Aristolochic acid nephropathy revisited: a place for innate and adaptive immunity?

被引:27
作者
Pozdzik, Agnieszka A. [1 ,3 ]
Berton, Alix [2 ]
Schmeiser, Heinz H. [4 ]
Missoum, Wassim [1 ]
Decaestecker, Christine [5 ]
Salmon, Isabelle J. [2 ]
Vanherweghem, Jean-Louis [1 ]
Nortier, Joelle L. [1 ,3 ]
机构
[1] Univ Libre Bruxelles, Erasme Hosp, Dept Nephrol, B-1070 Brussels, Belgium
[2] Univ Libre Bruxelles, Erasme Hosp, Dept Pathol, B-1070 Brussels, Belgium
[3] Univ Libre Bruxelles, Erasme Hosp, Fac Med, Unit Expt Nephrol, B-1070 Brussels, Belgium
[4] German Canc Res Inst, Div Mol Toxicol, Heidelberg, Germany
[5] Univ Libre Bruxelles, Inst Pharm, Toxicol Lab, B-1070 Brussels, Belgium
关键词
aristolochic acid; cytotoxic T cells; interstitial inflammation; macrophages; renal fibrosis; CHINESE HERBS NEPHROPATHY; INTERSTITIAL RENAL FIBROSIS; UROTHELIAL CARCINOMA; FANCONIS-SYNDROME; DNA-ADDUCTS; TGF-BETA; PROGRESSION; PATIENT; INJURY; CELLS;
D O I
10.1111/j.1365-2559.2010.03509.x
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
Aristolochic acid nephropathy revisited: a place for innate and adaptive immunity? Aims: The histological features of aristolochic acid nephropathy (AAN) consist of paucicellular interstitial fibrosis, severe tubular atrophy, and almost intact glomeruli with media lesions of interlobular arteries. As an early phase of interstitial inflammation preceded peritubular fibrosis in the rat model of AAN, the aim was to investigate the presence of inflammatory cells in human AAN. Methods and results: Reports of confirmed cases and case series of AAN were reviewed in terms of interstitial inflammation and found to have very conflicting results. This prompted us to search for and characterize inflammatory cells within the native kidneys provided from four end-stage AAN patients. Prior aristolochic acid exposure was attested by the intrarenal presence of the typical aristolactam I-derived DNA adduct. Besides the tubulointerstitial lesions usually seen in the cortex, a massive infiltration of macrophages, T and B lymphocytes was detected by immunohistochemistry in the medullary rays and in the outer medullae with some extension to the upper cortical labyrinth. Conclusions: In parallel with histological findings reported in the rat model, inflammatory cells are present preferentially in the interstitium of the medullary rays and of the outer medulllae in renal interstitium from human AAN cases, even in the terminal stages. Further studies must be undertaken to determine the respective roles of innate and adaptive immunity in the progression of AAN.
引用
收藏
页码:449 / 463
页数:15
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