title: Tubular and interstitial expression of ICAM-1 as a marker of renal injury in IgA nephropathy.
abstract: BACKGROUND
  The upregulated renal expression of intercellular adhesion molecule 1 (ICAM-1) is associated with glomerular and interstitial infiltration of leukocytes.
  
  
  OBJECTIVE
  To test the hypothesis that renal expression of ICAM-1 may be predictive in the highly variable IgA nephropathy (IgAN).
  
  
  METHODS
  ICAM-1 (CD54) in tubular epithelium and interstitial leukocytes, macrophages (CD14), and T cells (CD3) were assessed using avidin-biotin-peroxidase in renal biopsy specimens from 45 patients with IgAN and from 29 patients with no glomerulonephritis.
  
  
  RESULTS
  In IgAN, tubular ICAM-1+ was seen in 25 of 45 (55%) biopsy specimens, associated with glomerular hypercellularity, glomerulosclerosis involving less than 50% of the glomerular area, interstitial cellular infiltration, tubular atrophy, and proteinuria (U = 44, p = 0.005). Interstitial ICAM-1+ leukocytes were correlated with glomerulosclerosis involving less and more than 50% of the glomerular area, tubular atrophy, interstitial fibrosis, and serum creatinine concentration (r = 0.6343, p < 0.001). In patients with an increase of 50% in the serum creatinine concentration, interstitial ICAM-1+ leukocytes and CD14+ and CD3+ cells were significantly more numerous than in patients with a stable creatinine concentration. In patients with no glomerulonephritis, tubular ICAM-1+ was seen in 7 of 29 (24%) biopsy specimens, inversely correlated with the number of normal glomeruli and associated with glomerulosclerosis covering more than 50% of the glomerular area, tubular atrophy, and creatinine.
  
  
  CONCLUSIONS
  Tubular and interstitial expression of ICAM-1 can be a marker of tubulointerstitial disturbance in IgAN. Interstitial ICAM-1 may be an adverse predictor of disease progression.
authors.affiliation: Service of Nephrology, Hospital Clínic, Barcelona, Spain. parrizabala@senefro.org
authors.forename: Pilar
authors.initials: P
authors.lastname: Arrizabalaga
authors.forename: Manel
authors.initials: M
authors.lastname: Solé
authors.forename: Rosa
authors.initials: R
authors.lastname: Abellana
authors.forename: Xavier
authors.initials: X
authors.lastname: de las Cuevas
authors.forename: Josep
authors.initials: J
authors.lastname: Soler
authors.forename: Jordi
authors.initials: J
authors.lastname: Pascual
authors.forename: Carlos
authors.initials: C
authors.lastname: Ascaso
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D018450:Disease Progression; D005260:Female; D005920:Glomerular Mesangium / Q000378:metabolism / Q000473:pathology; D005922:Glomerulonephritis, IGA / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D007684:Kidney Tubules / Q000378:metabolism / Q000473:pathology; D007962:Leukocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1