Immune profile and Epstein-Barr virus infection in acute interstitial nephritis: an immunohistochemical study in 78 patients

Nephron Clin Pract. 2011;119(4):c293-300. doi: 10.1159/000329671. Epub 2011 Sep 21.

Abstract

Background: Acute interstitial nephritis (AIN) is a common cause of acute kidney injury and is characterised by a dense interstitial cellular infiltrate, which has not been well defined. Previous studies have demonstrated a correlation between Epstein-Barr virus (EBV) infection and AIN. The purpose of our study was to define the nature of the interstitial immune infiltrate and to investigate the possibility of renal infection with EBV.

Methods: Seventy-eight patients with AIN were identified from renal biopsy reports in a single centre over an 18-year period. Immunohistochemical staining was performed to define the cellular infiltrate. In situ hybridization and immunohistology were used to detect EBV.

Results: A positive correlation between CD68 macrophage infiltration and serum creatinine concentration at presentation was identified. IL-4, eotaxin, CCR3, CCR5 and VCAM-1 were all expressed in biopsies of AIN. Using in situ hybridization and immunohistochemistry, EBV was not detected in any of the AIN sections analysed.

Conclusion: This study has assessed the nature of the interstitial infiltrate in AIN. EBV was not detected in the renal biopsies, suggesting that EBV is not a pathogenetic factor in AIN.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, CD / analysis
  • Antigens, Differentiation, Myelomonocytic / analysis
  • Chemokine CCL11 / analysis
  • Creatinine / blood
  • Eosinophils / pathology
  • Epstein-Barr Virus Infections / epidemiology*
  • Female
  • Herpesvirus 4, Human / immunology
  • Herpesvirus 4, Human / pathogenicity*
  • Humans
  • Interleukin-4 / analysis
  • Kidney / chemistry
  • Kidney / immunology
  • Kidney / pathology
  • Macrophages / pathology
  • Male
  • Middle Aged
  • Nephritis, Interstitial / chemically induced
  • Nephritis, Interstitial / etiology
  • Nephritis, Interstitial / immunology
  • Nephritis, Interstitial / virology*
  • RNA, Viral / analysis
  • Receptors, CCR3 / analysis
  • Receptors, CCR4 / analysis
  • Retrospective Studies
  • Th2 Cells / immunology
  • Vascular Cell Adhesion Molecule-1 / analysis
  • Viral Matrix Proteins / analysis
  • Young Adult

Substances

  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • CCL11 protein, human
  • CCR3 protein, human
  • CCR4 protein, human
  • CD68 antigen, human
  • Chemokine CCL11
  • EBV-associated membrane antigen, Epstein-Barr virus
  • Epstein-Barr virus encoded RNA 1
  • RNA, Viral
  • Receptors, CCR3
  • Receptors, CCR4
  • Vascular Cell Adhesion Molecule-1
  • Viral Matrix Proteins
  • Interleukin-4
  • Creatinine