title: Intraglomerular deposition of intact cross-linked fibrin in IgA nephropathy and Henoch-Schönlein purpura nephritis.
abstract: To investigate the significance of intraglomerular coagulation and fibrinolysis in IgA nephropathy (IgA-N) and Henoch-Schönlein purpura nephritis (HSPN), the distribution of intact cross-linked fibrin (XFb) modulated by plasmin activity was examined in 25 patients with IgA-N and in 12 with HSPN. In addition to the conventional method detecting fibrin-related antigen (FRA) with an antibody against fibrinogen, the enhanced intensity of immunoreactivity of cross-linked FRA (KL-FRA) using the monoclonal antibody DD3B6/22 after plasmin exposure was evaluated to assess intraglomerular deposition of intact XFb. Also, intraglomerular invasion of macrophages was detected using the monoclonal antibody KP1 against CD68. Sixteen of a total of 37 specimens (43%) showed increased intensity of XL-FRA staining after plasmin treatment which is considered to reflect the distribution of intact XFb. Increases in the intensity of XL-FRA staining were observed mainly in mesangium and partially along glomerular capillary loops and also in a few cases in the crescents. The incidence (67%) of increases in XL-FRA staining after plasmin exposure in HSPN specimens was significantly higher than that in IgA-N specimens (32%; p < 0.05). In the group positive for XL-FRA after plasmin exposure, the numbers of macrophages per glomerulus were significantly higher (n = 15; mean +/- SD = 1.6 +/- 0.9) than in the negative group (n = 6; 0.5 +/- 0.6; p < 0.01). In HSPN, the number of macrophages per glomerulus (n = 8; 1.9 +/- 1.0) was higher than that in IgA-N (n = 13; 0.9 +/- 0.9; p < 0.05). Based on these results, we conclude that XFb is often produced and distributed in intact form in the glomeruli both in IgA-N and HSPN, associated with a relatively low intraglomerular plasmin activity, and that intraglomerular coagulation may progress in accordance with macrophage infiltration, especially in HSPN.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Kyoto University, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ono
authors.forename: E
authors.initials: E
authors.lastname: Muso
authors.forename: K
authors.initials: K
authors.lastname: Suyama
authors.forename: A
authors.initials: A
authors.lastname: Oyama
authors.forename: H
authors.initials: H
authors.lastname: Matsushima
authors.forename: M
authors.initials: M
authors.lastname: Yashiro
authors.forename: T
authors.initials: T
authors.lastname: Kuwahara
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.forename: K
authors.initials: K
authors.lastname: Kanatsu
authors.forename: S
authors.initials: S
authors.lastname: Sasayama
mesh_terms: D005337:Fibrin / Q000378:metabolism*; D005341:Fibrinolysin / Q000494:pharmacology; D005342:Fibrinolysis; D005922:Glomerulonephritis, IGA / Q000378:metabolism*; D006801:Humans; D011695:IgA Vasculitis / Q000378:metabolism*; D013194:Staining and Labeling / Q000379:methods
chemical_list: D005337:Fibrin; D005341:Fibrinolysin