Analysis of T Cell Subsets in Adult Primary/Idiopathic Minimal Change Disease: A Pilot Study

Salcido-Ochoa, Francisco; Hue, Susan Swee-Shan; Haase, Doreen; Choo, Jason Chon Jun; Yusof, Nurhashikin; Li, Reiko Lixiang; Allen, John C.; Iqbal, Jabed; Loh, Alwin Hwai Liang; Rötzschke, Olaf

doi:10.1155/2017/3095425

Cited by 13 publications

(7 citation statements)

References 26 publications

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“…Currently, minimal change disease (MCD) is believed to be due to podocyte damaged by glomerular permeability factors produced from abnormal T-lymphocyte subsets ( 37 , 38 ). Another study found that CD4 + T cells in patients with relapsed MCD were significantly upregulated ( 39 ), further confirming the role of T cells in the development of this condition. Thus, the occurrence of kidney diseases is related to the immune environment, especially the number and function of T-lymphocytes.…”

Section: Discussionmentioning

confidence: 75%

T-Lymphocyte Subsets Alteration, Infection and Renal Outcome in Advanced Chronic Kidney Disease

Xiong

Qiao

et al. 2021

Front. Med.

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Background: T-lymphocyte subsets reflect patients' immune status and are associated with adverse outcomes in various diseases. However, the association between T-lymphocyte subsets and major infection and renal outcome in chronic kidney disease (CKD) patients has not been well-addressed.Methods: Patients diagnosed with stage 3–5 of non-dialysis CKD were recruited, and healthy subjects were selected as the controls. T-lymphocyte subsets (CD3+, CD4+, CD8+) were detected by flow cytometry, and the CD4+/CD8+ T cell ratio was then calculated. Patients were divided into the normal-level group and the low-level group according to the clinical reference value. The primary outcomes were the major infection and renal outcome.Results: A total of 410 CKD patients were enrolled; the average age was 47.25 years. Compared to the healthy controls, the level of CD3+, CD4+, CD8+ T cells, and the CD4+/CD8+ T cell ratio were significantly decreased in CKD patients (p < 0.05). During the median follow-up of 2.56 (quartile interval 1.24–3.46) years, major infections occurred in 15.10% of the CKD patients. The incidence of infection was significantly higher in the low-level group of CD3+, CD4+ T cells, and CD4+/CD8+ T cell ratio compared with the normal level groups. Kaplan-Meier analysis showed that the lower level of CD3+, CD4+ T cells, and CD4+/CD8+T cell ratio is associated with a greater risk of infection. Cox regression analysis further confirmed that low CD3+, CD4+ T cells, and CD4+/CD8+ T cell ratio were independent risk factors of infection in CKD patients. Moreover, during the follow-up, renal events occurred in 37.50% of patients. Kaplan-Meier analysis indicated that low levels of CD3+, CD4+, and CD8+ T cells are significantly associated with renal outcome in CKD patients. Cox regression analysis showed that low level of CD3+ T cells (HR = 2.407, 95% CI: 1.664–3.482, p < 0.001), CD4+ T cells (HR = 2.397, 95% CI: 1.633–3.518, p < 0.001) and CD8+ T cells (HR = 2.416, 95% CI: 1.476–3.955, p < 0.001) were independent risk factors for renal outcome after multivariable-adjusted.Conclusion: CKD patients had a defect in T-lymphocyte subpopulation. T-lymphocyte subsets were closely associated with infection and renal outcome in CKD patients. Suggesting T-lymphocyte subsets are independent predictors of infection and renal outcome in CKD patients.

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Section: Discussionmentioning

confidence: 75%

T-Lymphocyte Subsets Alteration, Infection and Renal Outcome in Advanced Chronic Kidney Disease

Xiong

Qiao

et al. 2021

Front. Med.

