Existence and significance of hepatitis B virus DNA in kidneys of IgA nephropathy.
OBJECTIVE
To investigate the existence and significance of hepatitis B virus (HBV) DNA in the pathogenesis of IgA nephropathy (IgAN).


METHODS
Fifty cases of IgAN with HBV antigenaemia and/or hepatitis B virus antigens (HBAg, or HBsAg, HBcAg) detected by immunohistochemistry in renal tissues were enrolled in our study. The distribution and localization of HBV DNA were observed using in situ hybridization. Southern blot analysis was performed to reveal the state of renal HBV DNA.


RESULTS
Among the 50 patients with IgAN, HBs antigenemia was detected in 17 patients (34%). HBAg in renal tissues was detected in 48 patients (96%), the positive rate of HBAg, HBsAg, and HBcAg was 82% (41/50), 58% (29/50), and 42% (21/50) in glomeruli, respectively; and was 94% (47/50), 56% (28/50) and 78% (39/50) in tubular epithelia, respectively. Positive HBV DNA was detected in 72% (36/50) and 82% (41/50) cases in tubular epithelia and glomeruli respectively by in situ hybridization, and the positive signals were localized in the nuclei of tubular epithelial cells and glomerular mesangial cells as well as infiltrated interstitial lymphocytes. Moreover, 68% (34/50) cases were proved to be HBV DNA positive by Southern blot analysis, and all were the integrated form.


CONCLUSIONS
HBV infection might play an important role in occurrence and progress of IgAN. In addition to humoral immune damages mediated by HBAg-HBAb immune complex, renal tissues of some IgAN are directly infected with HBV and express HBAg in situ, and the cellular mechanism mediated by HBV originating from renal cells in situ may also be involved in the pathogenesis of IgAN.
Wang
Nian-Song
NS
Department of Nephrology, the Sixth Affiliated Hospital of Shanghai Jiaotong University, 600 Yushan Road, Shanghai 200233, China. wangniansong@yahoo.com.cn
Wu
Zhao-Long
ZL
Zhang
Yue-E
YE
Liao
Lu-Tan
LT
D000293:Adolescent; D000328:Adult; D000368:Aged; D015139:Blotting, Southern; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005922:Glomerulonephritis, IGA / Q000276:immunology / Q000821:virology*; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D017403:In Situ Hybridization; D007668:Kidney / Q000821:virology; D008297:Male; D008875:Middle Aged
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens