Dysregulation of the microvasculature in nonlesional non-sun-exposed skin of patients with lupus nephritis.
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Author
Izmirly, Peter MShvartsbeyn, Marianna
Meehan, Shane
Franks, Andrew
Braun, Alan
Ginzler, Ellen
Xu, Sherry X
Yee, Herman
Rivera, Tania L
Esmon, Charles
Barisoni, Laura
Merrill, Joan T
Buyon, Jill P
Clancy, Robert M
Journal title
The Journal of rheumatologyDate Published
2012-02-01Publication Volume
39Publication Issue
3Publication Begin page
510Publication End page
5
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Show full item recordAbstract
Membrane endothelial protein C receptor (mEPCR) is highly expressed in peritubular capillaries of kidneys from patients with active and poorly responsive lupus nephritis (LN). We investigated the hypothesis that changes in the microvasculature are widespread with extension to the dermal vasculature.Skin biopsies from uninvolved skin (buttocks) were performed in 27 patients with LN and 5 healthy controls. Sections were stained with specific antibodies reactive with mEPCR, adiponectin, intercellular adhesion molecule-1 (ICAM-1), and CD31; then assessed by enumeration of stained blood vessels (percentage positive blood vessels) blinded to knowledge of clinical information.
There was a significant increase in the prevalence of blood vessels that stained for mEPCR and ICAM-1 in patients compared to controls [94% vs 59% (p = 0.045) and 81% vs 67% (p = 0.037), respectively]. Adiponectin staining and CD31 staining were similar between the groups (45% vs 43% and 98% vs 92%). Dermal staining for mEPCR was greater in patients with proliferative glomerulonephritis than in those with membranous disease (96% vs 60%; p = 0.029). A composite of poor prognostic renal markers and death was significantly associated with greater expression of mEPCR staining.
These data are consistent with the notion that in patients with LN, activation of the microvasculature extends beyond the clinically targeted organ. The insidious expression of this widespread vasculopathy may be a contributor to longterm comorbidities.
Citation
Izmirly PM, Shvartsbeyn M, Meehan S, Franks A, Braun A, Ginzler E, Xu SX, Yee H, Rivera TL, Esmon C, Barisoni L, Merrill JT, Buyon JP, Clancy RM. Dysregulation of the microvasculature in nonlesional non-sun-exposed skin of patients with lupus nephritis. J Rheumatol. 2012 Mar;39(3):510-5. doi: 10.3899/jrheum.110878. Epub 2012 Feb 1. Erratum in: J Rheumatol. 2012 Apr;39(4):881. Rivera, Tania [corrected to Rivera, Tania L]. PMID: 22298906; PMCID: PMC4054860.DOI
10.3899/jrheum.110878ae974a485f413a2113503eed53cd6c53
10.3899/jrheum.110878
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