The role of ICAM-1 and a number of clinical and morphological factors in the development of tubulointerstitial fibrosis in chronic glomerulonephritis

Background. Today, it is known that all patients with chronic kidney disease have a progressive decrease in renal function over time due to the formation of tubulo-interstitial fibrosis. At present, it has been established that endothelial dysfunction (Ed) is formed long before the detection of sclerosis in the renal tissue, and exerts its influence on the development of various clinical and morphological manifestations of chronic glomerulonephritis. The intercellular adhesion molecule - 1 (IСАМ-1), involved in the processes of renal inflammation, is one of the factors of Ed. For this reason, the search for non-invasive methods for assessing the state of the renal tissue, including the identification of proteins involved in the processes of renal inflammation, fibrosis, and cell-cell interaction, becomes relevant as it will prevent or delay the progression of a decrease in renal function. Objective. Determination of the blood intercellular adhesion molecule-1 (ICAM-o concentration in conjunction with the clinical and morphological manifestations of chronic glomerulonephritis in the development of tubulo-interstitial fibrosis (TIF) in chronic glomerulonephritis (CGN). Material and methods. Eighty patients with CGN in the acute stage underwent a detailed clinical and laboratory examination, which included determination of the serum ICAM-1 level by enzyme immunoassay, and puncture kidney biopsy with subsequent morphological examination. Statistical analysis was performed using Microsoft Office Excel 2010 (Microsoft Corp., USA) and Statistica 10.0 (StatSoft Inc., USA). Results. a logistic regression analysis to access the impact of ICAM-1 in conjunction with clinical and morphological manifestations on the probability of detection of TIF in the biopsy specimen was carried out. As a result, it was revealed that such clinical and morphological signs as the blood albumin level, narrowing of the arteriole lumen, sclerosis of the glomeruli, along with an increased ICAM-i (Intercellular Adhesion Molecule i) level are factors for the development of TIF. In addition, based on the obtained equations of logistic regression, nomograms to predict the probability of detecting TIF in the kidney biopsy specime were calculated. Conclusion. The results of the study demonstrate the important role of ICAM-1 in the process of development of immunocomplex inflammation in glomerulonephritis and, as a result, increase the risk of developing TIF.

chronic glomerulonephritis, intercellular adhesion molecule-1, tubulointerstitial fibrosis, chronic kidney disease, endothelial dysfunction