Clinical and Experimental Nephrology

, Volume 12, Issue 6, pp 432–439

Analysis of intra-GBM microstructures in a SLE case with glomerulopathy associated with podocytic infolding

  • Yoshihide Fujigaki
  • Yoshinori Muranaka
  • Masanori Sakakima
  • Isao Ohta
  • Yukitoshi Sakao
  • Tomoyuki Fujikura
  • Yuan Sun
  • Ritsuko Katafuchi
  • Kensuke Joh
  • Akira Hishida
Original Article Special issue Podocytic infolding glomerulopathy: a proposed new disease entity

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Podocyte Computer tomography Electron tomography Transmission electron microscopy Vimentin C5b-9 

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Copyright information

© Japanese Society of Nephrology 2008

Authors and Affiliations

  • Yoshihide Fujigaki
    • 1
  • Yoshinori Muranaka
    • 2
  • Masanori Sakakima
    • 1
  • Isao Ohta
    • 2
  • Yukitoshi Sakao
    • 1
  • Tomoyuki Fujikura
    • 1
  • Yuan Sun
    • 1
  • Ritsuko Katafuchi
    • 3
  • Kensuke Joh
    • 4
  • Akira Hishida
    • 1
  1. 1.The First Department of MedicineHamamatsu University School of MedicineHamamatsuJapan
  2. 2.Equipment CenterHamamatsu University School of MedicineHamamatsuJapan
  3. 3.Division of NephrologyFukuoka-Higashi Medical CenterFukuokaJapan
  4. 4.Division of ImmunopathologyClinical Research Center, Chiba-East National HospitalChibaJapan

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