Renal macrophage infiltration is associated with a poor outcome in IgA nephropathy

OBJECTIVES: The objectives of our study were as follows: 1) to analyze the prognostic value of macrophage infiltration in primary IgA nephropathy (IgAN) and 2) to study the relationship between macrophages and other factors associated with the development of renal fibrosis, including mast cells, TGF-beta 1, alpha-SMA and NF-kB. METHODS: We analyzed 62 patients who had been diagnosed with IgAN between 1987 and 2003. Immunohistochemical staining was performed with monoclonal antibodies against CD68 and mast cell tryptase and polyclonal antibodies against TGF-beta 1, alpha-SMA and NF-kB p65. We also used Southwestern histochemistry for the in situ detection of activated NF-kB. RESULTS: The infiltration of macrophages into the tubulointerstitial compartment correlated with unfavorable clinical and histological parameters, and a worse clinical course of IgAN was significantly associated with the number of tubulointerstitial macrophages. Kaplan-Meier curves demonstrated that increased macrophage infiltration was associated with decreased renal survival. Moreover, the presence of macrophages was associated with mast cells, tubulointerstitial alpha-SMA expression and NF-kB activation (IH and Southwestern histochemistry). In the multivariate analysis, the two parameters that correlated with macrophage infiltration, proteinuria and tubulointerstitial injury, were independently associated with an unfavorable clinical course. CONCLUSION: An increased number of macrophages in the tubulointerstitial area may serve as a predictive factor for poor prognosis in patients with IgAN, and these cells were also associated with the expression of pro-fibrotic factors.

Morphological evidence of neurotoxicity in retina after methylmercury exposure

The visual system is particularly sensitive to methylmercury (MeHg) exposure and, therefore, provides a useful model for investigating the fundamental mechanisms that direct toxic effects. During a period of 70 days, adult of a freshwater fish species Hoplias malabaricus were fed with fish prey previously labeled with two different doses of methylmercury (0.075 and 0.75 mu g g(-1)) to determine the mercury distribution and morphological changes in the retina. Mercury deposits were found in the photoreceptor layer, in the inner plexiform layer and in the outer plexiform layer, demonstrating a dose-dependent bioaccumulation. The ultrastructure analysis of retina revealed a cellular deterioration in the photoreceptor layer, morphological changes in the inner and outer segments of rods, structural changes in the plasma membrane of rods and double cones, changes in the process of removal of membranous discs and a structural discontinuity. These results lead to the conclusion that methylmercury is able to cross the blood-retina barrier, accumulate in the cells and layers of retina and induce changes in photoreceptors of H. malabaricus even under subchronic exposure. (c) 2012 Elsevier Inc. All rights reserved.

Facial lesions caused by renal osteodystrophy in a patient with chronic renal insufficiency: a case report

PURPOSE: Chronic renal insufficiency (CRI) is the last stage of a chronic renal condition in which the kidney loses its filtration and endocrine functions. Chronic endocrine hypofunction causes generalized damage to the body known as Uremic Syndrome, which affects the central nervous system as well as the cardiovascular, hematologic, dermatologic, ophthalmic, endocrine, respiratory, gastrointestinal and skeletal systems. The present study reports the case of a female patient with CRI who presented facial osteodystrophy of the osteitis fibrosa type, and highlights the main features of this condition. CASE DESCRIPTION: A 24-year old, female, Caucasian patient presented chronic glomerulonephritis recurrence and lost the transplanted kidney five years before, undergoing arteriovenous fistula hemodialysis three times a week. She presented swelling of the left masseter area with a hard consistency on palpation, covered by intact skin, swelling at the bottom of the left atrium, with a hard consistency on palpation, a mucosa-like color and absence of inflammation signs, suggesting expansive bone lesions on the face. These features were compatible with hyperparathyroidism brown tumor and/or osteodystrophy. The CT scan showed expansive bone lesions of heterogeneous appearance on the left jaw, maxilla/nasal floor, and right frontotemporal suture areas. The clinical and histopathological characteristics of the lesion, in association with PHT hormone high serum levels led to renal osteodystrophy diagnosis. The patient was referred to the nephrology services. CONCLUSION: Osteodystrophic bone alterations have a high prevalence in renal disease patients, and the dentist must take these alterations into consideration in bone lesion diagnosis for this specific group of patients.

