Differentiation of glomerular and non-glomerular hematuria

Research Project

Project/Area Number	04670980
Research Category	Grant-in-Aid for General Scientific Research (C)
Allocation Type	Single-year Grants
Research Field	Urology
Research Institution	Keio University, School of Medicine
Principal Investigator	BABA Shiro Keio Univ., School of Med., Assist.Prof, 医学部, 講師 (00051889)
Co-Investigator(Kenkyū-buntansha)	ASANUMA Hiroshi Keio Univ., School of Med., Assistant, 医学部, 助手 (70245570) 斎藤史郎慶応義塾大学, 医学部, 助手 (80170504)
Project Period (FY)	1992 – 1993
Project Status	Completed (Fiscal Year 1993)
Budget Amount *help	¥1,500,000 (Direct Cost: ¥1,500,000) Fiscal Year 1993: ¥500,000 (Direct Cost: ¥500,000) Fiscal Year 1992: ¥1,000,000 (Direct Cost: ¥1,000,000)
Keywords	Hematuria / Pheophorbide-a / 腎炎 / フェオフォーバイド / 赤血球膜 / 側方拡散
Research Abstract	Asymptomatic microscopic hematuria is a relatively common finding, occuring in about 15% of adult population. The frequency of serious urologic disease in patients with asymptomatic microscopic hematuria was 6.7% in men who were older than 56 years old. This finding suggests that complete urologic investigation of all patients with any degree of asymptomatic microhematuria can not be recommended. In order to develop a new simple test to differentiate microscopic hematuria due to urologic disorders from that of glomerular diseases, we examined blood cells obtained from fresh urine samples, using scanning electron microscopy and spectroscopic measurement of fluorescence using pheophorbide-A,which was excited with Argon ion laser (488nm) on ACAS-570. The glomerular hematuria was easily differentiated from non-glomerular hematuria by the typical deformity of the blood cell membrane which was predominantly observed in the former. This electron microscopic study, however, necessitates a long preparation time which may be inappropriate for clinical situation. Pheophorbide-A,which is a photosensitizer and have been used for photodynamic therapy is easily disolved in the water and is accumulated within the normal blood cell and eaqually distributed one hour after it's application in the culture medium at the concentration of 4mug/ml, which is also the case for non-glomerular microhematuria. In glomerular hematuria, pheophorbide-A was more rapidly absorbed by the blood cell (within 30 minutes), and the distribution pattern seemed more irregular in shape. This staining technique is simple and can be applied for the differential diagnosis of glomerular and non-glomerular microhematuria, although further studies such as quantative analysis of intracellular accumulation are needed.