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Master Thesis

Rôle des cellules épithéliales pariétales dans le syndrome néphrotique idiopathique

Abstract : Idiopathic nephrotic syndrome is the most frequent glomerular disease in young adults. It regroups two variants, minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS). They are characterized by a podocyte dysfunction, consecutive to cytoskeleton disorganization, leading to massive proteinuria. CMIP is a central factor involved in podocyte dysfunction and apoptosis. Activated parietal epithelial cells (PECs) are the main component of sclerotic lesions during FSGS. We wanted to investigate whether CMIP and PEC activation marker expressions were associated with poor renal outcome. We included all the INS diagnosed in Bordeaux between January 2007 and December 2014.CMIP immunohistochemistry was performed on 106 biopsies and compared to renal outcome, using a composite primary endpoint with a superior to 30% glomerular filtration rate inflexion at 5 years or the occurrence of end stage renal disease (dialysis or kidney transplantation). Expression patterns of activated PECs markers (claudin-1 and CD44) and podocyte markers (synaptopodin) were also compared. CMIP staining was positive in 56% of the cases. In our univariate analysis CMIP staining was positive in 73.7% of the patient in the endpoint group compared to 65.7% of the patient not reaching endpoint (p=0.76). In our multivariate analysis, the only feature associated to our endpoint was the INS variant, MCD patients being less susceptible to reach the endpoint (OR 0.28, IC 95% 0.08-0.96). PEC markers were performed on 6 MCD and 17 FSGS biopsies. Claudin-1 tuft staining was strictly limited to FSGS patients. CD44 staining was not FSGS specific, being positive in 80% of the MCD biopsies. In biopsies displaying optical FSGS lesions, CD44 staining was geographically associated in 84% of the cases. In this study, CMIP was not associated with our renal composite endpoint. PEC activation markers could be another prognosis factor, given the crucial role of aPECs in the scarring processes of FSGS.
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Submitted on : Monday, November 16, 2020 - 4:35:07 PM
Last modification on : Saturday, December 19, 2020 - 3:12:50 AM
Long-term archiving on: : Wednesday, February 17, 2021 - 7:39:38 PM


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  • HAL Id : dumas-03008181, version 1



Arthur Lacapère. Rôle des cellules épithéliales pariétales dans le syndrome néphrotique idiopathique. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03008181⟩



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