Funktion des Rezeptors der sekretorischen Phospholipasen A 2 bei der Signaltransduktion in glomerulären Mesangiumzellen und entzündlichen Erkrankungen der Niere

Die sekretorischen Phospholipasen A2 (sPLA2) sind Enzyme, welche die Hydrolyse der Esterbindung an der sn-2-Position von Phospholipiden katalysieren, wodurch freie Fettsäuren, welche als Vorläufermolekül von Eicosanoiden dienen, freiwerden. Außerdem wurde gezeigt, dass sPLA2s auch unabhängig von ihrer katalytischen Aktivität durch die Bindung an einen spezifischen sPLA2-M-Typ-Rezeptor (MTR) intrazelluläre Signalwege, wie z.B. die Induktion von proinflammatorischen Genen, aktivieren können. Deshalb wurden in dieser Arbeit weiterführende Studien zur Aufklärung der Lokalisation und der Signaltransduktion der sPLA2s sowie die Bedeutung des MTR durchgeführt. Als Zellmodell für in-vitro-Studien wurden glomeruläre Mesangiumzellen verwendet, da diese Zellen eine zentrale Rolle bei entzündlichen Nierenerkrankungen, wie z.B. der Glomerulonephritis spielen. Durch Isolierung von Mesangiumzellen aus MTR-knockout-Mäusen (C57BL/6) sollten potentielle Unterschiede in der MTR-vermittelten Signaltransduktion im Vergleich zu Mesangiumzellen isoliert aus (C57BL/6) Wildtyp-Mäusen herausgearbeitet werden. Die Untersuchungen dieser Arbeit zeigen, dass verschiedene sPLA2-Enzyme in Maus-Mesangiumzellen exprimiert werden und diese an der konstitutiven Biosynthese von Prostaglandinen beteiligt sind. Der spezifische M-Typ-Rezeptor wird in diesen Zellen im Gegensatz zu Ratten-Mesangiumzellen weder unter physiologischen noch unter proinflammatorischen Bedingungen exprimiert und spielt daher vermutlich keine Rolle bei der Signaltransduktion durch sPLA2s.

Regulation der Sphingosinkinase 1 und 2 und der neutralen Ceramidase in renalen Mesangiumzellen der Ratte

