Yıl: 2022 Cilt: 64 Sayı: 1 Sayfa Aralığı: 59 - 68 Metin Dili: İngilizce DOI: 10.24953/turkjped.2020.2172 İndeks Tarihi: 15-12-2022

Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages

Öz:
Background. Crescentic glomerulonephritis (CGN) is a rapidly progressive and rare cause of glomerulonephritis in childhood. The aim of this study is to evaluate demographic data of children with crescentic glomerulonephritis, to classify the etiologies and to investigate the correlation between the severity of kidney disease and the expression of CD163+ macrophages. Methods. Between the years 2000 and 2016 in a single center, patients under 18 years of age with kidney biopsies containing crescents were included in the study. A total of 88 children were enrolled. The expression of CD163 in kidney tissues was detected by immunohistochemistry in 61 patients. Clinical features and outcome were collected from their medical records. Results. The most common etiology was Henoch-Schönlein purpura (HSP) nephritis/Immunglobulin A vasculitis (26.1%), followed by lupus nephritis (22.7%) and idiopathic crescentic glomerulonephritis (18.2%). CD163 positive cell counts in patients with GFR levels less and more than 60 ml/min/1.73 m2 at their last visit were 7.6±6.6 cells vs. 2.0±3.0 cells (p=0.057) per one glomerulus and 52.2±18.2 cells/hpf vs. 33.3±10.0 cells/hpf (p <0.05) in tubulointerstitium, respectively. Tubulointerstitital CD163+ cells were also found to be higher in patients with end stage kidney disease than complete and partial responders (68 cells/hpf vs 39 cells/hpf, p<0.05). Conclusions. CD163 positive cell counts, particularly in tubulointerstitial areas, have been associated with poor prognosis of CGN.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Atkins RC, Holdsworth SR, Glasgow EF, Matthews FE. The macrophage in human rapidly progressive glomerulonephritis. Lancet 1976; 1: 830-832. https://doi.org/10.1016/S0140-6736(76)90480-3
  • 2. Chen A, Lee K, Guan T, He JC, Scholondorff D. Role of CD8+ T cells in crescentic glomerulonephritis. Nephrol Dial Trans 2020; 35: 564-572. https://doi.org/10.1093/ndt/gfz043
  • 3. Holdsworth SR, Neale TJ, Wilson CB. Abrogation of macrophage-dependent injury in experimental glomerulonephritis in the rabbit. Use of an antimacrophage serum. J Clin Invest 1981; 68: 686-698. https://doi.org/10.1172/JCI110304
  • 4. Li J, Liu CH, Xu DL, Gao B. Clinicopathological significance of CD 163 positive macrophages in patients with proliferative glomerulonephritis. Am J Med Sci 2015; 350: 387-392. https://doi.org/10.1097/MAJ.0000000000000569
  • 5. Zhao L, David MZ, Hyjek E, Chang A, Meehan SM. M2 macrophage infiltrates in the early stages of ANCA-associated pauci-immune necrotizing GN. Clin J Am Soc Nephrol 2015; 10: 54-62. https://doi.org/10.2215/CJN.03230314
  • 6. Li J, Liu CH, Gao B, Xu DL. Clinical-pathologic significance of CD163 positive macrophage in IgA nephropathy patients with crescents. Int J Clin Exp Med 2015; 8: 9299-9305.
