Couzi Lionel, Merville Pierre, Deminière Colette, Moreau Jean-François, Combe Christian, Pellegrin Jean-Luc, Viallard Jean-François, Blanco Patrick
CHU, and UMR-CNRS 5164, Université Victor Segalen Bordeaux 2, Bordeaux, France.
Arthritis Rheum. 2007 Jul;56(7):2362-70. doi: 10.1002/art.22654.
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.
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.
CD8+ T cells were the predominant kidney-infiltrating subset of cells. The mean +/- 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.
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.
近期研究表明，CD8 + T淋巴细胞通过诱导组织损伤的能力，在系统性红斑狼疮（SLE）发病机制中具有潜在影响。本研究旨在分析III级和IV级狼疮性肾炎患者肾脏中CD8 +细胞的定位，并与SLE的组织学、生物学和临床特征建立相关性。
纳入25例连续的III级或IV级狼疮性肾炎SLE患者。进行血液淋巴细胞的表型分析和肾脏免疫组织化学研究。
CD8 + T细胞是主要浸润肾脏的细胞亚群。CD8 + T细胞和CD4 + T细胞的平均±标准差数量分别为66.2±65.2/mm²和19.3±29.4/mm²。血液中CD3 +、CD8 +、DR +细胞百分比与肾脏CD8 + T细胞总数之间存在显著相关性（r = 0.42，P = 0.039）。肾脏CD8 + T细胞浸润与肾脏活动指数（r = 0.63，P = 0.0007）和高血清肌酐水平（r = 0.75，P = 0.0001）密切相关。这种主要位于肾小球周围区域的CD8 + T细胞浸润与细胞性新月体和鲍曼囊破裂相关，并且与传统诱导治疗后的不良反应相关。
CD8 + T淋巴细胞浸润重度（III级和IV级）狼疮性肾炎患者的肾小球周围区域，并与诱导治疗后的不良预后相关。这些结果揭示了狼疮性肾炎中一种新的潜在效应途径。
