Co-Investigator(Kenkyū-buntansha) |
HOSOYA Mitsuaki Fukushima Medical University, School of Medicine, Pediatrics, Professor (80192318)
SUYAMA Kazuhide Fukushima Medical University, School of Medicine, Pediatrics, Research Associate (90423798)
TAKANO Kei Fukushima Medical University, School of Medicine, Pediatrics, Research Associate (40448634)
HASHIMOTO Kouichi Fukushima Medical University, School of Medicine, Pediatrics, Research Associate (50322342)
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Research Abstract |
To reveal the human glomerulogenesis, we evaluated the process of development of glomeruli and staining for CD31, CD34, FB21, alfa-Smooth Muscle Actin (alfa-SMA), and nephrin in fetal and infant kidneys. We investigated the process of glomerular development in four developmental stages[V-stage, S-stage, C-stage and M-stage]and glomerular CD31, CD34, FB21, alfa-SMA, and Nephrin staining in each group. V-stage proportion was highest in Group A. After 20 weeks, V stage proportion gradually decreased. S- and C-stage proportions were higher in Groups B and C than in Groups D, E and F. M-stage proportion was highest in Group F. CD31, CD34 and FB21 were stained similarly in for endothelial cells in the kidneys of fetuses at over 25 weeks of gestation. Alfa-SMA stained in mesangial cells were found to the lower clefts of the S-shaped bodies first of all. Similarly Nephrin stained in epithelial cells were first observed in S-shaped body weakly. These results suggest that the glomerulus matures
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to M-stage from V stage from 25-34 weeks of gestation and that maturation of endothelial cells starts at 25 weeks and is completed by 35 weeks in the fetus. Epithelial cells and mesangial cells are appeared first at the S-stage. On the other hand, to clarify whether serum concentration of HGF and renal HGF receptor (HGFR) expression can predict the prognosis of renal dysfunction, we evaluated serum concentration of HGF and the expression of HGFR-MET and a -SMA in HSPN patients without crescent formation and with crescent formation. These patients were divided into two groups based on pathological findings on the first biopsy. Group 1 consisted of 20 patients with ISKDC I or II, while group 2 consisted of 35 patients with ISKDC III or VI or V. The mean scores of glomerular and interstitial alpha-SMA staining in group 2 were significantly higher than those in group 1. At second biopsy, the mean scores of c-Met positive staining in group 2 were lower than those in group 1. Our results suggest that the expression of glomerular and interstitial alpha-SMA at first biopsy can predict the prognosis of children with HSPN and the expression of glomerular c-Met at second biopsy may be associated with the reproduction of kidney. Less
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