Predominance of type-2 immune response in idiopathic membranous nephropathy - Cytoplasmic cytokine analysis

被引:41
作者
Hirayama, K
Ebihara, I
Yamamoto, S
Kai, H
Muro, K
Yamagata, K
Kobayashi, M
Koyama, A
机构
[1] Univ Tsukuba, Inst Clin Med, Dept Internal Med, Tsukuba, Ibaraki 3058575, Japan
[2] Tokyo Med & Dent Univ, Kasumigaura Hosp, Dept Nephrol, Ami, Ibaraki, Japan
来源
NEPHRON | 2002年 / 91卷 / 02期
关键词
membranous nephropathy; cytokine; interleukin-10; flow cytometry; Th1/Th2; paradigm;
D O I
10.1159/000058401
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: The Th1/Th2 paradigm is proving increasingly useful in the understanding of infectious diseases and many autoimmune diseases. Th1 cells predominantly produce interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) and are instrumental in initiating delayed-type hypersensitivity and activating macrophages. Th2 cells secrete other. cytokines, such as IL-4, IL-5, IL-10 and IL-13 that trigger B-cell activation and immunoglobulin synthesis. It has been shown that in patients with membranous nephropathy, there may be a predominance of Th2, because of the presence of IgG, particularly IgG4, which belongs to a subclass of the type-2 immune response, and complement deposits in glomeruli. In this study, we investigated the immunoresponse of helper T cells, i.e. Th predominance in patients with idiopathic membranous nephropathy. Methods:We used flow cytometry to assess the levels of circulating Th cells in patients with idiopathic membranous nephropathy (n = 8) and in normal individuals (n = 23) based on the expression of intra- cellulartype-1 and type-2 cytokines. Because the production of each of these cytokines has a specific time course, we observed the cytokine synthesis at 3, 6, 9 and 12 h after stimulation. Results: The percentages of IL-2+/CD4+ cells from patients with idiopathic membranous nephropathy were significantly lower than those from normal individuals at 6, 9 and 12 h, with the difference becoming more significant over time. IFN-7+/CD4+ cells and IL-4+/CD4+ cells were not significantly different between the two groups. in patients with idiopathic membranous nephropathy, the percentages of IL-10+/CD4+ cells were significantly higher than those in normal individuals at each point in time. Conclusion: Increased IL-10-producing Th cells may lead to suppression of delayed-type hypersensitivity and activate suppressor cells and IgG4 synthesis, resulting in idiopathic membranous nephropathy. Copyright (C) 2002 S. Karger AG, Basel.
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收藏
页码:255 / 261
页数:7
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