各種腎疾患における凝固因子ならびに血小板の糸球体内局在の免疫電顕による観察

抄録

Utilizing polyclonal antibodies to fibrinogen/fibrin related antigens (FRA), factor VIII related antigen (vWf : Ag), factor XIII subunit-A (F. XIII-A) and platelet membrane antigen (PMA), immunoelectron microscopy (IEM) was performed on kidney tissues from 2 normal humans and 41 patients with various renal disases. In normal human kidneys, FRA deposition was present only in the capillary lumen, and vWf : Ag was detected in the endothelial cells, but F. XIII-A and PMA were negative. On the tissue from patients with renal diseases, FRA was deposited in almost all cases; FRA were positive in the glomerular capillaries and mesangium of patients with Henoch-Schonlein purpura nephritis (HSPN), crescentic GN (crGN) and lupus nephritis, indicating the association between mesangial FRA deposition and mesangial proliferation. In contrast, the localization of FRA was restricted to capillary lumens in minimal change nephrotic syndrome (MCNS) and hemolytic-uremic syndrome (HUS). VWf : Ag was fre-quently localized in the mesangium and glomerular endothelial cells. F. XIII-A was deposited dominantly in the glomerular capillary lumens. PMA was present with glomeruli of 50% of patients. FRA, vWf : Ag and F. XIII-A was generally co-deposited in the glomerular capillary lumens, and FRA and vWf : Ag were deposited in the mesangium of IgA nephropathy, HSPN, membrano-proliferative GN and crGN, suggesting the local activation of the coag-ulation system. FRA deposition was occasionally dissociated with vWf : Ag or F. XIII-A, which is probably due to non-specific trapping of fibrinogen or difference in the clearance mechanism of each coagulation protein.