凋亡是一把双刃剑，在慢性肾脏疾病的进展过程中导致肾小球硬化，而在急性肾炎却起到了促进炎症消退的作用。
NephrolDialTransplant.2007Mar;22（3）:740-8Significanceofglomerularcellapoptosisintheresolutionofacutepost-streptococcalglomerulonephritis.OdaT,YoshizawaN,YamakamiK,IshidaA,HottaO,SuzukiS,MiuraS.DepartmentofMedicine,NationalDefenseMedicalCollege,3-2Namiki,Tokorozawa-shi,Saitama359-8513,Japan.takashio@ndmc.ac.jpBACKGROUND:Glomerularhypercellularityduetoresidentglomerularcellproliferationandleucocyteinfiltrationhasbeendescribedinacutepost-streptococcalglomerulonephritis（APSGN）.APSGNusuallyresolveswithoutprogression.However,themechanismofresolutionremainstobedetermined.
METHODS:Renalbiopsytissuesfrom15patientswithAPSGN（obtained1-31daysafterdiseaseonset）andfivecontrolpatientswithminorglomerularabnormalitywereevaluatedwithrespecttoglomerularresolution.Apoptoticcellswereassessedbyterminaldeoxynucleotidyltransferase-mediateddUTPnickend-labelling（TUNEL）aswellasbyimmunostainingofsingle-strandedDNA（ssDNA）.
RESULTS:Thenumberofglomerularcellswashighintheearly-phaseofAPSGNanddecreasedovertime.NoTUNEL+glomerularcellswerefoundincontrolsubjects,whereasprominentglomerularTUNEL+cellswereobservedinAPSGNpatients,particularlyintheearlyphaseofthedisease.ThenumberofglomerularTUNEL+cellsdecreasedexponentiallybutwasstillprominentinrenaltissuebiopsiedat31daysafterdiseaseonset.DoublestainingforssDNAandglomerularcellmarkersshowedthatglomerularapoptoticcellswerepredominantlymesangiumandendothelialcells,withsomeneutrophilsandmacrophages.
CONCLUSIONS:TheseresultssuggestthatapoptosisexistsintheglomerulusinpatientswithAPSGNfromtheearlytothelatestagesofthediseaseandcontributestotheresolutionofglomerularhypercellularity.
