J Pathol Transl Med.  2021 Nov;55(6):369-379. 10.4132/jptm.2021.08.03.

Post-mortem assessment of vimentin expression as a biomarker for renal tubular regeneration following acute kidney injury

Affiliations
  • 1Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA
  • 2Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA
  • 3Department of Mathematics, Faculty of Sciences, Lebanese University, Nabatieh, Lebanon
  • 4Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA

Abstract

Background
Acute kidney injury (AKI) is a common cause of morbidity and mortality. It mainly targets the renal tubular epithelium with pathological changes, referred to as acute tubular injury. The latter is followed by a regenerative response that is difficult to visualize on routine hematoxylin and eosin (H&E) stains. In this study, we examined the regenerative capacity of renal tubules by correlating vimentin (VIM) immunohistochemical (IHC) expression and pathological findings of AKI and renal tubular regeneration (RTR) on H&E.
Methods
We reviewed 23 autopsies performed in the clinical setting of AKI and RTR. VIM expression was scored in the renal cortical tubular epithelium using a statistical cutoff ≥ 3% for high expression and < 3% for low expression.
Results
Of the 23 kidney tissues examined, seven (30.4%) had low VIM expression, and 16 (69.6%) had high VIM expression. Kidney tissues with evidence of AKI and RTR had significantly higher VIM expression. Renal peritubular microenvironment features showing regenerative changes on H&E were associated with high VIM expression. In the univariate model, kidney tissues with RTR were 18-fold more likely to have high VIM expression.
Conclusions
In conclusion, our findings suggest that VIM could serve as an IHC marker for RTR following AKI. However, correlation with H&E findings remains critical to excluding chronic tubular damage. Collectively, our preliminary results pave the way for future studies including a larger sample size to validate the use of VIM as a reliable biomarker for RTR.

Keyword

Acute kidney injury; Acute tubular injury; Renal tubular regeneration; Vimentin; Biomarker; Immunohistochemistry

Figure

  • Fig. 1 Representative hematoxylin and eosin (H&E) (upper panels) and immunohistochemistry (lower panels) images of kidney tissues. (A) Kidney tissues showing diffuse and strong vimentin (VIM) expression in areas of chronic tubular damage (patients with chronic kidney disease). (B) Kidney tissues showing low and high VIM expression. Slides were stained with H&E and VIM stains, and images were examined at × 400.

  • Fig. 2 Correlation between vimentin (VIM) expression on one hand and pathologic evidence of acute kidney injury (AKI) (A) and renal tubular regeneration (RTR) (B) on the other hand. Kidney tissues with evidence of AKI and RTR had significantly higher VIM expression (p = .065 and p = .017, respectively). Chi-square test was used to assess significant association between the two variables (*p < .05).


Reference

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