특발성 막성사구체신병증의 신사구체에서 α-Smooth Muscle Actin, Vimentin 발현과 예후와의 상관관계
Expression of Glomerular -Smooth Muscle Actin and Vimentin in Idiopathic Membranous Nephropathy as Prognostic Indicators
이민진, 김옥경,
소속 상세정보
이민진 ( Lee Min-Jin )
이화여자대학교 의과대학 병리학교실
김옥경 ( Kim Ok-Kyung )
이화여자대학교 의과대학 병리학교실
KMID : 0357920010350010026
Abstract
Background: The natural history of idiopathic membranous nephropathy (IMN) is heterogeneous with some patients showing spontaneous remission while others show a progressive course leading to end-stage renal failure. We tried to assess quantitatively -smooth muscle actin ( -SMA) and vimentin expression as markers to predict the outcome of membranous nephropathy.
Methods: This study included 24 patients with biopsy proven IMN. We measured the volume of the positive area for -SMA and vimentin within the glomeruli and compared the results with 5 patients in the normal control group. We evaluated glomerular -SMA and vimentin expression in correlation with BUN and serum creatinine level at the time of diagnosis and after treatment.
Results: Glomerular -SMA and vimentin in IMN were higher than in the control group. Glomerular -SMA was significantly higher in progressive IMN than in non-progressive IMN. The glomerular -SMA was sifnificantly correlated with BUN and serum creatinine at last follow-up (p<0.05), but there was no statistically significant correlation at diagnosis. The glomerular vimentin was not different between progressive and non-progressive groups.
Conclusion: These data suggest that the expression of glomerular -SMA may be a useful prognostic indicator and may be able to differentiate between patients with membranous nephropathy who respond well to treatment and those who continue to progress.
키워드
Idiopathic membranous nephropathy;Prognosis;Morphometry;α-Smooth muscle actin;Vimentin
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