In den letzten Jahren gewann die Erforschung des Sphingolipidstoffwechsels in den verschiedensten Zellsystemen immer mehr an Bedeutung, da es sich zeigte, dass einige Sphingolipidspezies, vor allem Ceramid und Sphingosin-1-Phosphat, als wichtige intra- und extrazelluläre Botenstoffe wirken und bei einer Vielzahl unterschiedlicher zellulärer Antworten, wie Apoptose, Proliferation und Migration, eine wichtige Rolle spielen. Während Ceramid eher pro-apoptotisch und wachstumshemmend wirkt, begünstigt Sphingosin-1-Phosphat als „Gegenspieler“ eher die Proliferation und das Zellwachstum. Ceramid kann relativ schnell in Sphingosin-1-Phosphat umgewandelt werden durch die Wirkung zweier Enzymklassen, den Ceramidasen und den Sphingosinkinasen. Konsequenterweise ist die Regulation dieser Enzyme von entscheidender Bedeutung für das zelluläre Gleichgewicht zwischen Ceramid und Sphingosin-1-Phosphat. Im Rahmen dieser Dissertation wurde die Wirkung von extrazellulären Nukleotiden, die ebenfalls als Regulatoren zahlreicher zellulärer Antworten, wie z.B. Proliferation und Migration, bekannt sind und über entsprechende Oberflächenrezeptoren, die Purinrezeptoren, wirken, auf die Aktivität besonders der Sphingosinkinasen 1 und 2 näher untersucht. Es sollte geklärt werden, ob die Sphingosinkinasen an einigen durch extrazelluläre Nukleotide induzierbaren zellulären Antworten, in diesem Falle der Migration und der Proliferation von Zellen, beteiligt sind. Als Zellsystem wurden Nierenmesangiumzellen verwendet, da diese Zellen bei verschiedenen entzündlichen Nierenerkrankungen (Glomerulonephritiden) eine wichtige Rolle spielen. Es konnte in dieser Arbeit gezeigt werden, dass extrazelluläre Nukleotide die Aktivität der Sphingosinkinase 1 in den Mesangiumzellen stimulieren können. Zu beobachten ist dabei eine biphasische Aktivitätssteigerung der Sphingosinkinase 1. Die erste Aktivitätssteigerung nach einer Kurzzeitstimulation ist dabei auf eine Phosphorylierung des Enzyms zurückzuführen, während die zweite Aktivitätssteigerung mit einer Aktivierung des Sphingosinkinase 1-Promotors, einer verstärkten mRNA-Expression und einer de novo Proteinsynthese zu erklären ist. Diese Induktion kann durch die Verwendung von Hemmstoffen des PKC- und MAPK-Signalweges, sowie durch Verwendung eines Transkriptions- (Actinomycin D) oder eines Translationsinhibitors (Cycloheximid) blockiert werden. Die Halbwertszeit der mRNA der Sphingosinkinase 1 in den Mesangiumzellen konnte auf ca. 20 Minuten bestimmt werden. Im Gegensatz dazu ist die Sphingosinkinase 2 nicht durch ATP aktivierbar, wohl aber durch diverse Abbauprodukte von ATP, wie AMP und Adenosin, sowie durch UTP und seine Abbauprodukten UDP und UMP. Die neutrale Ceramidase kann nicht durch ATP und UTP aktiviert werden, wohl aber durch P2X7-Rezeptoragonisten (Bz-ATP, αβ-Me-ATP, γS-ATP) und TPA. In einem zweiten Schritt wurde die Rolle der Sphingosinkinasen und der neutralen Ceramidase bei der durch extrazelluläre Nukleotide induzierten Migration und Proliferation untersucht. Es zeigte sich mit Hilfe von genspezifischer siRNA zur Depletion der Sphingosinkinasen und der neutralen Ceramidase, sowie durch Verwendung von Kinase-Hemmstoffen und damit einhergehend der Inhibierung der Signalwege und mit Hilfe von verschiedenen Zelllinien isoliert aus Wildtyp-, SPHK 1-überexprimierenden und mSPHK1-defizienten Mäusen, dass die Aktivierung der Sphingosinkinase 1 durch extrazelluläre Nukleotide von entscheidender Bedeutung für die Migrationsfähigkeit der Zellen ist, jedoch keinen signifikanten Einfluss auf die Proliferationsrate der Mesangiumzellen hat. Auch die Aktivität der neutralen Ceramidase ist von entscheidender Bedeutung für die Migrationsfähigkeit der Zellen. Durch Depletion der neutralen Ceramidase scheint Ceramid in den Zellen zu akkumulieren, was die Proliferationsrate reduziert. Für die Proliferation der Mesangiumzellen könnte die Sphingosinkinase 2 als negativer Regulator fungieren, wie die Experimente mit der genspezifischen siRNA unter UTP-Stimulation gezeigt haben. Für die Migration der Mesangiumzellen gilt darüber hinaus, dass auch das Produkt der Sphingosinkinase 1, Sphingosin-1-Phosphat, in der Lage ist, die Migration zu stimulieren. Im Gegensatz dazu spielt Sphingosin-1-Phosphat für die Induktion der Proliferation der hier verwendeten Zellen keine wesentliche Rolle. Zusammenfassend zeigen die Daten, dass die Sphingosinkinase 1 und vorgeschaltet auch die neutrale Ceramidase bei der Migration von Mesangiumzellen eine zentrale Rolle spielen und damit als therapeutische Angriffspunkte bei der Behandlung von Krankheiten, die durch eine vermehrte Migration gekennzeichnet sind, in Frage kommen.

