title: A novel evaluation method for paraffinized human renal biopsies using quantitative analysis of microdissected glomeruli and VCAM-1 as marker of inflammatory mesangial cell activation.
abstract: BACKGROUND
  In the glomerular mesangium, immunologic and/or infectious activation of the inflammatory, NF-kappaB-mediated signal pathway can induce a progression of already existing mesangial lesions in non-immunologic and immunologic glomerular disease. This progression is preceded by upregulated mesangial gene expression of which the vascular cell adhesion molecule-1, VCAM-1 (vascular cell adhesion molecule-1), is a well-established marker. Its evaluation on minimal tissue such as routinely paraffinized needle core biopsies is not established and needs the development of a novel evaluation method more meaningful than common immunohistology.
  
  
  METHODS
  By laser-microdissection, 10 glomeruli/case were isolated from 5 micro m thick tissue slices in a total of 15 cases of mesangial proliferation with different renal diseases (IgA nephropathy, lupus nephritis and mesangial proliferative lesions of unknown aetiology) vs transplant biopsies as negative and TNF alpha-treated cultured human mesangial cells as positive controls. After reverse transcription of isolated RNA, cDNA aliquots were quantified for VCAM-1 expression by real-time PCR using the threshold cycle (C(t)) method, normalized for the housekeeping gene beta-actin, and compared with qualitative RT-PCR results.
  
  
  RESULTS
  Unsuspected VCAM-1 transcript steady-state levels could be detected by real-time PCR in agreement with qualitative PCR, while morphologic and immunohistologic analyses were unrevealing. As yields of RNA extraction in femtogram quantities cannot be measured spectrophotometrically, a C(t)-ratio was formed between beta-actin and VCAM-1 per case showing high VCAM-1 expression in lupus nephritis (1.39), and moderate expression in IgA nephropathy (1.08-1.23) vs TNF alpha-treated mesangial cells (0.97-1.23) and negative control cases (0.66-0.68).
  
  
  CONCLUSIONS
  This is the first reported gene expression analysis method for routinely paraffininzed human renal biopsies, demonstrating the power of combined laser-microdissection and PCR quantification as novel methods for the evaluation of minimal tissue beyond purely descriptive morphologic analysis.
authors.affiliation: Department of Pathology, University of Cologne, Cologne General Hospital, Merheim Medical Center, Cologne, Germany. jochen.fries@uni-koeln.fr
authors.forename: Jochen W U
authors.initials: JW
authors.lastname: Fries
authors.forename: Tanja
authors.initials: T
authors.lastname: Roth
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Dienes
authors.forename: Manfred
authors.initials: M
authors.lastname: Weber
authors.forename: Margarete
authors.initials: M
authors.lastname: Odenthal
mesh_terms: D015415:Biomarkers; D001707:Biopsy, Needle; D046508:Culture Techniques; D004210:Dissection / Q000295:instrumentation; D005260:Female; D005920:Glomerular Mesangium / Q000473:pathology; D005921:Glomerulonephritis / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology*; D007834:Lasers; D008297:Male; D012313:RNA / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D019010:Vascular Cell Adhesion Molecule-1 / Q000032:analysis*
chemical_list: D015415:Biomarkers; D019010:Vascular Cell Adhesion Molecule-1; D012313:RNA