Renal tissue mast cells in liver diseases

Role of stem cell factor and mast cells in the progression of chronic glomerulonephritides

BACKGROUND

Mast cells (MCs) have been implicated in the pathogenesis of atherosclerosis and tissue fibrosis. However, the role of MC in the development of renal fibrosis has not been fully elucidated. Stem cell factor (SCF; the ligand for MC c-kit receptor) is thought to attract and activate MCs.

METHODS

The intensity of MC infiltration and SCF expression in renal biopsies from 56 patients with different forms of primary and secondary glomerulonephritis and five controls were investigated by immunohistochemistry, using a monoclonal anti-human MC tryptase antibody and a polyclonal antihuman SCF antibody.

RESULTS

A large number of MCs were detected in the renal interstitium of the diseased kidneys. Immunostainable SCF was detected in tubular as well as interstitial cells. MC infiltration was significantly higher in glomerulonephritis (16.9 +/- 10.2 cells/field) compared with controls (2.8 +/- 2.1 cells/field, P = 0.03). Similarly, immunostainable SCF was 0.6 +/- 0.3% for controls and 3.3 +/- 2.1% in the glomerulonephritis group (P = 0.02). MC infiltration was highly correlated with SCF expression in diseased kidneys (r = 0.93, P = 0.0001). Double immunostain showed them to colocalize in some interstitial cells. Analysis of MC proliferation [proliferating cell nuclear antigen (PCNA) positivity] and apoptosis (in situ end labeling of DNA) showed these cells to be terminally differentiated. Both MCs and SCF were correlated with interstitial fibrosis (R = 0.71 for MC and R = 0.62 for SCF, P = 0.0001) and interstitial alpha-smooth muscle actin (R = 0.69 for MC and R = 0.60 for SCF P = 0.0001). Using regression analysis, the number of MC infiltration was found to be a very powerful determinant of interstitial fibrosis in the glomerulonephritis group (R2 = 91.4%).

CONCLUSION

MCs as an infiltrating hematopoietic cell and its growth factor (SCF) seem to be up-regulated in glomerulonephritis, and may play a role in the development of renal fibrosis.

Contribution of mast cells to the tubulointerstitial lesions in IgA nephritis

BACKGROUND

Mast cells have never been extensively investigated in renal disease, particularly glomerulonephritis. Recent improvements in monoclonal antibody production to mast cell specific enzymes have made it possible to study mast cells in tissues more accurately and easily. Mast cells have been found to secrete basic fibroblast growth factor (bFGF) in human pulmonary fibrosis.

METHODS

Mast cells in 67 cases of IgA nephritis were investigated. Toluidine blue (TB) stainings at pH 5.0 and pH 0.5 were employed histochemically, and anti-human mast cell tryptase and chymase monoclonal antibodies were used immunohistochemically. Anti-bFGF antibody was also used immunohistochemically.

RESULTS

Mast cells were scattered in the interstitium including in fibrotic areas. TB pH 0.5-positive mast cells were more numerous than TB pH 5. 0-positive mast cells. Immunostaining with anti-tryptase monoclonal antibody detected more mast cells than the TB stainings. Mast cells in the interstitium of IgA nephritis had both tryptase and chymase. Immunoelectron microscopy showed that tryptase was exclusively localized in the specific granules of mast cells. The average number of tryptase positive mast cell in the interstitium of IgA nephritis was lower than that of T lymphocyte but more than that of macrophages. The average number of mast cells increased with the progression of interstitial fibrosis and had a significant correlation with 24-hour creatinine clearance. Using double labeled immunohistochemistry, some tryptase-positive mast cells had bFGF in their cytoplasm. Electron microscopy showed that mast cells were associated with fibroblasts and/or lymphocytes in the interstitium.

CONCLUSION

Mast cells are one of the constitutive cells in the interstitium of IgA nephritis patients and affect renal function by contributing to the interstitial fibrosis.