Oligodendroglial exosomes in glia to neuron signaling

In the CNS, myelinating oligodendrocytes and axons form a functional unit based on intimate cell-cell interactions. In addition to axonal insulation serving to increase the conduction velocity of electrical impulses, oligodendrocytes provide trophic support to neurons essential for the long-term functional integrity of axons. The glial signals maintaining axonal functions are just at the beginning to become uncovered. Yet, their determination is highly relevant for all types of demyelinating diseases, where lack of glial support significantly contributes to pathology. rnThe present PhD thesis uncovers exosomes as a novel signaling entity in the CNS by which cargo can be transferred from oligodendrocytes to neurons. Exosomes are small membranous vesicles of endocytic origin, which are released by almost every cell type and have been implicated in intercellular communication. Oligodendrocytes secrete exosomes containing a distinct set of proteins as well as mRNA and microRNA. Intriguingly, oligodendroglial exosome release is stimulated by the neurotransmitter glutamate indicating that neuronal electrical activity controls glial exosome release. In this study, the role of exosomes in neuron-glia communication and their implications on glial support was examined. Cortical neurons internalized and accumulated oligodendroglial exosomes in the neuronal cell soma in a time-dependent manner. Moreover, uptake occurred likewise at the somatodendritic and axonal compartment of the neurons via dynamin and clathrin dependent endocytosis. Intriguingly, neuronal internalization of exosomes resulted in functional retrieval of exosomal cargo in vitro and in vivo upon stereotactic injection of Cre recombinase bearing exosomes. Functional recovery of Cre recombinase from transferred exosomes was indicated by acquired reporter recombination in the target cell. Electrophysiological analysis showed an increased firing rate in neurons exposed to oligodendroglial exosomes. Moreover, microarray analysis revealed differentially expressed genes after exosome treatment, indicating functional implications on neuronal gene expression and activity. rnTaken together, the results of this PhD thesis represent a proof of principle for exosome transmission from oligodendrocytes to neurons suggesting a new route of horizontal transfer in the CNS.rn

Analyse der Wirkung des Naturstoffes Oxacyclododecindion in einem chronisch-inflammatorischen Krankheitsmodell

Die medikamentöse Standardtherapie entzündlich-rheumatischer Erkrankungen wie der rheumatoider Arthritis (RA) und des systemischen Lupus erythematodes (SLE) sind oft unzureichend und erlauben keine nebenwirkungsarme beziehungsweise -freie Behandlung. Daher ist es von großem Interesse für diese Indikationsgebiete, wirkungsvolle Substanzen zu entwickeln, die für eine Langzeittherapie geeignet sind. Naturstoffe wie Oxacyclododecindion (Oxa) können dabei als mögliche Leitstruktur dienen. Oxa wurde bereits in in-vitro Untersuchungen als ein potenter Inhibitor der Expression von proinflammatorischen und profibrotischen Genen identifiziert. rnZiel dieser Arbeit war es in in-vivo Modellen der RA und des SLEs das therapeutische Potential des Naturstoffes Oxa aufzuklären. Da eine Etablierung der Kollagen-induzierten Arthritis im untersuchten murinen RA-Modell, dem HLA-DR4.AE° Stamm, nicht möglich war, wurden die Untersuchungen ausschließlich im MRL Faslpr Mausstamm, einem anerkannten SLE-Modell durchgeführt. MRL Faslpr Mäuse entwickeln wie SLE-Patienten unter anderem eine schwerwiegende Glomerulonephritis. rnIn den Nieren weiblicher MRL Faslpr Mäuse konnte die Oxa-Behandlung die Expression zahlreicher proinflammatorischer Mediatoren beeinflussen, die in Zusammenhang mit der Pathogenese des humanen SLE gebracht werden. So reduziert der Naturstoff die Expression von Zytokinen wie TNFα, IFNγ und IL6 als auch Chemokinen wie CCL2, CSF-1 und RANTES auf mRNA- und Proteinebene. Dabei war die Wirkung von Oxa in den in-vivo Analysen ähnlich gut wie die des potenten Glukokortikoids Dexamethason. Die Reduktion chemotaktischer Moleküle durch die Oxa-Behandlung führte nachweislich zu einer reduzierten Akkumulation von Immunzellen. Die anti-inflammatorischen und immunmodulatorischen Effekte von Oxa waren so ausgeprägt, dass klinisch-pathologische Marker der Glomerulonephritis, wie die Ablagerung von Immunkomplexen, die vermehrte Bildung von Kollagenfasern und die Ausscheidung von Proteinen im Urin gemildert wurden. Weiterführende Untersuchungen im SLE Modell konnten neue Zielmoleküle von Oxa identifizieren, wie KIM1 und zahlreiche SLE-assoziierte microRNAs (miR 19a, 29c und 369). Diese Befunde legen nahe, dass Oxa eine vielversprechende anti-entzündliche und -fibrotische Verbindung darstellt. rnDie Entschlüsselung des Wirkmechanismus von Oxa steht erst am Anfang. Die Analysen im Rahmen dieser Arbeit zeigten jedoch, dass Oxa einen Einfluss auf die Phosphorylierung und somit Aktivierung der p38 MAPK sowie auf die mRNA-Stabilität von proinflammatorischen Zytokinen wie TNFα zu haben scheint.rn

