Journal of Pathology and Translational Medicine

Original Articles

Aberrant Blood Vessel Formation Connecting the Glomerular Capillary Tuft and the Interstitium Is a Characteristic Feature of Focal Segmental Glomerulosclerosis-like IgA Nephropathy: Beom Jin Lim, Min Ju Kim, Soon Won Hong, Hyeon Joo Jeong; J Pathol Transl Med. 2016;50(3):211-216. Published online April 11, 2016; DOI: https://doi.org/10.4132/jptm.2016.02.01

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Background
Segmental glomerulosclerosis without significant mesangial or endocapillary proliferation is rarely seen in IgA nephropathy (IgAN), which simulates idiopathic focal segmental glomerulosclerosis (FSGS). We recently recognized aberrant blood vessels running through the adhesion sites of sclerosed tufts and Bowman’s capsule in IgAN cases with mild glomerular histologic change.
Methods
To characterize aberrant blood vessels in relation to segmental sclerosis, we retrospectively reviewed the clinical and histologic features of 51 cases of FSGS-like IgAN and compared them with 51 age and gender-matched idiopathic FSGS cases.
Results
In FSGS-like IgAN, aberrant blood vessel formation was observed in 15.7% of cases, 1.0% of the total glomeruli, and 7.3% of the segmentally sclerosed glomeruli, significantly more frequently than in the idiopathic FSGS cases (p = .009). Aberrant blood vessels occasionally accompanied mild cellular proliferation surrounding penetrating neovessels. Clinically, all FSGS-like IgAN cases had hematuria; however, nephrotic range proteinuria was significantly less frequent than idiopathic FSGS.
Conclusions
Aberrant blood vessels in IgAN are related to glomerular capillary injury and may indicate abnormal repair processes in IgAN.

Citations

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IgA nephropathy
Maria F. Soares, Ian S.D. Roberts
Current Opinion in Nephrology and Hypertension.2017; 26(3): 165. CrossRef

An Analysis of Focal Segmental Glomerulosclerosis according to Morphologic Subtypes.: Min Ju Kim, Dokyung Kim, Beom Jin Lim, Hyeon Joo Jeong; Korean J Pathol. 2010;44(6):589-596.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.589

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Abstract PDF

BACKGROUND
The histological subtypes of focal segmental glomerulosclerosis (FSGS) have different significance and influence clinical presentations and outcomes in patients with FSGS. However, no such data has been reported in Korea.
METHODS
We reviewed renal biopsy specimens of 69 adult patients who were diagnosed with idiopathic FSGS between 2000 and 2008, subclassified them according to the Columbia classification and correlated the results with clinical findings.
RESULTS
The frequencies of the FSGS subtypes were not otherwise specified (NOS) (n = 28), tip (n = 21), perihilar (n = 11), collapsing (n = 5) and cellular types (n = 4) in descending order. Nephrotic syndrome was more common in patients with the tip and collapsing types than the perihilar type. The prevalence of chronic kidney disease stage 4/5 at the time of renal biopsy was significantly higher in patients with the cellular type than the NOS or the tip type. The remission rate after treatment tended to be higher in patients with the NOS type (22.0%) and the tip type (15.2%) than the perihilar (6.8%) and collapsing types (3.4%).
CONCLUSIONS
Classifying FSGS subtypes may be helpful to predict of clinical features and renal outcomes.

Citations

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Podocytopathy and Morphologic Changes in Focal Segmental Glomerulosclerosis
Hyeon Joo Jeong
Journal of the Korean Society of Pediatric Nephrology.2013; 17(1): 13. CrossRef
Pathology and Classification of Focal Segmental Glomerulosclerosis
Yong-Jin Kim
Journal of the Korean Society of Pediatric Nephrology.2012; 16(1): 21. CrossRef

Significance of Osteopontin Expression in the Progression of Human Focal Segmental Glomerulosclerosis.: Ghil Suk Yoon, Tae Sook Kim; Korean J Pathol. 2010;44(5):462-468.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.462

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Abstract PDF

BACKGROUND
Osteopontin (OPN) is a cytokine related to cell-matrix adhesion and cell survival and is expressed in the distal convoluted tubules in normal adult kidneys. Only one in vitro study has investigated the role of OPN in mechanically stretched podocytes and their actin cytoskeleton rearrangement.
METHODS
Glomerular OPN expression was investigated in biopsies from patients with human idiopathic focal segmental glomerulosclerosis (FSGS) (n = 25) and in normal renal biopsies (n = 16) by immunohistochemistry.
RESULTS
OPN was expressed in the podocytes from patients with FSGS. OPN expression increased in podocytes from both non-sclerotic hypertrophic and sclerotic glomerular tufts in patients with FSGS compared to the podocytes in normal controls.
CONCLUSIONS
The results suggest that OPN plays a role in the early adaptive response of podocytes to the increased mechanical load caused by glomerular hypertrophy preceding FSGS. OPN was involved in cell-matrix adhesion and influenced the detachment delay of podocytes from the glomerular basement membrane and apoptosis.

Citations

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Podocyte Expression of Osteopontin and FSP-1/S100A4 in Human Crescentic Glomerulonephritis
Ghil Suk Yoon, Tae Sook Kim
The Korean Journal of Pathology.2011; 45(3): 237. CrossRef

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