Analysis of intra-GBM microstructures in a SLE case with glomerulopathy associated with podocytic infolding
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Systemically podocytic infolding into the GBM which causes nonargyrophilic holes in the GBM in association with intra-GBM microstructures has been considered as a new pathological entity. However, its pathomechanisms are largely unknown.
We analyzed intra-GBM microstructures in an SLE patient with glomerulopathy associated with podocytic infolding by immunoelectron microscopy for vimentin (a marker for both podocyte and endothelium) and C5b-9 and by 3D reconstruction of transmission electron microscopy (TEM) images by computer tomography method.
Immunofluorescent study showed immunoglobulin deposition in a diffuse, capillary pattern; however, electron-dense deposits like stage 3 membranous nephropathy could be found only in some capillary loops by TEM in spite of the systemic existence of podocytic infolding and the intra-GBM microstructures. Three-dimensional reconstructed images of the TEM images revealed that some of the intra-GBM microstructures made connections with the podocyte. The clustered microstructures underneath the podocyte and their surroundings looked as a whole like the degraded part of podocyte in 3D reconstructed images. Immunoelectron microscopy showed that vimentin was positive in most intra-GBM microstructures. C5b-9 was positive along the entire epithelial side of the GBM and in some microstructures, suggesting that the podocytes may be attacked by C5b-9 and that the microstructures may contain C5b-9 bound cellular membranes.
Intra-GBM microstructures may be originated mainly from the podocyte. Podotyte and GBM injuries caused by C5b-9 attack to podocytes might contribute in part to podocytic infolding and intra-GBM microstructures in this case.
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- Analysis of intra-GBM microstructures in a SLE case with glomerulopathy associated with podocytic infolding
Clinical and Experimental Nephrology
Volume 12, Issue 6 , pp 432-439
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- Springer Japan
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- Computer tomography
- Electron tomography
- Transmission electron microscopy
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- Author Affiliations
- 1. The First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
- 2. Equipment Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
- 3. Division of Nephrology, Fukuoka-Higashi Medical Center, Fukuoka, Japan
- 4. Division of Immunopathology, Clinical Research Center, Chiba-East National Hospital, Chiba, Japan