Reversal of established lupus nephritis and prolonged survival of New Zealand black x New Zealand white mice treated with the topoisomerase I inhibitor irinotecan

Systemic lupus erythematosus is a chronic autoimmune disorder that predominantly affects women of childbearing age. Lupus-associated glomerulonephritis is a major cause of mortality in these patients. Current treatment protocols for systemic lupus erythematosus include cyclophosphamide, prednisolone, azathioprine, and mycophenolate mofetil. However, in mice none of these agents alone or in combination were shown to reverse established proteinuria. Using New Zealand Black x New Zealand White F1 mice, we report that administration of the topoisomerase I inhibitor irinotecan from week 13 completely prevented the onset of proteinuria and prolonged survival up to at least 90 wk without detectable side effects. Furthermore, application of irinotecan to mice with established lupus nephritis, as indicated by grade 3+ (> or =300 mg/dl) and grade 4+ (> or =2000 mg/dl) proteinuria and, according to a median age of 35 wk, resulted in remission rates of 75% and 55%, respectively. Survival was significantly prolonged with 73 wk (grade 3+ and 4+ combined) versus 40 wk for control animals. Although total IgG and anti-dsDNA Abs in the serum and mesangial IgG deposits in the kidneys were not reduced in irinotecan-treated mice, subendothelial immune deposits were considerably diminished, suggesting a prevention of glomerular basement membrane disruption. This effect was accompanied by increased rates of ssDNA breaks and inhibition of renal cell apoptosis being different to what is known about irinotecan in anticancer therapy. In conclusion, our data provide evidence that irinotecan might represent an entirely new strategy for the treatment of systemic lupus erythematosus.

Dialysis and Renal Transplantation in HIV-Infected Patients: a European Survey

OBJECTIVES:: To determine prevalence and characteristics of end-stage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients. METHODS:: Cross-sectional multicenter survey of EuroSIDA clinics during 2008. RESULTS:: Prevalence of ESRD was 0.5%. Of 122 patients with ESRD 96 were on dialysis and 26 had received a RT. Median age was 47 years, 73% were males and 43% were black. Median duration of HIV infection was 11 years. Thirty-three percent had prior AIDS; 91% were receiving antiretrovirals; and 88% had undetectable viral load. Median CD4T-cell count was 341 cells per cubic millimetre; 20.5% had hepatitis C coinfection. Most frequent causes of ESRD were HIV-associated nephropathy (46%) and other glomerulonephritis (28%). Hemodialysis (93%) was the most common dialysis modality; 34% of patients were on the RT waiting list. A poor HIV control was the reason for exclusion from RT waiting list in 22.4% of cases. All the RT recipients were all alive at the time of the survey. Acute rejection was reported in 8 patients (30%). Functioning graft was present in 21 (80%). CONCLUSIONS:: This is the first multinational cross-sectional study of ESRD among European HIV population. Low prevalence of ESRD was found. Two-thirds of patients were excluded from RT for non-HIV/AIDS-related pathologies. Most patients had a functioning graft despite a high acute rejection rate.

