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Expression of Ki-67 antigen using monoclonal antibody MIB-1 in children with post-streptococcal glomerulonephritis
1Department of Pediatrics, College of Medicine, Inje University, Pusan Paik Hospital, Pusan, Korea.
Insights
Ki-67 antigen expression, a marker for cell proliferation, is significantly higher in the glomeruli of children with active post-streptococcal glomerulonephritis (PSGN) compared to the convalescent phase. This suggests MIB-1 expression correlates with active glomerular injury in pediatric PSGN.
Area of Science:
- Pediatric Nephrology
- Immunohistochemistry
- Glomerular Diseases
Background:
- Post-streptococcal glomerulonephritis (PSGN) is a common cause of acute kidney injury in children.
- Understanding cellular proliferation in PSGN is crucial for assessing disease activity and prognosis.
- Ki-67 antigen (MIB-1) is a widely used marker for cell proliferation.
Purpose of the Study:
- To investigate the expression of Ki-67 antigen (MIB-1) in glomeruli and renal tubules of children with PSGN.
- To correlate MIB-1 expression with disease activity (active vs. convalescent phases) and histological findings.
- To explore the relationship between MIB-1 expression and renal function parameters.
Main Methods:
- Analyzed renal biopsies from 21 children with PSGN using monoclonal antibody MIB-1 for immunohistochemistry.
- Classified patients into active and convalescent groups based on clinical and laboratory criteria.
- Assessed MIB-1 expression in glomeruli and tubules, correlating findings with cellularity, neutrophilic infiltration, immunofluorescence, and electron microscopy results.
Main Results:
- MIB-1 expression was observed in 63.6% of glomeruli and 95.7% of renal tubules.
- Glomerular MIB-1 expression was significantly higher in the active PSGN group (84.6%) compared to the convalescent group (25%) (P=0.018).
- Active PSGN group showed increased glomerular cellularity and neutrophilic infiltration compared to the convalescent group.
Conclusions:
- Glomerular MIB-1 expression is significantly elevated during the active phase of PSGN in children.
- MIB-1 expression in glomeruli appears to be associated with endocapillary proliferation and exudative lesions in pediatric PSGN.
- MIB-1 is a potential marker for assessing glomerular injury and proliferation in active pediatric PSGN.
Abstract:
We investigated the expression of Ki-67 antigen using monoclonal antibody MIB-1 in glomeruli and renal tubules of 21 children (18 males, 3 females) with post-streptococcal glomerulonephritis (PSGN). Patients were divided into two groups of active and convalescent phases. The active group (n=13) comprised those patients with clinical manifestations of the acute nephritic syndrome consisting of edema, hypertension, hematuria, and oliguria or those in whom percutaneous renal biopsy was performed within 4 weeks of onset of the symptoms of PSGN and those with serum C3 levels below 55 mg/dl at the time of biopsy. MIB-1 expression was considered positive when staining of endocapillary cells was observed. Of the 21 biopsies, expression of MIB-1 in glomeruli and renal tubules was observed in 14 cases (63.6%) and 20 cases (95.7%), respectively. The expression of MIB-1 in glomeruli of patients with active disease (11/13, 84.6%) was significantly higher than that of the convalescent group (2/8, 25%) (P=0.018). The cellularity in the glomeruli was more severe in the active group than the convalescent group (P=0.0475). There was a significant difference of neutrophilic infiltration in glomeruli between the active group and the convalescent group (P=0.0117). However, glomerular MIB-1 expression did not correlate with the degree of immunofluorescence, the number of neutrophils in the glomeruli on light microscopy, and the presence of subepithelial dense deposits on electron microscopy. There was no significant correlation between MIB-1 and serum C3 level. There was no significant correlation between glomerular MIB-1 expression and creatinine clearance (r=-0. 180, P=0.556) or 24-h urinary protein excretion (r=0.434, P=0.137). Our results suggest that the expression of MIB- in glomeruli in the active phase in PSGN was higher than in the convalescent phase and expression of glomerular MIB-1 appears to be related to glomerular endocapillary proliferation with exudative lesions in children with PSGN.