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The glomerular capillary basement membrane showed foci of basement membrane irregularity and few foci of 'double contours'.
The first group showed marked formation of PrPd-associated abnormal coated pits and associated membrane irregularity and invaginations, increased lysosomes in neurons (mostly PrPd positive) and had more readily detectable spiral membrane inclusions.
The analysed tubulointerstitial lesions comprised inflammatory infiltration, presence of hyaline cylinders, tubular basement membrane irregularity, tubular calcification, tubular vacuolization, and the association of interstitial fibrosis and tubular atrophy (IFTA).
Characteristics such as number of cell layers, nuclear size, nuclear membrane irregularity, chromatin pattern, nuclear:cytoplasmic ratio, presence of nucleoli and mitosis were evaluated in order to provide a final diagnosis of (1) normal, (2) metaplasia, (3) atypia, (4) carcinoma in situ (CIS) and (5) carcinoma.
All NPHP variants share the described renal histology pattern with the exception of infantile NPHP (type 2), which shows additional features reminiscent of autosomal dominant or recessive PKD, such as kidney enlargement, absence of the tubular basement membrane irregularity characteristic of NPHP, and presence of cysts outside the medullary region.
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The nuclear features include enlarged, elongated and overlapping nuclei; membrane irregularities (irregular contours, grooves and pseudoinclusions); chromatin clearing, margination and glassy nuclei.
The tubular invaginations also colocalized with membrane irregularities seen in bright field.
There were mild mesangial cell interposition and basement membrane irregularities, with no more than a hint of glomerular hyper cellularity.
Intriguingly, most of these cells showed high-intensity CFSE spots, which colocalized with the membrane irregularities (Supplementary Figure S1).
SMase treatment at activities of 1 mU/ml and higher induced CD59 clusters that colocalized with the membrane irregularities observed in the bright-field images.
An intriguing finding was the presence of large CFSE-positive protein clusters that appeared in conjunction with the detected membrane irregularities.
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