[Kidney biopsy in Mantua: 2000-2009 report]. / Biopsie renali a Mantova: report 2000-2009.

The aim of this study was to report the frequency of kidney diseases related to gender, age, clinical presentation and renal function at the time of kidney biopsy in the population of Mantua province (400,000 residents). We collected the results of 132 real-time ultrasound-guided fine-needle (18 G) kidney biopsies by optical and immunofluorescence microscopy. The clinical presentation at the time of biopsy was nephrotic syndrome in 57%, nephritic syndrome in 22%, and urinary abnormalities in 21% of cases. Serum creatinine was >-1.5 mg/dL in 48% of patients. Membranous nephropathy was the most frequent histological finding (21.4%), followed by IgA nephropathy (14.5%), focal glomerulosclerosis (11.5%), diabetic nephropathy (8.4%), and chronic interstitial nephritis (6.9%). Primary glomerulonephritis including membranous glomerulonephritis and IgA nephropathy showed a male predominance. The pathological correlations in native biopsy-proven renal disease provided useful information for clinical practice. The histological findings in our patient series are similar to those recorded in Italian and European registries. A less invasive policy in the case of isolated urinary abnormalities and a normal eGFR resulted in a lower incidence of IgA nephropathy in our series than was recorded in the national Italian registry.

Expression of gangliosides on glial and neuronal cells in normal and pathological adult human brain.

Few studies have assessed the glycolipid phenotype of glial cells in the human central nervous system (CNS) in situ. We investigated by immunohistochemistry the expression and cellular distribution of a panel of gangliosides (GM1, GM2, acetyl-GM3, GD1a, GD1b, GD2, GD3, GT1b, GQ1b and the A2B5 antibody) in adult, human normal and pathological brain, namely multiple sclerosis (MS) and other neurological diseases (OND). In normal conditions, we found diffuse expression in the white matter of most gangliosides tested, with the exception of acetyl-GM3, GT1b and GQ1b. By double immunofluorescence with phenotypic markers, GM1 and GD1b were preferentially expressed on GFAP+ astrocytes, GD1a on NG2+ oligodendrocyte precursors, A2B5 immunostained both populations, while GD2 was selectively present on mature oligodendrocytes. In the gray matter, only GM1, GD2 and A2B5 were present on neuronal cells. Interestingly, those gangliosides present on astrocytes in normal conditions were preferentially expressed on NG2+ cells in chronic MS lesions and in OND. Selective expression of GT1b upon astrocytes and NG2+ cells was instead observed in MS lesions, but not in OND. The definition of the glycolipid phenotype of CNS glial cells may be useful to identify distinct biological glial subsets and provide insights on the potential autoantigenic role of gangliosides in CNS autoimmune diseases.

Heavy metals nanoparticles in fetal kidney and liver tissues.

The proliferation of the nanotechnologies with the production of engineered nanoparticles presents a dilemma to regulators regarding hazard identification mostly for human health. We investigated the presence of inorganic micro and nanosized contamination in fetal liver and kidney tissues by Field Emission Gun-Environmental Scanning Electron Microscope (FEGESEM) innovative observations. An observational study in 16 fetuses, complicated (n=8) or not (n=8) by neural tube defects, whose mothers obtained the authorization for abortion between 21-23 weeks of gestation was carried out. Heavy metals concentrations in maternal blood were undetectable. FEGESEM assessment showed particles of iron, silicon, aluminum and magnesium in different tissues analyzed. The mean size and the number of the foreign bodies detected in kidney and liver tissues were higher in NTD fetuses as well as the number of total particles (P < 0.05, for all). The present study shows first the presence of xenobiotic, nanoscaled contamination, not detectable in maternal blood in fetuses. Data are suggestive and open-up a new clue for further investigations to elucidate the relationship between pollution at nanoscale stage and multiorgan damage.

Gonadal structures in a fetus with complete androgen insensitivity syndrome and persistent Müllerian derivatives: comparison with normal fetal development.

OBJECTIVE: To report a case of complete androgen insensitivity syndrome (CAIS) with Müllerian duct persistence. DESIGN: Case report. SETTING: Academic hospital. PATIENT(S): A case of CAIS at 20 weeks' gestational age, and three male and one female 20-week-old fetuses for comparison. INTERVENTION(S): DNA screening for androgen receptor (AR), antimüllerian hormone (AMH), and AMH receptor type 2 (AMHR2) gene mutations, and morphologic examination of Wolffian and Müllerian derivatives and immunohistochemistry for AMH, AMHR2, and bone morphogenetic protein receptor type 1A (BMPR1A) in aborted fetuses. MAIN OUTCOME MEASURE(S): Histopathologic, genetic, and immunohistochemical studies. RESULT(S): A novel mutation of AR (D767V) was identified in the index fetus. The CAIS case showed Wolffian duct degeneration, Leydig cell hyperplasia, and normally developed Sertoli cells. No AMH and AMHR2 gene sequence alterations were observed in the CAIS case, and the uterus and vagina were developed to a similar extent as found in the normal female 20-week-old fetus. The CAIS testes expressed more abundant AMH and showed fewer AMHR2-positive peritubular mesenchymal cells than the normal male testes, but BMPR1A stained similarly. CONCLUSION(S): Our study indicates that testes differentiation and development as well as the expression patterns of AMH, AMHR2, and BMPR1A are independent from AR function, at least up to the second trimester. The mechanisms by which the lack of functional androgen interferes with AMH action and Müllerian duct regression remain undefined.