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Proteinuria and activated T-lymphocytes in diabetic nephropathy
J J Bending1, A Lobo-Yeo, D Vergani
1Unit for Metabolic Medicine, United Medical School, England, United Kingdom.
Diabetes
|May 1, 1988
Summary
Activated T-lymphocytes (ATL) are elevated in some patients with diabetic nephropathy, suggesting an immune role in proteinuria development. This immune response may be exhausted in advanced stages of kidney disease.
Area of Science:
- Immunology
- Nephrology
- Endocrinology
Background:
- Activated T-lymphocytes (ATL) are implicated in immune-mediated renal disease.
- The role of ATL in diabetic nephropathy and proteinuria is not fully understood.
Purpose of the Study:
- To investigate the presence and levels of ATL in patients with insulin-dependent diabetes mellitus (IDDM) and varying degrees of proteinuria.
- To explore the association between ATL and the development of diabetic nephropathy.
Main Methods:
- Blood samples were collected from IDDM patients with diabetic nephropathy (nonnephrotic and nephrotic proteinuria) and control subjects without proteinuria.
- T-lymphocytes were purified and stained for HLA-DR expression using immunofluorescence to identify activated cells.
- Absolute numbers and percentages of DR-positive T-lymphocytes were quantified.
Main Results:
- Patients with nonnephrotic proteinuria showed significantly higher numbers and percentages of ATL compared to nonproteinuric controls.
- Patients with nephrotic proteinuria exhibited lower levels of ATL compared to controls, suggesting potential immune exhaustion.
- Increased ATL may be linked to the immune processes driving proteinuria in diabetic nephropathy.
Conclusions:
- Elevated ATL are associated with the development of proteinuria in IDDM patients.
- The immune response involving ATL might be a factor in diabetic nephropathy.
- Immune exhaustion may occur in advanced stages of diabetic renal disease with nephrotic proteinuria.