IgA nephropathy (IgAN) is the most common glomerulopathy worldwide with divergent incidence and prevalence rates,chiefly reflecting different biopsy practices in different parts of the world.It is a heterogeneous disease with respect to clinical and pathological features and the ultimate outcome.This heterogeneity has defied all the attempts to develop a consensus classification,optimize its management and foretell its prognostication,till recent past (1).A concerted effort over 5-year period by a working group comprising of world-renowned nephrologists (from International IgAN Network) and nephropathologists (from Renal Pathology Society) with special interest in the disease led to the promulgation of the Oxford classification of IgAN in 2009 (2,3). ...

Introduction: IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis, and is the most common type of glomerulopathy which leading to end-stage renal disease (ESRD). Prompt diagnosis of high-risk patients is important to initiate specific treatment early and prevent progression to ESRD. Oxford pathological classification, known as MEST-C score, attempts to predict prognosis based on pathological factors. Objectives: In this study, we evaluated the value of pathological and clinical variables in estimating the prognosis of IgAN in Iranian patients. Patients and Methods: In this retrospective cohort study, 165 specimens were reviewed by a nephropathologist, who reported the MEST-C score after the definitive diagnosis of IgAN. Patient records were reviewed to gather clinical data, including serum creatinine, 24-hour urine protein levels, diagnosis of hypertension and/or diabetes, and any treatment received. The pre-specified endpoints were determined as progression to ESRD, a reduction in estimated glomerular filtration rate (eGFR) to less than 50% of its baseline, performance of renal transplant, or death. The variables were compared in patients who had reached the pre-specified endpoints and those who had not, to estimate their prognostic value. Results: Findings showed that the urinary protein level and T-score on biopsy were significant prognostic factors. Other pathological factors such as C, S, and M scores lost their significance on multivariate analysis. Further research is needed to validate the efficacy of the MEST-C score in different racial populations. Conclusion: In our study, urinary protein level at diagnosis and T-score on biopsy were validated as prognostic factors, while M, E, S and C scores were not deemed significant. Further research is necessary to validate the MEST-C scoring system in different populations before its use in routine clinical practice.

Background: Embryo cryopreservation is the process that water is removed from the cell by cryoprotectant materials, and embryos are stored at temperature below zero. This process may affect the viability and developmental potential of embryos.Objective: In this study, the effect of the vitrification cryotop method on the expression level of Oct4 and MEST developmental genes in mouse blastocysts was examined.Materials and Methods: The collected 2-cell embryos of superovulated mouse by oviduct flushing were divided into non-vitrified and vitrified groups. These embryos were cultured to the blastocyst stage directly in the non-vitrified group and in the vitrified group, these embryos were cultured to 4-8 cell embryos, vitrified with cryotop in these stages and after 2-6 months, warmed and cultured to blastocyst embryos. Quantitative expression of two developmental genes, namely Oct4 and MEST, were performed in these groups, using RNA purification and Real-time RT-PCR.Results: Quantitative PCR analysis showed that the expression level of both genes, Oct4 and MEST, was reduced significantly in the vitrified-warmed group relative to the control group (p=0.046 and p=0.001).Conclusion: This study revealed that morphologically normal embryos show a reduced amount of Oct4 and MEST transcripts which indicate that the vitrification method negatively effects the expression level of these two developmental genes.