title: Morphometric and immunohistochemical insight into focal segmental glomerulosclerosis in obese and non-obese patients.
abstract: BACKGROUND
  A number of studies have reported an alarming increase in the incidence of obesity related-glomerulopathy. Focal segmental glomerulosclerosis has recently been shown to be key lesion leading to end-stage renal disease in these cases.
  
  
  METHODS
  Nineteen patients with obesity-related focal segmental glomerulosclerosis (O-FSGS) and 16 with idiopathic focal segmental glomerulosclerosis (I-FSGS) were examined by percutaneous renal biopsy. Glomerular and interstitial parameters in O-FSGS and I-FSGS were compared morphometrically as well as immunomorphological study was done to evaluate immunohistochemical profile of TGFbeta- 1, monocytes/macrophages, T lymphocytes and alpha-SMA in these groups.
  
  
  RESULTS
  The total glomerular cells, mesangial areas, glomerular alpha-SMA staining, glomerular monocytes/macrophages and glomerular T-cells were in IFSGS increased in comparison with O-FSGS, most of them significantly, whereas total glomerular area was significantly greater in O-FSGS patients. The tubular immunoexpression of TGF-beta-1, interstitial volume and interstitial alpha-SMA staining were significantly increased in I-FSGS cases in comparison with O-FSGS group, but interstitial CD68+ and CD3+ cells did not differ significantly. Moreover, we found in both O-FSGS and I-FSGS groups significant positive correlations between glomerular immunoexpression of alpha-SMA and glomerular CD 68+ cells, tubular immunoexpression of TGF-beta-1 and interstitial immunoexpression of alpha-SMA as well as tubular immunoexpression of TGF-beta-1 and interstitial volume. Negative correlation between tubular immunoexpression of TGF-beta-1 and interstitial CD3+ cells was significant only in IFSGS group.
  
  
  CONCLUSIONS
  Our morphometric and immunohistochemical study suggests that O-FSGS and I-FSGS are separate morphological entities whereas mechanisms of glomerular and interstitial injury in these cases seem to be rather similar.
authors.affiliation: Department of Nephropathology. Medical University of Lódź, Poland. hobo@csk.umed.lodz.pl
authors.forename: M
authors.initials: M
authors.lastname: Danilewicz
authors.forename: M
authors.initials: M
authors.lastname: Wagrowska-Danielwicz
mesh_terms: D000328:Adult; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009765:Obesity / Q000150:complications*