Subcellular Localization of the Non-Structural Proteins 3C and 3CD of the Honeybee Virus Deformed Wing Virus

Apis mellifera L., the European honeybee, is a crucial pollinator of many important agricultural crops in the United States. Recently, honeybee colonies have been affected by Colony Collapse Disorder (CCD), a disorder in which the colony fails due to the disappearance of a key functional group of worker bees. Though no direct causalrelationship has been confirmed, hives that experience CCD have been shown to have a high incidence of Deformed Wing Virus (DWV), a common honeybee virus. While the genome sequence and gene-order of DWV has been analyzed fairly recently, few other studies have been performed to understand the molecular characterization of the virus.Since little is known about where DWV proteins localize in infected host cells, the objective of this project was to determine the subcellular localization of two of the important non-structural proteins that are encoded in the DWV genome. This project focused on the protein 3C, an autocatalytic protease which cleaves itself from a longer polyprotein and helps to cut all of the other proteins apart from one another so that they can become functional, and 3D, the RNA-dependent RNA polymerase (RdRp) which is critical for replication of the virus because it copies the viral genome. By tagging nested constructs containing these two proteins and tracking where they localized in living cells, this study aimed to better understand the replication of DWV and to elicit possible targetsfor further research on how to control the virus. Since DWV is a picorna-like virus, distantly related to human viruses such as polio, and picornavirus non-structural proteins aggregate at cellular membranes during viral replication, the major hypothesis was that the 3C and 3CD proteins would localize at cellular organelle membranes as well. Using confocal microscopy, both proteins were found to localize in the cytoplasm, but the 3CDprotein was found to be mostly diffuse cytoplasmic, and the 3C protein was found to localize more specifically on membranous structures just outside of the nucleus.

Structural modification of DNA--a therapeutic option in SLE?

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs, with glomerulonephritis representing a frequent and serious manifestation. SLE is characterized by the presence of various autoantibodies, including anti-DNA antibodies that occur in approximately 70% of patients with SLE and which contribute to disease pathogenesis. Consequently, immunosuppressive therapies are applied in the treatment of SLE to reduce autoantibody levels. However, increasing evidence suggests that DNA--especially double--stranded DNA-constitutes an important pathogenic factor that is able to activate inflammatory responses by itself in autoimmune diseases. Therefore, modifying the structure of DNA to reduce its pathogenicity might be a more targeted approach for the treatment of SLE than immunosuppression. This article presents information in support of this strategy, and discusses the potential methods of DNA structure manipulation--in light of data obtained from mouse models of SLE--including topoisomerase I inhibition, administration of DNase I, or modification of histones using heparin or histone deacetylase inhibitors.

Aberrant E-cadherin, beta-catenin, and glial fibrillary acidic protein (GFAP) expression in canine choroid plexus tumors

Expression of E-cadherin and beta-catenin has been widely studied in various human and canine epithelial tumors and has been correlated with dedifferentiation, invasiveness, and metastasis. Choroid plexus tumors (CPTs) are of epithelial origin, and the most important prognostic factor in human medicine is the tumor grade. Limited information is available regarding E-cadherin and beta-catenin expression in human CPTs, and no information is found in the veterinary literature. In the current study, 42 canine CPTs (19 choroid plexus papillomas and 23 choroid plexus carcinomas) were retrospectively reviewed, and the intensity and cellular staining pattern of E-cadherin and beta-catenin were correlated with histological features, paying special attention to grade, invasion, and metastasis. In addition, cytokeratin and glial fibrillary acidic protein (GFAP) antibodies were evaluated as markers for canine CPTs. It was found that loss of E-cadherin and beta-catenin expression was uncommon in canine CPTs. Rather, membranous expression of both molecules was increased in CPTs compared to normal choroid plexus (NCP), regardless of tumor grade. Additionally, aberrant cytoplasmic or nuclear expression of both E-cadherin and beta-catenin was often observed in CPTs. GFAP was frequently expressed in CPTs in contrast to NCP. None of these parameters were correlated with malignancy, and therefore, do not appear to be useful for prognostic information. Nevertheless, a panel of antibodies including E-cadherin and GFAP might be useful to support the diagnosis of CPTs and help to differentiate them from other tumors, such as ependymomas and metastatic epithelial tumors.

