Abstrait

T and B cells immunophenotypes in blood and urine of patients with focal segmental glomerulosclerosis in relation to disease severity

Sabiha Anis*, Ejaz Ahmed, Rana Muzaffar, Syed Adibul Hasan Rizv

Background: Disordered immune system is responsible for the pathogenesis in most of the glomerulonephritis (GN) including FSGS. Elucidation of involvement of immune cells is important to avoid invasive procedures for monitoring of disease progression. Methods: We analyzed the frequencies of CD25, CD122 and CD5 on CD4+, CD8+ and CD19+ T and B cells in blood and urine samples of 50 individuals including FSGS, other GN, pathological controls (PC)) and healthy controls (HC)). Data was analyzed using spss software. Results: The ratio of CD4+25+to CD4+122+ was found significantly low in blood of FSGS patients compared to HC and PC (37.6 ± 44.1% vs. 100% in HC and PC, P = 0.000). The ratio of CD19+25+ to CD19+122+ cells were also significantly low in FSGS compared to HC (21.6 ± 20.6% vs.9.4 ± 7.7%, P =0.021) . Overall, the percentages CD4+ 25+ 122+, CD8+25+ 122+and CD19+25+ 122+ cells were more in the urine of FSGS patients compared to controls. CD19+5+ B cells were significantly high in blood and urine of FSGS compared to controls. These cells were also significantly more in the blood of steroid dependent and resistant FSGS patients compared to steroid responsive and in urine of patients with renal dysfunction compared to normal renal functions. Conclusions: Our results show that T and B cells have a definite role in the pathogenesis of FSGS. A low expression of CD25 found on T and B cells in FSGS found in this study indicate down regulation of Treg and Breg cells in these patients. A high expression of CD5+B in blood and urine of FSGS may be responsible for disease severity. The results of this study are important as it may help in avoiding unnecessary invasive procedure for patient monitoring. However there is a need to do further studies to validate these results.