Urinary podocytes for the assessment of disease activity in lupus nephritis.
BACKGROUND
Detection of podocytes in the urine indicates that severe injury of podocytes occurred in the glomerulus in children.


METHODS
The pathological significance of podocytes in the urine was determined in patients with lupus nephritis. Podocytes were detected by immunofluorescence using a monoclonal antibody against podocalyxin present on the surface of podocytes. Subjects who participated in the present study were of the following types: patients with systemic lupus erythematosus with stable renal function (group A, n = 8; WHO classes IlIa, b, IVb, and IVc at the time of biopsy); patients with clinically active lupus nephritis (group B, n = 8; WHO classes IVb and IVc); and healthy control subjects (group C, n = 10).


RESULTS
Podocytes were absent in the urine of subjects in groups A and C. However, podocytes were present in the urine of group B subjects. Patients in group B were examined monthly for urinary podocytes and were treated with methylprednisolone followed by prednisolone. Urinary podocytes were absent in all patients in group B after treatment.


CONCLUSIONS
These data indicate that urinary podocytes may be markers of the severity of lupus nephritis and that steroid therapy may be effective for podocyte injury in lupus nephritis.
Nakamura
T
T
Department of Medicine, Misato Junshin Hospital, Saitama, Japan.
Ushiyama
C
C
Suzuki
S
S
Hara
M
M
Shimada
N
N
Sekizuka
K
K
Ebihara
I
I
Koide
H
H
D000328:Adult; D000911:Antibodies, Monoclonal; D003598:Cytoskeletal Proteins / Q000032:analysis; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007678:Kidney Glomerulus / Q000737:chemistry / Q000473:pathology*; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000652:urine*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011237:Predictive Value of Tests; D011239:Prednisolone / Q000627:therapeutic use; D012795:Sialoglycoproteins / Q000032:analysis; D016896:Treatment Outcome; D014556:Urine / Q000166:cytology*
D000911:Antibodies, Monoclonal; D003598:Cytoskeletal Proteins; D012795:Sialoglycoproteins; C001643:podocalyxin; D011239:Prednisolone; D008775:Methylprednisolone