Lupus nephropathy: clinical, immunohistochemistry and quantitative morphometric analysis studies

ABSTRACT

Lupus nephritis includes a wide range of parenchymal injuries and severity. Better predictors to outcome are needed for patients newly diagnosed with lupus nephritis, so that an appropriate management strategy may be selected. This study aimed to determine whether the ratio of hepatocyte growth factor [HGF] to transforming growth factor beta 1 [TGF beta1] in lupus nephritis could be a prognostic factor for response to therapy with cyclophosphamide and steroids at six months. Also, to determine whether a simple automated system for objective scoring of biopsies of lupus nephritis could be a prognostic factor for response to therapy with cyclophosphamide and steroids at 6 months. Consequently, renal biopsy findings and clinical parameters of thirty parasites-free patients with new onset lupus nephritis were recorded. Histopathologic, clinical, immune-histochemical and morphometric data at baseline served to define the predictive value for outcome after 6 months of therapy. The results showed a significant positive relationship between response to therapy and HGF IS [P= 0.007], HGF ES [P= 0.026], HGF IS/ TGFbeta1 IS ratio [P= 0.022] and HGF ES/ TGFbeta1 ES ratio [P= 0.001]. A significant inverse relationship was proved between response to therapy and TGFbeta1 IS [P= 0.025] as well as TGFbeta1 ES [P= 0.017]. Also, a significant inverse relationship was present between response to therapy and nuclear index, tubular index and matrix index [P = 0.03, 0.03 and 0.029 respectively]