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| 혈청 HBsAg 양성인 막증식성 사구체신염 환자에서 HBsAg 간염바이러스 DNA의 신조직내 분포 |
| 김연수 , 이중건 , 임춘수 , 정윤철 , 안규리 , 한진석 , 김성권 , 이정상 , 정순일 , 이종호 |
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| Abstract |
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Hepatitis B virus(HBV) infection has been sug- gested as the etiologic agent in membranoproli- ferative glomerulonephritis(MPGN), but the mecha- nism by which HBV infection leads to MPGN in human has not been established. To localize the HBV antigen and HBV-DNA in the kidney tissue, we examined paraffin sections of kidney biopsies which were positive for HBsAg by immunohisto- chemical study from 13 HBV carriers with MPGN (HBV-MPGN). Polymerase chain reaction(PCR) and in situ PCR(ISP) were used for the HBV DNA amplification and localization in kidney tissues. Pri- mers used in PCR and ISP were from the S, C, and X HBV-DNA regions. Irnmunohistochemical study showed HBsAg depo- sits on the mesangium and glomerular capillaries. Arteriolar deposits were also occasionally observed. PCR for the S, C, and X regions were positive in 11 patients(85%), 11 patients(85%), and 9 patients (69%), respectively. The PCR findings were further confirmed by direct sequencing of PCR products and the arnplification of HSP70 gene as a control. ISP showed the amplified HBV-DNA at the glomeruli and renal tubules. Far S region, ISP was positive in 7 patients. For C and X regions, ISP was positive in 8 patients, respectively. 5 patients showed the posi- tive signals for both the glorneruli and tubules, while 4 patients were positive at the tubules only. These 4 patients seemed to have the longer disease durations when compared to the other 5 patients (52.8 months vs. 11.8 months), but it was not statistically signi- ficant. In conclusion, the detection and the locali- zation of HBV antigen and DNA in renal tissues indicate the presence of the complete virion in the kidney. These results suggest that HBV may infect the kidneys of HBV carriers with MPGN. |
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