| Title | Mycophenolate mofetil combined with prednisone for diffuse proliferative lupus nephritis: a histopathological study. | | Author(s) | Ding L, Zhao M, Zou W, Liu Y, Wang H | | Institution | Institute of Nephrology and Renal Unit of the First Hospital, Peking University, Beijing, PR China. | | Source | Lupus 2004; 13(2):113-8. | | MeSH | Actins
Adolescent
Adult
Chronic Disease
Collagen
Drug Therapy, Combination
Female
Fibronectins
Glucocorticoids
Histocytochemistry
Humans
Immunosuppressive Agents
Lupus Nephritis
Male
Mycophenolic Acid
Prednisone
Sialoglycoproteins
| | Abstract | Mycophenolate mofetil (MMF) is a potential new treatment for diffuse proliferative lupus nephritis. This study examines the clinical and histopathological effects, and potential mechanisms, of combination MMF/prednisone therapy in diffuse proliferative lupus nephritis. Nine patients with diffuse proliferative lupus nephritis confirmed by renal biopsy received MMF/prednisone for six months when repeat biopsies were performed. Clinical and histopathological parameters of activity and chronicity were studied. Collagens were detected by Sirus red staining; leucocyte phenotype, osteopontin (OPN), fibrinectin (FN), alpha-smooth muscle actin (alpha-SMA) and TGF-beta1 were detected by immunohistochemistry. The changes of clinical and histopathologic parameters were assessed and compared to histopathologic indicators. Eight of the nine patients achieved clinical remission; renal function deteriorated in one. Histopathological activity indices reduced significantly (9.56 +/- 2.83 versus 5.22 +/- 1.86, P < 0.01); however, the chronicity indices did not change (3.56 +/- 1.42 versus 3.22 +/- 1.20). T-cell and monocyte/macrophage infiltration. OPN expression and the percentage of proliferative cells in both glomerulus and tubulo-interstitium decreased significantly. Other features of chronic lesions, except for glomerular collagen deposition, did not change. In conclusion, MMF/prednisone therapy was effective for our patients with proliferative lupus nephritis. The active inflammatory lesions could be ameliorated through reduction of lymphocyte and monocyte/macrophage infiltration, inhibition of cell proliferation and downregulation of adhesive molecules. However, the chronic fibrotic lesions could not be significantly reduced. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 14995004 |
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