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dc.contributor.authorSoares, M.
dc.contributor.authorGenitsch, V.
dc.contributor.authorChakera, Aron
dc.contributor.authorSmith, A.
dc.contributor.authorMacEwen, C.
dc.contributor.authorBellur, S.
dc.contributor.authorAlham, N.
dc.contributor.authorRoberts, I.
dc.date.accessioned2019-02-19T04:15:20Z
dc.date.available2019-02-19T04:15:20Z
dc.date.created2019-02-19T03:58:38Z
dc.date.issued2019
dc.identifier.citationSoares, M. and Genitsch, V. and Chakera, A. and Smith, A. and MacEwen, C. and Bellur, S. and Alham, N. et al. 2019. Relationship between renal CD68<sup>+</sup> infiltrates and the Oxford Classification of IgA nephropathy. Histopathology.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/73948
dc.identifier.doi10.1111/his.13768
dc.description.abstract

© 2018 John Wiley & Sons Ltd Aims: The Oxford Classification E score (endocapillary hypercellularity) predicts renal functional decline in IgA nephropathy (IgAN) patients free from steroid/immunosuppressive (IS) therapy, but is poorly reproducible. We hypothesise that endocapillary hypercellularity reflects glomerular inflammation and that the presence of CD68-positive cells is a more robust marker of E score. Methods and results: CD68-positive cells were quantified in glomeruli and tubulointerstitium in biopsies from 118 IgAN patients, and cell counts were correlated with the criteria of the Oxford Classification, assigned on PAS-stained serial sections. There was a strong correlation between median glomerular CD68 count and the percentage of glomeruli showing endocapillary hypercellularity (r = 0.67; P &lt; 0.001; r2 = 0.45), while there was no correlation between CD68-positive cells and mesangial hypercellularity, % segmental sclerosis, % of crescents and % tubular atrophy/interstitial fibrosis (TA/IF). ROC curve analysis demonstrated that a maximum glomerular CD68 count of 6 is the best cut-off for distinguishing E0 from E1 (sensitivity 94.1%, specificity 71%, area under the curve = 89%). Identification of biopsies with a maximum glomerular CD68-count &gt;6 was reproducible (kappa score 0.8), and there was a strong correlation between glomerular CD68 counts obtained by conventional light microscopy and by image analysis (r = 0.80, r2 = 0.64, P &lt; 0.0001). Digital image analysis revealed that tubulointerstitial CD68-positive cells correlated moderately with % TA/IF (r = 0.59, r2 = 0.35, P &lt; 0.001) and GFR at the time of biopsy (r = 0.54, r2 = 0.29, P &lt; 0.0001), but not with mesangial and endocapillary hypercellularity. Conclusions: While glomerular CD68-positive cells emerge as markers of endocapillary hypercellularity, their tubulointerstitial counterparts are associated with chronic damage.

dc.titleRelationship between renal CD68<sup>+</sup> infiltrates and the Oxford Classification of IgA nephropathy
dc.typeJournal Article
dcterms.source.issn0309-0167
dcterms.source.titleHistopathology
curtin.departmentCurtin Medical School
curtin.accessStatusFulltext not available


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