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Asymptomatic circulating T-cell clone cause renal polymorphic inflammatory fibrosis.

David Ribes1, Audrey Casemayou2,3, Hélène El Hachem1,3

  • 1Département de Néphrologie et Transplantation d'organes et Centre de référence des maladies rénales rares, CHU Rangueil, Toulouse, France.

Clinical and Experimental Nephrology
|December 27, 2016
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Summary

Persistent clonal T cells were identified in patients with unexplained inflammatory renal fibrosis. These cells can activate kidney cells, potentially causing autoimmune kidney disease without direct lymphoma involvement.

Keywords:
Biomed-2Interstitial nephritisLarge granular lymphocytic leukemiaRenal fibrosisT-cell clone

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Area of Science:

  • Nephrology
  • Immunology
  • Oncology

Background:

  • Renal complications of non-Hodgkin lymphoma include monoclonal immunoglobulin-related diseases.
  • Clonal circulating T cells are linked to autoimmune disorders via cytokine imbalance and lymphocyte subpopulations.

Observation:

  • A persistent clonal T-cell population was identified in two patients with unexplained inflammatory renal fibrosis.
  • Peripheral blood mononuclear cells with clonal T cells induced a pro-inflammatory state in renal epithelial cells in vitro.

Findings:

  • Clonal T cells were identified using immunophenotyping and TCR gene rearrangement analysis.
  • In vitro studies showed clonal T cells can activate renal epithelial cells, leading to NF-κB translocation and inflammatory gene overexpression.

Implications:

  • Circulating T-cell clones may directly activate kidney cells or foster autoimmune responses against them.
  • This suggests a potential pathway for inflammatory renal fibrosis in the absence of direct lymphoma infiltration.