Effects of methylprednisolone and cyclophosphamide pulse therapy on renal infiltrating cells in patients with crescentic glomerulonephritis. NLM AIDSLINE Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

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Effects of methylprednisolone and cyclophosphamide pulse therapy on renal infiltrating cells in patients with crescentic glomerulonephritis.

Chin Med J (Engl). 1997 Mar;110(3):206-9. Unique Identifier : AIDSLINE MED/98256698
Tang Z; Zhou H; Yao X; Hu W; Leishi L; Jinling Hospital, School of Medicine, Nanjing University, China.

Abstract: OBJECTIVE: To investigate the effects of pulse methylprednisolone MP) and monthly intravenous cyclophosphamide (CTX) therapy (MP + CTX) on renal infiltrating cells in patients with rapid progressive glomerular nephritis (RPGN). METHODS: Twelve patients with RPGN (> 50% crescents) were given MP + CTX therapy and received repeated renal biopsies within 4 to 12 weeks after MP + CTX treatment. Seven were diagnosed as type II RPGN, including one case of IgA nephropathy, 2 cases of idiopathic RPGN and 4 cases of lupus nephritis and five were diagnosed as type III RPGN, including 2 cases of idiopathic RPGN and 3 cases of vasculitis. The changes of infiltrating CD4+, CD8+, CD68+ and proliferating cell nuclear antigen-PCNA+ cell levels were determined by four PAP method in glomeruli and interstitium. RESULTS: In the patients before MP + CTX therapy, there were higher levels of infiltrating CD4+ and CD8+ cells (306 +/- 118 and 223 +/- 98.4Num/mm2) in renal interstitium, CD68+ cells (17.2 9.95 Num/G) in glomeruli and (1120 +/- 229 Num/mm2) in interstitium, and PCNA+ cells (7.56 +/- 3.57 Num/G) in glomeruli and (17.6 +/- 6.85 Num/mm2) in interstitium as compared with those in the patients after MP + CTX therapy (CD4+/CD8+ cells were 171 +/- 87.5/121 +/- 38.4 Num/mm2, CD68+ cells were 9.04 +/- 4.33 Num/G and 600 +/- 107 Num/mm2, and PCNA+ cells were 2.04 +/- 1.43 Num/G and 9.40 +/- 4.45 Num/mm2). These changes were associated with improving renal dysfunctions (the levels of serum creatinine and proteinuria decreased gradually from 766 +/- 356 to 284 +/- 192 mumol/L and 2.60 +/- 1.46 to 1.29 +/- 0.85 g/day). CONCLUSIONS: Our data indicate that the renal infiltrating cells may play an important role in renal injury in patients with RPGN. The effects of MP + CTX therapy on improving renal dysfunctions may partially contribute to its amelioration of infiltrating cells in renal tissues. The degrees of CD4+, CD68+, and PCNA+ cells in the kidney may be useful indicators of MP + CTX therapy for RPGN.
Keywords: *Anti-Inflammatory Agents, Steroidal/ADMINISTRATION & DOSAGE *Cyclophosphamide/ADMINISTRATION & DOSAGE *CD4-Positive T-Lymphocytes/DRUG EFFECTS *Glomerulonephritis/PATHOLOGY *Immunosuppressive Agents/ADMINISTRATION & DOSAGE *Methylprednisolone/ADMINISTRATION & DOSAGEKWDanti-inflammatoryagents,steroidal/administration&dosageKWDcyclophosphamide/administration&dosageKWDcd4-positivet-lymphocytes/drugeffectsKWDglomerulonephritis/pathologyKWDimmunosuppressiveagents/administration&dosageKWDmethylprednisolone/administration&dosage
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Copyright © 1998 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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