[Costimulatory B7 molecules in drug induced interstitial nephritis and IgA nephropathy with tubulointerstitial injury].
OBJECTIVE
To evaluate the role of costimulatory B7 molecules in the pathogenesis of drug induced interstitial nephritis(D-TIN) and IgA nephropathy with severe tubulointerstitial injury(IgAN).


METHODS
Renal biopsy materials from D-TIN(n = 15) and IgAN(n = 15) were used. Cadaveric donors for kidney transplantation(n = 10) served as normal controls. The lymphocyte subsets and the expression of B7-1, B7-2 and HLA-DR in the renal tissue were analyzed by immunohistochemistry staining.


RESULTS
CD4+ and CD8+ cells in the interstitium markedly increased in patients with D-TIN. Parallelly, B7-1 and B7-2 expressing cells in the interstitium also augmented in this group of patients. The expression of B7-1 and HLA-DR on the renal tubular cells increased in patients with D-TIN. Although CD4+ and CD8+ cells increased in the interstitium of IgAN, the B7-1 and B7-2 expressing cells in the interstitium were not different from those of the normal controls. Although the renal tubular expression of B7-1 was upregulated in IgAN, the expression of HLA-DR kept in the normal range.


CONCLUSIONS
These results indicate that the costimulatory molecules mediated T cell activation plays an important role in the pathogenesis of D-TIN. The interstitial infiltrating and tubular cells both act as an antigen presenting cells in the initiation of immune injury in D-TIN. However, such evidence has not been found in patients with IgAN.
Institute of Nephrology, Jinling Hospital, Nanjin University School of Medicine.
Z
Z
Liu
H
H
Huan
J
J
Wang
D000328:Adult; D018122:B7-1 Antigen / Q000378:metabolism*; D005260:Female; D005922:Glomerulonephritis, IGA / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced / Q000276:immunology*
D018122:B7-1 Antigen