Apoptosis in human immunodeficiency virus-associated nephropathy

Area of Science:

• Nephrology
• Immunology
• Cell Biology

Background:

• Focal segmental glomerulosclerosis associated with human immunodeficiency virus nephropathy (HIVFGS) affects glomeruli, tubules, and interstitium.
• The exact pathogenesis of HIVFGS is unknown, but human immunodeficiency virus (HIV) peptides may be crucial.
• HIV peptides and peptide-antibody complexes are immunomodulatory and linked to apoptosis in lymphoid cells.

Purpose of the Study:

• To investigate the presence and role of apoptosis in the pathogenesis of HIVFGS.
• To compare apoptosis levels in renal biopsy specimens from patients with HIVFGS and idiopathic focal glomerulosclerosis (FGS).

Main Methods:

• Renal biopsy specimens from eight HIVFGS patients and ten idiopathic FGS patients were analyzed.
• The Apoptag kit was used to detect single-cell apoptosis by staining 3' nucleosome fragments.
• Apoptosis was quantified per glomerulus, in total renal tissue, and in tubules and interstitium per square millimeter using a computerized digital image analyzer.

Main Results:

• No significant difference in apoptotic cells per glomerulus or per square millimeter of interstitium was observed between HIVFGS and idiopathic FGS groups.
• A significantly greater number of tubular apoptotic cells per square millimeter was found in HIVFGS patients compared to idiopathic FGS patients (P = 0.03).
• The difference in apoptotic cells per total square millimeter of renal tissue approached statistical significance (P = 0.066).

Conclusions:

• Apoptosis may be associated with the pathogenesis of human immunodeficiency virus nephropathy.
• Increased tubular apoptosis appears to be a significant factor in the tubular disease observed in HIVFGS.