title: Common histological patterns in glomerular epithelial cells in secondary focal segmental glomerulosclerosis.
abstract: Parietal epithelial cells (PECs) are involved in the development of sclerotic lesions in primary focal and segmental glomerulosclerosis (FSGS). Here, the role of PECs was explored in the more common secondary FSGS lesions in 68 patient biopsies, diagnosed with 11 different frequently or rarely encountered glomerular pathologies and additional secondary FSGS lesions. For each biopsy, one section was quadruple stained for PECs (ANXA3), podocytes (synaptopodin), PEC matrix (LKIV69), and Hoechst (nuclei), and a second was quadruple stained for activated PECs (CD44 and cytokeratin-19), PEC matrix, and nuclei. In all lesions, cellular adhesions (synechiae) between Bowman's capsule and the tuft were formed by cells expressing podocyte and/or PEC markers. Cells expressing PEC markers were detected in all FSGS lesions independent of the underlying glomerular disease and often stained positive for markers of activation. Small FSGS lesions, which were hardly identified on PAS sections previously, were detectable by immunofluorescent staining using PEC markers, potentially improving the diagnostic sensitivity to identify these lesions. Thus, similar patterns of cells expressing podocyte and/or PEC markers were found in the formation of secondary FSGS lesions independent of the underlying glomerular disease. Hence, our findings support the hypothesis that FSGS lesions follow a final cellular pathway to nephron loss that includes involvement of cells expressing PEC markers.
authors: Department of Internal Medicine II, Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.
authors: Christoph
authors: C
authors: Kuppe
authors: Department of Cellular and Molecular Pathology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors: Hermann-Josef
authors: HJ
authors: Gröne
authors: Department of Internal Medicine II, Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.
authors: Tammo
authors: T
authors: Ostendorf
authors: Department of Biochemistry, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Toin H
authors: TH
authors: van Kuppevelt
authors: Department of Pathology, RWTH Aachen University Hospital, Aachen, Germany.
authors: Peter
authors: P
authors: Boor
authors: Department of Internal Medicine II, Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.
authors: Jürgen
authors: J
authors: Floege
authors: Department of Internal Medicine II, Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.|Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Bart
authors: B
authors: Smeets
authors: Department of Internal Medicine II, Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.
authors: Marcus J
authors: MJ
authors: Moeller
mesh_terms: D000328:Adult; D000368:Aged; D017318:Annexin A3 / Q000032:analysis; D050476:Bowman Capsule / Q000473:pathology; D002448:Cell Adhesion; D002467:Cell Nucleus / Q000473:pathology; D062445:Claudin-1 / Q000032:analysis; D004847:Epithelial Cells / Q000737:chemistry / Q000473:pathology*; D005260:Female; D005455:Fluorescent Antibody Technique; D005923:Glomerulosclerosis, Focal Segmental / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D018960:Hyaluronan Receptors / Q000032:analysis; D053539:Keratin-19 / Q000032:analysis; D007678:Kidney Glomerulus / Q000737:chemistry / Q000473:pathology*; D008297:Male; D008840:Microfilament Proteins / Q000032:analysis; D008875:Middle Aged; D050199:Podocytes / Q000737:chemistry / Q000473:pathology; D013194:Staining and Labeling; D055815:Young Adult
chemical_list: D062445:Claudin-1; D018960:Hyaluronan Receptors; D053539:Keratin-19; D008840:Microfilament Proteins; C503967:SYNPO protein, human; D017318:Annexin A3