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“…35 However, a recent study in adults with new onset idiopathic MCD showed no significant difference in the percentage of CD4 + and CD8 + T cells compared with controls. 36 In our cohort of SDNS patients, the percentage of CD4 + memory T cells was significantly higher in both MCD and FSGS compared with controls, excluding it as a useful marker to differentiate between MCD and FSGS in our patients with SDNS.…”

Section: Discussionmentioning

confidence: 58%

MeSsAGe risk score: tool for renal biopsy decision in steroid-dependent nephrotic syndrome

et al. 2019

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BACKGROUND: A lack of consensus exists as to the timing of kidney biopsy in children with steroid-dependent nephrotic syndrome (SDNS) where minimal change disease (MCD) predominates. This study aimed at examining the applicability of a biomarker-assisted risk score model to select SDNS patients at high risk of focal segmental glomerulosclerosis (FSGS) for biopsy. METHODS: Fifty-five patients with SDNS and biopsy-proven MCD (n = 40) or FSGS (n = 15) were studied. A risk score model was developed with variables consisting of age, sex, eGFR, suPAR levels and percentage of CD8 + memory T cells. Following multivariate regression analysis, total risk score was calculated as sum of the products of odds ratios and corresponding variables. Predictive cutoff point was determined using receiver operator characteristics (ROC) curve analysis. RESULTS: Plasma suPAR levels in FSGS patients were significantly higher, while percentage of CD45RO + CD8 + CD3 + was significantly lower than in MCD patients and controls. ROC analysis suggests the risk score model with threshold score of 16.7 (AUC 0.84, 95% CI 0.72-0.96) was a good predictor of FSGS on biopsy. The 100% PPV cutoff was >24.0, while the 100% NPV was <13.3. CONCLUSION: A suPAR and CD8 + memory T cell percentage-based risk score model was developed to stratify SDNS patients for biopsy and for predicting FSGS.

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“…However, not much is known about which type of T cell subset and cytokine play a critical role in the pathogenesis of MCD. Previous studies revealed that patients with MCD were characterized by downregulation of Th1 cytokines and predominance of Th2 and Th17, which might be harmful factors of glomerulus, leading to the occurrence and development of MCD (Le Berre et al, 2005;Salcido-Ochoa et al, 2017). However, Kaneko et al (2002) reported that the percentages of Th1, Th2 and the ratio of Th1/Th2 showed no significant differences between nephrotic relapse, remission and healthy controls in childhood.…”

Section: Introductionmentioning

confidence: 97%

Usefulness of the cytokines expression of Th1/Th2/Th17 and urinary CD80 excretion in adult-onset minimal change disease

Chen

Jiang

et al. 2020

PeerJ

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Background Minimal change disease (MCD) is a common form of nephrotic syndrome in adults. However, the molecular mechanism underlying the pathogenesis of MCD remains incompletely understood. In this study, we aimed to investigate the role of the cytokines expression of Th1/Th2/Th17 and urinary CD80 excretion in adult-onset MCD patients. Methods The lymphocyte subsets, 34 cytokine levels of Th1/Th2/Th17, serum and urine concentrations of CD80, and expression of CD80 in glomeruli were analyzed in 28 cases (15 males and 13 females; average age: 34.1 years, age range: 18–56 years), including 10 patients with MCD in relapse, nine patients with MCD in remission and nine healthy controls. Results There was no significant difference of CD3+CD4+ cells proportion among patients with MCD in relapse, MCD in remission and healthy controls (P = 0.802). The cytokine levels of GM-CSF and tumor necrosis factor (TNF)-related activation-induced cytokine (TRANCE) in patients with MCD in relapse increased 1.5 times higher than those in remission. An evident increase in the excretion of urinary CD80 was found in patients with relapsed MCD compared with those in remission (598.4 ± 115.8 vs 81.78 ± 7.04 ng/g creatinine, P < 0.001) and healthy controls (598.4 ± 115.8 vs 67.44 ± 8.94 ng/g creatinine, P < 0.001). CD80 expression was observed in podocyte of MCD patient in relapse by immunofluorescence technique. Conclusions The cytokines GM-CSF and TRANCE are increased and the urinary CD80 levels are elevated in adult-onset MCD patients in relapse, indicating a disorder of Th1/Th2/Th17 balance and that the elevated excretion of CD80 may underlie the pathogenesis and development of adult-onset MCD.

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Analysis of T Cell Subsets in Adult Primary/Idiopathic Minimal Change Disease: A Pilot Study

Cited by 13 publications

References 26 publications

T-Lymphocyte Subsets Alteration, Infection and Renal Outcome in Advanced Chronic Kidney Disease

T-Lymphocyte Subsets Alteration, Infection and Renal Outcome in Advanced Chronic Kidney Disease

MeSsAGe risk score: tool for renal biopsy decision in steroid-dependent nephrotic syndrome

Usefulness of the cytokines expression of Th1/Th2/Th17 and urinary CD80 excretion in adult-onset minimal change disease

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