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KMID : 0357920010350010026
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Korean Journal of Pathology
2001 Volume.35 No. 1 p.26 ~ p.34
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Expression of Glomerular -Smooth Muscle Actin and Vimentin in Idiopathic Membranous Nephropathy as Prognostic Indicators
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Lee Min-Jin
Kim Ok-Kyung
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Abstract
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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.
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KEYWORD
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Idiopathic membranous nephropathy, Prognosis, Morphometry, α-Smooth muscle actin, Vimentin
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