Departamento de Patologia Genética e Evolução, Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
J Bras Nefrol. 2020 Mar;42(1):59-66. doi: 10.1590/2175-8239-jbn-2018-0222. Epub 2020 Jan 31.
Mast cells may be involved in inflammation and contribute to the onset of fibrosis in lupus nephritis (LN).
This study aimed to correlate the presence of mast cells in kidney biopsy specimens of pediatric patients with LN with activity (AI) and chronicity (CI) indices and assess how effectively mast cells may be used as a prognostic factor.
The study included 40 patients aged 6-18 years diagnosed with LN at the Renal Disease Service of the Federal University of Triângulo Mineiro between 1996 and 2015. Workup and epidemiological data were evaluated vis-à-vis AI, CI, and mast cell counts (MCC).
Significant positive correlations were found between mast cell counts (MCC) and AI (p = 0.003; r: 0.66) and MCC and CI (p = 0.048; r: 0.48). The ROC curve showed that mast cells were highly sensitive and specific in the differentiation of patients with an AI > 12 from individuals with an AI ≤ 12. Serum creatinine levels were higher in individuals with class IV LN than in patients with class V disease [1.50 (0.40-20.90) vs. 0.70 (0.62-0.90), p = 0.04]. Blood urea nitrogen had a positive significant correlation with MCC (p = 0.002; r: 0.75). A trend toward a negative correlation was observed between MCC and serum albumin (p = 0.06; r: -0.5459). Kidney biopsies of patients with nephrotic syndrome had higher MCC [2.12 (0.41-5.140) vs. 0.53 (0.0-3.94), p = 0.07].
Inflammatory cell infiltration and morphological differences between cell types in the inflammatory infiltrate are relevant factors in the assessment of the LN. Mast cell analysis and AI/CI assessment may be relevant prognostic indicators for pediatric patients with LN.
肥大细胞可能参与炎症，并导致狼疮性肾炎（LN）纤维化的发生。
本研究旨在探讨儿童 LN 患者肾活检组织中肥大细胞的存在与活动指数（AI）和慢性指数（CI）的相关性，并评估肥大细胞作为预后因素的有效性。
该研究纳入了 1996 年至 2015 年期间在米纳斯吉拉斯联邦大学肾脏疾病科诊断为 LN 的 40 名 6-18 岁患者。对 AI、CI 和肥大细胞计数（MCC）进行了评估。
发现肥大细胞计数（MCC）与 AI（p=0.003；r：0.66）和 MCC 与 CI（p=0.048；r：0.48）之间存在显著正相关。ROC 曲线显示，肥大细胞在区分 AI>12 的患者和 AI≤12 的患者方面具有高度的敏感性和特异性。与 V 级疾病相比，IV 级 LN 患者的血清肌酐水平更高[1.50（0.40-20.90）vs. 0.70（0.62-0.90），p=0.04]。血尿素氮与 MCC 呈显著正相关（p=0.002；r：0.75）。MCC 与血清白蛋白呈负相关趋势（p=0.06；r：-0.5459）。肾病综合征患者的肾活检标本中 MCC 较高[2.12（0.41-5.140）vs. 0.53（0.0-3.94），p=0.07]。
炎症细胞浸润和炎症浸润中细胞类型的形态差异是评估 LN 的重要因素。肥大细胞分析和 AI/CI 评估可能是儿童 LN 患者的相关预后指标。