  • 7. Erwig LP, Kluth DC, Rees AJ. Macrophage heterogeneity in renal inflammation. Nephrol Dial Transplant 2003; 18: 1962-1965. https://doi.org/10.1093/ndt/gfg313
  • 8. Barros MHM, Hauck F, Dreyer JH, Kempkes B, Niedobitek G. Macrophage polarisation: an immunohistochemical approach for identifying M1 and M2 macrophages. PloS One 2013; 8: e80908. https://doi.org/10.1371/journal.pone.0080908
  • 9. Williams TM, Little MH, Ricardo SD. Macrophages in renal development, injury and repair. Semin Nephrol 2010; 30: 255-267. https://doi.org/10.1016/j.semnephrol.2010.03.011
  • 10. Han Y, Ma FY, Tesch GH, Msnthry CL, Nikolic- Paterson DJ. Role of macrophages in the fibrotic phase of rat crescentic glomerulonephritis. Am J Physiol Renal Physiol 2013; 304: F1043-F1053. https://doi.org/10.1152/ajprenal.00389.2012
  • 11. Schwartz GJ, Munoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009; 20: 629-637. https://doi.org/10.1681/ASN.2008030287
  • 12. Jennette JC. Rapidly progressive crescentic glomerulonephritis. Kidney Int 2003; 63: 1164-1177. https://doi.org/10.1046/j.1523-1755.2003.00843.x
  • 13. Lopez-Gomez JM, Rivera F; Spanish Registry of Glomerulonephritis. Renal biopsy findings in acute renal failure in the cohort of patients in the Spanish Registry of Glomerulonephritis. Clin J Am Soc Nephrol 2008; 3: 674-681. https://doi.org/10.2215/CJN.04441007
  • 14. Dewan D, Gulati S, Sharma RK, et al. Clinical spectrum and outcome of crescentic glomerulonephritis in children in developing countries. Pediatr Nephrol 2008; 23: 389-394. https://doi.org/10.1007/s00467-007-0647-3
  • 15. Ozlu SG, Caltık A, Aydog O, et al. Crescentic glomerulonephritis in children: a single centre experience. World J Pediatr 2016; 12: 225-230. https://doi.org/10.1007/s12519-015-0036-0
  • 16. Chen S, Tang Z, Xiang H, et al. Etiology and outcome of crescentic glomerulonephritis from a single center in China: a 10-year review. Am J Kidney Dis 2016; 67: 376-383. https://doi.org/10.1053/j.ajkd.2015.07.034
  • 17. Gupta R, Singh L, Sharma A, Bagga A, Agarwal SK, Dinda AK. Crescentic glomerulonephritis: a clinical and histomorphological analysis of 46 cases. Indian J Pathol Microbiol 2011; 54: 497-500. https://doi.org/10.4103/0377-4929.85081
  • 18. Koyama A, Yamagata K, Makino H, et al. A nationwide survey of rapidly progressive glomerulonephritis in Japan: etiology, prognosis and treatment diversity. Clin Exp Nephrol 2009; 13: 633-650. https://doi.org/10.1007/s10157-009-0201-7
  • 19. Stewart M, Savage JM, Bell B, McCord B. Long term renal prognosis of Henoch-Schönlein purpura in an unselected childhood population. Eur J Pediatr 1988; 147: 113-115. https://doi.org/10.1007/BF00442205
  • 20. Niaudet P, Habib R. Schönlein-Henoch purpura nephritis: pronostic factors and therapy. Ann Med Interne (Paris) 1994; 145: 577-580.
  • 21. Hogg RJ. A Clinico-pathologic study of crescentic glomerulonephritis in 50 children. A report of the Southwest Pediatric Nephrology Study Group. Kidney Int 1985; 27: 450-458. https://doi.org/10.1038/ki.1985.30
  • 22. Piyaphanee N, Ananboonatrick C, Supavekin S, Sumboonnanonda A. Renal outcomes and risk factors for ESRD in children with rapidly progressive glomerulonephritis. Pediatr Int 2017; 59: 334-341. https://doi.org/10.1111/ped.13140
  • 23. Ikezumi Y, Suzuki T, Karasawa T, et al. Identification of alternatively activated macrophages in newonset paediatric and adult immunoglobulin A nephropathy: potential role in mesangial matrix expansion. Histopathology 2011; 58: 198-210. https://doi.org/10.1111/j.1365-2559.2011.03742.x
  • 24. Nikolic-Paterson DJ, Wang S, Lan HY. Macrophages promote renal fibrosis through direct and indirect mechanism. Kidney Int Suppl 2014; 4: 34-38. https://doi.org/10.1038/kisup.2014.7
  • 25. Li J, Yu YF, Liu CH, Wang CM. Significance of M2 macrophages in glomerulonephritis with crescents. Pathol Res Pract 2017; 213: 1215-1220. https://doi.org/10.1016/j.prp.2017.04.011
