RPGN. (3) De novo tubular expression of ICAM-1 and VCAM-1 suggests that epithelial cells may participate in adhesive interactions in RPGN. (4) De novo expression of VCAM-1 at the glomerular tuft in PR3-ANCA positive patients seems greater than in MPO-ANCA positive patients, which suggests that testing specific immune activation mechanisms may play a role in ANCA-associated GN.

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Acknowledgments

The authors thank Dr. R. Vilella and P. Engel for generous gifts of CD54, CD106, and CD14 monoclonal antibodies and N. Babot for excellent immunohistochemistry.

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Authors and Affiliations

  1. Service of Nephrology, Hospital Clínic and the Biomedical Investigation Institute August Pi i Sunyer, c/ Villarroel, 170, 08036, Barcelona, Spain

    P. Arrizabalaga

  2. Service of Pathology, Hospital Clínic and the Biomedical Investigation Institute August Pi i Sunyer, Barcelona, Spain

    M. Solé

  3. Department of Public Health, University of Barcelona and the Biomedical Investigation Institute August Pi i Sunyer, Barcelona, Spain

    R. Abellana & C. Ascaso

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  1. P. Arrizabalaga
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  2. M. Solé
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  3. R. Abellana
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  4. C. Ascaso
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Correspondence to P. Arrizabalaga.

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Arrizabalaga, P., Solé, M., Abellana, R. et al. Renal Expression of Adhesion Molecules in Anca-Associated Disease. J Clin Immunol 28, 411–419 (2008). https://doi.org/10.1007/s10875-008-9215-2

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  • DOI: https://doi.org/10.1007/s10875-008-9215-2

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