Characterisation of renal immune cell infiltrates in children with nephrotic syndrome

被引:44
作者
Benz, Kerstin [1 ,2 ]
Buettner, Maike [2 ]
Dittrich, Katalin [1 ]
Campean, Valentina [2 ]
Doetsch, Joerg [1 ]
Amann, Kerstin [2 ]
机构
[1] Univ Erlangen Nurnberg, Klin Kinder & Jugendliche, D-91054 Erlangen, Germany
[2] Univ Erlangen Nurnberg, Pathol Inst Erlangen, D-91054 Erlangen, Germany
关键词
B-lymphocyte; Idiopathic nephrotic syndrome; Macrophage; Renal infiltration; T-lymphocyte; T-CELLS; LYMPHOCYTE POPULATIONS; RITUXIMAB TREATMENT; PATHOGENESIS; SYSTEM; IGE;
D O I
10.1007/s00467-010-1507-0
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
There is increasing evidence that not only T cells but also B cells may play an important role in the pathogenesis of idiopathic nephrotic syndrome (NS). We have evaluated the infiltrating immune cells found in renal biopsies from 38 children with NS using immunohistochemistry techniques involving antibodies against T cells (CD3, CD4, CD8, FoxP3), B cells (CD20), macrophages (CD68) and follicular dendritic cells (CD21). Kidney biopsies with thin basement membrane disease were used as controls. We found higher numbers of interstitial CD3-positive T cells and macrophages in patients with focal segmental glomerulosclerosis (FSGS) than in those with minimal change glomerulopathy (MCGN) and in the controls, and significantly lower FoxP3-positive cells in patients with FSGS, MCGN and steroid-dependent NS than in the controls. Significantly higher numbers of glomerular B cells were found in FSGN patients than in MCGN patients and controls. Of note, in three patients who were later successfully treated with anti-CD20 antibody rituximab, the number of renal B cells was negligible in the preceding biopsy. In conclusion, the higher numbers of interstitial CD3-positive T cells in renal biopsies of pediatric patients with FSGS argue for a higher inflammatory activity. The significantly higher number of glomerular B cells in FSGS patients may indicate a particular pathogenetic role or epiphenomenon in this disease. However, patients with no interstitial or glomerular B cells could also benefit from rituximab treatment.
引用
收藏
页码:1291 / 1298
页数:8
相关论文
共 31 条
[1]   Surveillance of Antigen-Presenting Cells by CD4+CD25+Regulatory T Cells in Autoimmunity Immunopathogenesis and Therapeutic Implications [J].
Andre, Sebastien ;
Tough, David F. ;
Lacroix-Desmazes, Sebastien ;
Kaveri, Srini V. ;
Bayry, Jagadeesh .
AMERICAN JOURNAL OF PATHOLOGY, 2009, 174 (05) :1575-1587
[2]  
*APN, 1981, EUR J PEDIATR, V135, P229
[3]   Rituximab in patients with the steroid-resistant nephrotic syndrome [J].
Bagga, Arvind ;
Sinha, Aditi ;
Moudgil, Asha .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (26) :2751-2752
[4]   Change of the course of steroid-dependent nephrotic syndrome after rituximab therapy [J].
Benz, K ;
Dötsch, J ;
Rascher, W ;
Stachel, D .
PEDIATRIC NEPHROLOGY, 2004, 19 (07) :794-797
[5]  
Cohen CD, 2005, J NEPHROL, V18, P328
[6]   Rituximab:: is replacement of cyclophosphamide and calcineurin inhibitors in steroid-dependent nephrotic syndrome possible? [J].
Doetsch, Jorg ;
Mueller-Wiefel, Dirk E. ;
Kemper, Markus J. .
PEDIATRIC NEPHROLOGY, 2008, 23 (01) :3-7
[7]   Rituximab treatment of idiopathic membranous nephropathy [J].
Fervenza, F. C. ;
Cosio, F. G. ;
Erickson, S. B. ;
Specks, U. ;
Herzenberg, A. M. ;
Dillon, J. J. ;
Leung, N. ;
Cohen, I. M. ;
Wochos, D. N. ;
Bergstralh, E. ;
Hladunewich, M. ;
Cattran, D. C. .
KIDNEY INTERNATIONAL, 2008, 73 (01) :117-125
[8]   Dominant T cells in idiopathic nephrotic syndrome of childhood [J].
Frank, C ;
Herrmann, M ;
Fernandez, S ;
Dirnecker, D ;
Böswald, M ;
Kolowos, W ;
Ruder, H ;
Haas, JP .
KIDNEY INTERNATIONAL, 2000, 57 (02) :510-517
[9]   Comprehensive immunohistological analysis of the endothelin system in human kidney grafts [J].
Frank, K ;
Zeier, M ;
Gross, ML ;
Waldherr, R ;
Ritz, E ;
Amann, K .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2006, 21 (05) :1365-1372
[10]   Rituximab therapy for steroid-dependent minimal change nephrotic syndrome [J].
Gilbert, Rodney D. ;
Hulse, Eleanor ;
Rigden, Susan .
PEDIATRIC NEPHROLOGY, 2006, 21 (11) :1698-1700