Predominance of CD8+ T lymphocytes among periglomerular infiltrating cells and link to the prognosis of class III and class IV lupus nephritis
Predominance of CD8+ T lymphocytes among periglomerular infiltrating cells and link to the prognosis of class III and class IV lupus nephritis
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DOI：
10.1002/art.22654
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发表时间：
2007-07-01
影响因子：
--
通讯作者：
Blanco, Patrick
中科院分区：
文献类型：
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作者：
Couzi, Lionel;Merville, Pierre;Blanco, Patrick
目标。最近的研究表明，CD8+T淋巴细胞通过诱导组织损伤，在系统性红斑狼疮(SLE)的发病机制中具有潜在的意义。本研究的目的是分析CD8+细胞在III型和IV型狼疮性肾炎患者肾脏中的定位，并建立其与SLE的组织学、生物学和临床特征的相关性。入选25例狼疮性肾炎III级或IV级的SLE患者。进行血淋巴细胞表型分析和肾脏免疫组织化学研究。CD8+T细胞是主要的肾脏浸润性细胞亚群。CD8+T细胞和CD4+T细胞的平均tSD分别为66.2 65.2/mm(2)和19.3+/-29.4/mm(2)。血CD_3~+、CD_8~+、DR~+细胞百分率与肾CD_8~+T细胞总数呈显著正相关(r=0.42，P=0.039)。肾组织CD8+T细胞浸润与肾脏活动指数(r=0.63，P=0.0007)、血肌酐水平(r=0.75，P=0.0001)呈正相关。CD8+T细胞主要分布于肾小球周围，与细胞新月体和包膜破裂有关，与常规诱导治疗反应差有关。重症(III和IV级)狼疮性肾炎患者的肾小球周围有CD8+T淋巴细胞浸润，并与诱导治疗后预后不良有关。这些结果揭示了狼疮性肾炎的一个新的潜在效应通路操纵者。
Objective. Recent studies have revealed a potential implication of CD8+ T lymphocytes in the pathogenesis of systemic lupus erythematosus (SLE) through their ability to induce tissue damage. The aim of the present study was to analyze the localization of CD8+ cells in the kidneys of patients with class III and class IV lupus nephritis and to establish correlations with histologic, biologic, and clinical features of SLE.Methods. Twenty-five consecutive SLE patients with class III or class IV lupus nephritis were enrolled. Phenotype analyses of blood lymphocytes and renal immunohistochemistry studies were performed.Results. CD8+ T cells were the predominant kidney-infiltrating subset of cells. The mean t SD numbers of CD8+ T cells and CD4+ T cells were 66.2 65.2/mm(2) and 19.3 +/- 29.4/mm(2), respectively. There was a significant correlation between the percentage of blood CD3+,CD8+,DR+ cells and the total number of renal CD8+ T cells (r = 0.42, P = 0.039). Renal CD8+ T cell infiltration correlated well with the renal activity index (r = 0.63, P = 0.0007) and with high serum creatinine levels (r = 0.75, P = 0.0001). This CD8+ T cell infiltrate, which was predominantly in the periglomerular area, was correlated with cellular crescents and Bowman's capsule rupture and was associated with a poor response after conventional induction therapy.Conclusion. CD8+ T lymphocytes infiltrate the periglomerular area in patients with severe (class III and class IV) lupus nephritis and are linked to a poor outcome after induction therapy. These results reveal a new potential effector pathway operant in lupus nephritis.