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Published on: November 1, 2018
The distribution and significance of renal infiltrating cells in patients with diffuse crescentic glomerulonephritis
1Department of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Objective:
To study the significance and distribution of renal infiltrating cells, including monocytes (CD68+ cells), proliferative cell nuclear antigen positive cells (PCNA+ cells), CD4+ and CD8+ cells in diffuse crescent glomerulonephritis (DCGN).
Methods:
Fifty-six patients with DCGN were studied, including 10 cases of anti-glomerular basement membrane (GBM)--type I DCGN, 26 immune complex--type II DCGN, and 20 cases of pauci-immune--type III DCGN. Glomerular and interstitial infiltrates of CD68+ and PCNA+ cells, and interstitial infiltrates of CD4+ and CD8+ cells were detected by using four-layer PAP methods.
Results:
There was a significant increase of renal infiltrating CD68+, PCNA+, CD4+ and CD8+ cells in patients with DCGN compared with that in normal controls. In patients with type I DCGN, there was a higher number of renal infiltrating CD68+ and PCNA+ cells than that in patients with type II and III DCGN. A glomerular infiltrates of CD68+ and PCNA+ cells correlated with the interstitial infiltrates of CD4+ cells in type I or III DCGN patients. In lupus DCGN patients, the numbers of renal infiltrating CD68+ and PCNA+ cells were similar to vasculitis or type III DCGN patients.
Conclusion:
These findings demonstrate that the renal infiltrates of CD68+ and PCNA+ cells play an important role in patients with DCGN, that the infiltrates of CD4+ cells correlate with the infiltrates of CD68+ and PCNA+ cells may be an active marker of DCGN, and that cell-mediated immunity may contribute to crescent formation in lupus DCGN patients.
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