CD34 expression as a novel marker of transformed mesangial cells in biopsied glomerular diseases

CD34 is a marker of haematopoietic progenitor cells, stromal precursors, vascular endothelial cells, and a variety of stromal tumour cells. This immunohistochemical study examined the CD34 expression of glomerular mesangial cells in normal and diseased glomeruli and compared it with the staining patterns of alpha-smooth muscle actin (ASMA), as a transformed mesangial cell marker, and CD31, as an endothelial cell marker. In addition, the CD34 and ASMA expression of mesangial cells in various glomerulonephritis and the relationship of the immunostaining intensity to the severity of IgA nephropathy were semiquantitatively evaluated. In normal glomeruli, all cell types were negative for CD34, but in glomeruli in mesangial proliferative glomerulonephritis, CD34 was expressed exclusively in mesangial cells, corresponding to ASMA expression. The dendritic and scattered staining pattern, the mesangial location of positive signals, and the enhanced expression were clearly different from CD31 expression in diseased glomeruli. In comparison with normal controls, the grade of immunostaining for CD34 (CD34 INDEX) in mesangial proliferative glomerular diseases was higher than that of ASMA (ASMA INDEX). With the severity of glomerulonephritis, the CD34 INDEX gradually increased. These studies indicate that CD34 is a useful marker of mesangial transformation and that immunohistochemical examination with the anti-CD34 antibody is useful for the diagnosis and stage determination of glomerular diseases.