Abstract:OBJECTIVE: To explore the possible correlation between the expression of the renin angiotensin system (RAS) and renal pathologic lesions, and to study the mechanism of renal progressive damages in children with the nephrotic syndrome (NS).METHODS: Eighty five children (64 boys and 21 girls) with the primary NS were involved in this study. Renal biopsies were performed in all of them. In situ hybridization was used to semiquantitate ACE mRNA expression in renals. Histopathological lesions of renals were evaluated by the method of counting score. RESULTS: ①The percentage of ACE mRNA positive cells in glomerulars of the children with NS was higher than that in normal glomerulars [( 22.61 ± 12.3 ) % vs ( 3.97 ± 1.43 ) %; P< 0.01 ]; so was it in tubulointerstitiums [( 58.42 ± 17.61 ) % vs ( 19.15 ± 5.96 ) %; P< 0.01 ]. ②No differences of ACE mRNA expression and histopathological lesions in tubulointerstitiums among the 5 different pathologic types (MCD, FSGS, MN, MPGN and MsPGN) were found. There were significant differences in ACE mRNA expression and histopathological lesions in glomerulars of the children with MCD compared with those with FSGS, MN, MPGN or MsPGN (all P< 0.01 ). ③There were significant differences in the percentage of ACE mRNA expression positive cells between the children with different degrees of kidney pathologic lesions [mild=( 30.50 ± 6.52 ) %; moderate=( 45.20 ± 11.06 ) %; severe=( 54.77 ± 11.86 ) %; P< 0.01 ].CONCLUSIONS: The RAS disorder in situ renals might be one of the important causes of progressive renal lesions in children with NS.