  • 26. Gulhan B, Orhan D, Kale G, Besbas N, Ozen S. Studying cytokines of T helper cells in the kidney disease of IgA vasculitis (Henoch-Schönlein purpura). Pediatr Nephrol 2015; 30: 1269-1277. https://doi.org/10.1007/s00467-015-3051-4
  • 27. Yazıcı MU, Orhan D, Kale G, Besbas N, Ozen S. Studying IFN-gamma, IL-17 and FOXP3 in pediatric lupus nephritis. Pediatr Nephrol 2014; 29: 853-862. https://doi.org/10.1007/s00467-013-2695-1
  • 28. Ikezumi Y, Suzuki T, Imai N, et al. Histological diffences in new-onset IgA nephropathy between children and adults. Nephrol Dial Transplant 2006; 21: 3466-3474. https://doi.org/10.1093/ndt/gfl455
APA Kayki G, Orhan D, Gülhan B, Topaloglu R, Akçören Z, DÜZOVA A, Ozaltin F, Ozen S, Bilginer Y, Güçer K (2022). Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. , 59 - 68. 10.24953/turkjped.2020.2172
Chicago Kayki Gozdem,Orhan Diclehan,Gülhan Bora,Topaloglu Rezan,Akçören Zuhal,DÜZOVA ALI,Ozaltin Fatih,Ozen Seza,Bilginer Yelda,Güçer Kadri Şafak Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. (2022): 59 - 68. 10.24953/turkjped.2020.2172
MLA Kayki Gozdem,Orhan Diclehan,Gülhan Bora,Topaloglu Rezan,Akçören Zuhal,DÜZOVA ALI,Ozaltin Fatih,Ozen Seza,Bilginer Yelda,Güçer Kadri Şafak Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. , 2022, ss.59 - 68. 10.24953/turkjped.2020.2172
AMA Kayki G,Orhan D,Gülhan B,Topaloglu R,Akçören Z,DÜZOVA A,Ozaltin F,Ozen S,Bilginer Y,Güçer K Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. . 2022; 59 - 68. 10.24953/turkjped.2020.2172
Vancouver Kayki G,Orhan D,Gülhan B,Topaloglu R,Akçören Z,DÜZOVA A,Ozaltin F,Ozen S,Bilginer Y,Güçer K Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. . 2022; 59 - 68. 10.24953/turkjped.2020.2172
IEEE Kayki G,Orhan D,Gülhan B,Topaloglu R,Akçören Z,DÜZOVA A,Ozaltin F,Ozen S,Bilginer Y,Güçer K "Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages." , ss.59 - 68, 2022. 10.24953/turkjped.2020.2172
ISNAD Kayki, Gozdem vd. "Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages". (2022), 59-68. https://doi.org/10.24953/turkjped.2020.2172
APA Kayki G, Orhan D, Gülhan B, Topaloglu R, Akçören Z, DÜZOVA A, Ozaltin F, Ozen S, Bilginer Y, Güçer K (2022). Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. Turkish Journal of Pediatrics, 64(1), 59 - 68. 10.24953/turkjped.2020.2172
Chicago Kayki Gozdem,Orhan Diclehan,Gülhan Bora,Topaloglu Rezan,Akçören Zuhal,DÜZOVA ALI,Ozaltin Fatih,Ozen Seza,Bilginer Yelda,Güçer Kadri Şafak Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. Turkish Journal of Pediatrics 64, no.1 (2022): 59 - 68. 10.24953/turkjped.2020.2172
MLA Kayki Gozdem,Orhan Diclehan,Gülhan Bora,Topaloglu Rezan,Akçören Zuhal,DÜZOVA ALI,Ozaltin Fatih,Ozen Seza,Bilginer Yelda,Güçer Kadri Şafak Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. Turkish Journal of Pediatrics, vol.64, no.1, 2022, ss.59 - 68. 10.24953/turkjped.2020.2172
AMA Kayki G,Orhan D,Gülhan B,Topaloglu R,Akçören Z,DÜZOVA A,Ozaltin F,Ozen S,Bilginer Y,Güçer K Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. Turkish Journal of Pediatrics. 2022; 64(1): 59 - 68. 10.24953/turkjped.2020.2172
Vancouver Kayki G,Orhan D,Gülhan B,Topaloglu R,Akçören Z,DÜZOVA A,Ozaltin F,Ozen S,Bilginer Y,Güçer K Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages. Turkish Journal of Pediatrics. 2022; 64(1): 59 - 68. 10.24953/turkjped.2020.2172
IEEE Kayki G,Orhan D,Gülhan B,Topaloglu R,Akçören Z,DÜZOVA A,Ozaltin F,Ozen S,Bilginer Y,Güçer K "Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages." Turkish Journal of Pediatrics, 64, ss.59 - 68, 2022. 10.24953/turkjped.2020.2172
ISNAD Kayki, Gozdem vd. "Glomerulonephritis with crescents in childhood; etiologies and significance of M2 macrophages". Turkish Journal of Pediatrics 64/1 (2022), 59-68. https://doi.org/10.24953/turkjped.2020.2172