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免疫球蛋白 A 肾病患者扁桃体中 CD208+树突状细胞增加的临床和免疫学意义。

Clinical and immunological implications of increase in CD208+ dendritic cells in tonsils of patients with immunoglobulin A nephropathy.

机构信息

Department of Nephrology and Endocrinology, National Defense Medical College, Tokorozawa, Saitama, Japan.

出版信息

Nephrol Dial Transplant. 2013 Dec;28(12):3004-13. doi: 10.1093/ndt/gft399. Epub 2013 Sep 29.

DOI:10.1093/ndt/gft399
PMID:24081865
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3843345/
Abstract

BACKGROUND

The therapeutic effect of tonsillectomy for immunoglobulin A nephropathy (IgAN) has been widely recognized, but the mechanism by which tonsillar immunity leads to glomerulonephritis has been unclear. We investigated subtypes and localization of dendritic cells (DCs) in tonsils and looked for relationships between the tonsillar DCs and the clinical features and renal histological changes of patients with IgAN.

METHODS

We examined tonsils from 33 IgAN patients, using as control tonsillar specimens from subjects without glomerulonephritis. Five distinct markers of DCs (CD303, CD1c, CD209, CD208 and CD1a) were analyzed by immunohistochemistry and flow cytometry. The mRNA levels of these DC markers were evaluated using real-time polymerase chain reaction. The clinical data and histological results obtained evaluating renal biopsy tissues were statistically compared with immunological data.

RESULTS

Of the five subtypes of DCs, CD208(+) DCs were significantly increased in the tonsils of IgAN patients compared with that of controls. Furthermore, the number of CD208(+) DCs in the tonsils was positively and linearly correlated with the proportion of crescentic glomeruli in renal biopsy tissues and with the urinary protein level. Only few CD208(+) cells, however, were found in the kidney biopsy specimens of IgAN patients.

CONCLUSIONS

These observations suggest that increased CD208(+) DCs in tonsils may play a directive role in the pathogenesis of IgAN. The present results support the therapeutic significance of tonsillectomy for IgAN patients.

摘要

背景

扁桃体切除术治疗免疫球蛋白 A 肾病（IgAN）的疗效已得到广泛认可，但扁桃体免疫如何导致肾小球肾炎的机制尚不清楚。我们研究了扁桃体树突状细胞（DC）的亚型和定位，并寻找了扁桃体 DC 与 IgAN 患者的临床特征和肾组织学变化之间的关系。

方法

我们检查了 33 例 IgAN 患者的扁桃体，并以无肾小球肾炎的患者的扁桃体标本作为对照。通过免疫组织化学和流式细胞术分析了 5 种不同的 DC 标志物（CD303、CD1c、CD209、CD208 和 CD1a）。使用实时聚合酶链反应评估这些 DC 标志物的 mRNA 水平。用统计学方法比较了评估肾活检组织获得的临床数据和组织学结果与免疫学数据。

结果

在 5 种 DC 亚型中，IgAN 患者扁桃体中的 CD208（+）DC 明显高于对照组。此外，扁桃体中 CD208（+）DC 的数量与肾活检组织中新月体肾小球的比例和尿蛋白水平呈正线性相关。然而，在 IgAN 患者的肾活检标本中仅发现少数 CD208（+）细胞。

结论

这些观察结果表明，扁桃体中 CD208（+）DC 的增加可能在 IgAN 的发病机制中起指导作用。本研究结果支持 IgAN 患者行扁桃体切除术的治疗意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/e4b68cb50491/gft39907.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/f6fcdc4989ef/gft39901.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/2031b5d2fa6a/gft39902.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/d076b1b5dab3/gft39903.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/a4c227e43229/gft39904.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/458d6cb42b24/gft39905.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/0e4f8436d51d/gft39906.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/e4b68cb50491/gft39907.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/f6fcdc4989ef/gft39901.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/2031b5d2fa6a/gft39902.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/d076b1b5dab3/gft39903.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/a4c227e43229/gft39904.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/458d6cb42b24/gft39905.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/0e4f8436d51d/gft39906.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/3843345/e4b68cb50491/gft39907.jpg

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