Beta2-glycoprotein I Expression in Lupus Nephritis Patients with Antiphospholipid-associated Nephropathy

Abstract

Objective.Antiphospholipid-associated nephropathy (aPLN) is a severe condition in patients with lupus nephritis (LN). aPLN should be distinguished from other reasons for renal ischemia. The most important cofactor of antiphospholipid antibodies (aPL), β2-glycoprotein I (β2GPI), was shown in vitro to bind endothelial cells and to induce a procoagulant phenotype. The objectives of this study were to investigate whether β2GPI expression was involved in patients with LN with aPLN and to determine its specificity.Methods.We retrospectively investigated β2GPI expression in 231 renal biopsy specimens of patients with LN. Data from biopsy reports and clinical information were collected. Immunohistochemical staining for β2GPI expression was performed.Results.Histological aPLN was detected in 88 patients with LN (38.1%). The LN with aPLN consisted of 43 patients (18.6%). Expression of β2GPI was detected in endothelial cells in 14 (32.6%) in renal arteries or arterioles, 11 (25.6%) in glomerular or peritubular capillaries, and a total of 15 (34.9%) of the 43 patients with LN with aPLN. It was mainly expressed in the endothelial cells in patients with LN with aPLN (p < 0.05). The specificity of β2GPI expression in patients with LN with aPLN was 97.5%.Conclusion.Expression of β2GPI may be involved in the formation of aPLN in patients with LN. This expression in endothelial cells in kidney tissue may be considered a useful marker for aPLN.