Glomerulonephropathy in Aged Captive Key Largo Woodrats (Neotoma floridana smalli)

A retrospective review of mortality records of Key Largo woodrats (Neotoma floridana smalli) in a captive breeding program revealed chronic renal disease in 5 of 6 woodrats older than 4 years of age. Two of the 5 woodrats with chronic renal disease also had clinical evidence of diabetes mellitus. Kidneys from all 5 woodrats were examined via light microscopy, histochemical staining, immunohistochemical staining, and transmission electron microscopy. The dietary histories of the affected animals were examined as well. The most striking histopathologic abnormality in the affected kidneys was the presence of large protein casts within cortical and medullary tubules in combination with lesions of membranous glomerulopathy and glomerulosclerosis. Transmission electron microscopy revealed thickening and undulation of the tubular and glomerular mesangial basement membranes with the variable presence of electron-dense deposits within the capillary endothelial basement membrane. Patchy glomerular immunoreactivity for IgG was noted in 2 cases, but IgA and IgM immunoreactivity were not present. The pathologic changes in the kidneys of the Key Largo woodrats mirrored many of the features of chronic progressive nephropathy commonly diagnosed in laboratory rats. Woodrats in the captive population were fed an ad libitum high-protein diet similar to diets that have been shown in laboratory rats to exacerbate the development and progression of chronic progressive nephropathy. It is concluded that Key Largo woodrats develop glomerulonephropathy with features similar to chronic progressive nephropathy described in laboratory rats. Age, concomitant disease, and dietary factors may contribute to the development and severity of this potentially age-limiting disease in Key Largo woodrats.

Why is 11beta-hydroxysteroid dehydrogenase type 1 facing the endoplasmic reticulum lumen? Physiological relevance of the membrane topology of 11beta-HSD1

11Beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) is essential for the local activation of glucocorticoid receptors (GR). Unlike unliganded cytoplasmic GR, 11beta-HSD1 is an endoplasmic reticulum (ER)-membrane protein with lumenal orientation. Cortisone might gain direct access to 11beta-HSD1 by free diffusion across membranes, indirectly via intracellular binding proteins or, alternatively, by insertion into membranes. Membranous cortisol, formed by 11beta-HSD1 at the ER-lumenal side, might then activate cytoplasmic GR or bind to ER-lumenal secretory proteins. Compartmentalization of 11beta-HSD1 is important for its regulation by hexose-6-phosphate dehydrogenase (H6PDH), which regenerates cofactor NADPH in the ER lumen and stimulates oxoreductase activity. ER-lumenal orientation of 11beta-HSD1 is also essential for the metabolism of the alternative substrate 7-ketocholesterol (7KC), a major cholesterol oxidation product found in atherosclerotic plaques and taken up from processed cholesterol-rich food. An 11beta-HSD1 mutant adopting cytoplasmic orientation efficiently catalyzed the oxoreduction of cortisone but not 7KC, indicating access to cortisone from both sides of the ER-membrane but to 7KC only from the lumenal side. These aspects may be relevant for understanding the physiological role of 11beta-HSD1 and for developing therapeutic interventions to control glucocorticoid reactivation.

Coxsackie B viruses and the kidney--a neglected topic

Coxsackie B viruses types 1-6 (CVB1-6) occur worldwide and cause a broad spectrum of diseases, including myocarditis and aseptic meningitis. Although renal damage due to CVB has been suspected since the 1950s, these agents are only rarely searched for in today's clinical nephrological practice. Nevertheless, CVB can infect mesangial cells. Furthermore, infections with these viruses lead to a histological picture resembling mesangioproliferative glomerulonephritis and IgA-nephropathy in mice. In the present article, we provide an overview of this largely neglected topic, and of the slowly and steadily increasing evidence suggesting a link between coxsackieviral infections and kidney diseases.