rss
J Clin Pathol 2006;59:916-920 doi:10.1136/jcp.2005.031732
  • Original article

Ezrin—a useful factor in the prognosis of nephrotic syndrome in children: an immunohistochemical approach

  1. D Ostalska-Nowicka1,
  2. J Zachwieja1,
  3. M Nowicki2,
  4. E Kaczmarek3,
  5. A Siwinska1,
  6. M Witt4
  1. 1Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland
  2. 2Department of Histology and Embryology, Poznan University of Medical Sciences
  3. 3Department of Clinical Pathomorphology, Poznan University of Medical Sciences
  4. 4Department of Anatomy, University of Technology, Dresden Medical School, Dresden, Germany
  1. Correspondence to:
    D Ostalska-Nowicka
    Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, ul. Szpitalna 27/33, 60–572 Poznan, Poland; dostalska{at}interia.pl
  • Accepted 3 October 2005
  • Published Online First 7 March 2006

Abstract

Background: Minimal change disease (MCD) and diffuse mesangial proliferation (DMP) are the most common pathomorphological forms of nephrotic syndrome glomerulopathies in children. The clinical course of DMP can be characterised by either DMP-sensitivity (DMP-S) or DMP-resistance (DMP-R) to steroids, resulting in an unfavourable course of the glomerulopathy. Although the clinical processes of DMP-S and DMP-R are initially identical, resistance to steroids may be foreseen by the immunohistochemical expression of cytoskeleton-associated proteins in podocytes.

Aims: To estimate the immunohistochemical expression of ezrin in children with MCD, DMP and focal segmental glomerulosclerosis (FSGS) and to evaluate its usefulness in predicting resistance to steroids.

Materials and methods: Renal biopsy specimens of patients with MCD (n = 15), DMP (n = 16) and FSGS (n = 6) were taken. The control tissue consisted of normal-appearing cortex taken from kidneys resected for localised neoplasms (n = 6). The indirect immunohistochemical protocol for the use of a monoclonal antibody directed against ezrin was used.

Results: The immunohistochemical expression of ezrin in cases progressively reduced from MCD to DMP-S to DMP-R to FSGS. Except for DMP-R and FSGS (p>0.05), the difference in ezrin expression in podocytes was significant.

Conclusion: Ezrin can be a potent marker of podocyte injury (podocytopathy) and may help in the histological qualification of MCD, DMP and FSGS. The increased permeability of the filtration barrier in steroid-resistant and proteinuric glomerulopathies may be a consequence of subcellular changes in podocyte-associated proteins following decreased expression of ezrin.

Footnotes

  • Published Online First 7 March 2006

  • Competing interests: None.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. jcp.2005.031732v1
    2. 59/9/916 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.