The role of mast cells in acute tubulo-interstitial nephritis with uveitis.
We describe the clinicopathological characteristics of two patients with acute tubulo-interstitial nephritis with uveitis (TINU) with mast cells infiltrating the interstitium. The pathogenesis of TINU remains unknown, but a T-cell-mediated immune response was suggested to be involved. Recent studies have shown that infiltrating mast cells are closely associated with the development of renal interstitial fibrosis in glomerulonephritis. To address the role of mast cells in the renal interstitial injury in TINU, immunohistochemical studies were performed in renal biopsy sections using anti-human mast cell tryptase antibody specific for mast cells. In addition, we tried to detect CD68-positive macrophages to compare with the localisation of mast cells within the renal interstitium. Mast cells and macrophages could be detected in renal interstitial lesions of both patients. Massive infiltration of macrophages into interstitial lesions was observed, whereas mast cells were detected in a sporadic rather than a clustered manner, and associated with fibrotic lesions. Repeat renal biopsy findings suggested the involvement of these cells in the renal interstitial injury because the number of infiltrating mast cells and macrophages in the interstitium decreased with the improvements in clinical symptoms and pathological lesions.


CONCLUSIONS
The present study showed that mast cells might play an important role in the development of renal interstitial injury in tubulo-interstitial nephritis with uveitis.
Department of Paediatrics, School of Medicine, University of Tokushima, Kuramoto-cho-3-chome, 770-8503, Tokushima, Japan. shuchan@medclin.clin.med.tokushima-u.ac.jp.
Shuji
S
Kondo
Department of Paediatrics, School of Medicine, University of Tokushima, Kuramoto-cho-3-chome, 770-8503, Tokushima, Japan.
Shoji
S
Kagami
Department of Paediatrics, School of Medicine, University of Tokushima, Kuramoto-cho-3-chome, 770-8503, Tokushima, Japan.
Maki
M
Shimizu
Department of Paediatrics, School of Medicine, University of Tokushima, Kuramoto-cho-3-chome, 770-8503, Tokushima, Japan.
Akiko
A
Kitamura
Department of Paediatrics, School of Medicine, University of Tokushima, Kuramoto-cho-3-chome, 770-8503, Tokushima, Japan.
Maki
M
Urushihara
Department of 2 ND Pathology, School of Medicine, University of Tokushima, Tokushima, Japan.
Nobuo
N
Satake
Department of 2 ND Pathology, School of Medicine, University of Tokushima, Tokushima, Japan.
Keisuke
K
Izumi
Department of Paediatrics, School of Medicine, University of Tokushima, Kuramoto-cho-3-chome, 770-8503, Tokushima, Japan.
Yasuhiro
Y
Kuroda
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007684:Kidney Tubules / Q000503:physiopathology; D008264:Macrophages / Q000378:metabolism / Q000502:physiology; D008407:Mast Cells / Q000378:metabolism / Q000502:physiology*; D009395:Nephritis, Interstitial / Q000378:metabolism / Q000503:physiopathology*; D014605:Uveitis / Q000378:metabolism / Q000503:physiopathology*