High renal DC-SIGN+ cell density is associated with severe renal lesions and poor prognosis in patients with immunoglobulin A nephropathy
High renal DC-SIGN+ cell density is associated with severe renal lesions and poor prognosis in patients with immunoglobulin A nephropathy
复制标题
高肾 DC-SIGN( ) 细胞密度与免疫球蛋白 A 肾病患者的严重肾脏病变和不良预后相关
DOI：
10.1111/his.13803
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发表时间：
2019-04-01
期刊：
影响因子：
6.4
通讯作者：
Xu, Gang
中科院分区：
文献类型：
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作者：
Wang, Yuxi;Hu, Zhizhi;Xu, Gang
背景和目的在这项观察性队列研究中，我们评估了DC-SIGN（+）细胞在IgA肾病（IgAN）发病和进展中的预后价值。方法与结果2009年6月至2010年6月共纳入139例成人IgAN患者。我们通过免疫组织化学或免疫荧光对肾活检组织中的DC-SIGN（+）细胞进行了表征。评估DC-SIGN、细胞间粘附分子3 （ICAM-3）、CD4和CD8的相关性。将患者分为DC-SIGN(高)组和DC-SIGN(低)组。根据平均100个月的随访，分析DC-SIGN（+）细胞在IgAN进展中的预测价值。DC-SIGN（+）细胞常见于IgAN肾，而在正常肾中少见，且几乎所有DC-SIGN（+）细胞均表达MHC-II。我们还发现DC-SIGN（+）细胞邻近icam -3阳性CD4（+）和CD8（+）淋巴细胞。肾活检组织中DC-SIGN（+）细胞密度与ICAM-3（+）细胞、CD4（+）细胞和CD8（+）细胞密度呈线性正相关。DC-SIGN（高）组肾脏病变及炎症细胞浸润程度较DC-SIGN（低）组更为严重。与DC-SIGN（低）组患者相比，DC-SIGN（高）组患者在随访期间肾功能恶化的发生率也有所增加。结论DC-SIGN（+）细胞可能是加剧局部炎症反应的潜在因素。DC-SIGN（+）细胞的密度与患者肾脏病变的严重程度相关。高肾DC-SIGN（+）细胞密度可作为IgAN患者预后不良的预测因子。
Background and aims In this observational cohort study, we assessed the prognostic value of DC-SIGN(+) cells in the pathogenesis and progression of IgA nephropathy (IgAN). Methods and results A total of 139 adult IgAN patients were enrolled into this study from June 2009 to June 2010. We characterised DC-SIGN(+) cells by immunohistochemistry or immunofluorescence in renal biopsy tissue. Correlations between the DC-SIGN, intercellular adhesion molecule 3 (ICAM-3), CD4 and CD8 were evaluated. Patients were classified into the DC-SIGN(high) and DC-SIGN(low) groups. Depending on an average of 100-month follow-up, the predictive value of DC-SIGN(+) cells in IgAN progression was analysed. DC-SIGN(+) cells were found frequently in IgAN kidneys while rarely observed in normal kidneys, and almost all DC-SIGN(+) cells expressed MHC-II. We also found that DC-SIGN(+) cells were adjacent to ICAM-3-positive CD4(+) and CD8(+) lymphocytes. The density of DC-SIGN(+) cells was positively and linearly correlated with the density of ICAM-3(+) cells, CD4(+) cells and CD8(+) cells in renal biopsy tissues. In the DC-SIGN(high) group, the degree of renal lesion and inflammatory cell infiltration was more severe compared to the DC-SIGN(low) group. Patients in the DC-SIGN(high) group also had increased incidences of deteriorating renal function during the follow up compared to patients in the DC-SIGN(low) group. Conclusions DC-SIGN(+) cells probably served as a potential contributor to exacerbate local inflammatory response. The density of DC-SIGN(+) cells was associated with the severity of renal lesions of the patients. High renal DC-SIGN(+) cell density might be used as a predictor of poor prognosis in patients with IgAN.