Impaired cell-mediated immunity in lipoid nephrosis

Area of Science:

• Immunology
• Nephrology

Background:

• Cell-mediated immunity (CMI) plays a crucial role in host defense.
• Lipoid nephrosis (LN) is a nephrotic syndrome where immune function may be altered.
• Chronic diffuse proliferative glomerulonephritis (CGN) provides a comparison for immune responses in renal disease.

Purpose of the Study:

• To evaluate cell-mediated immunity (CMI) in patients with lipoid nephrosis (LN) and chronic diffuse proliferative glomerulonephritis (CGN).
• To compare CMI parameters between active LN, remitted LN, CGN, and healthy controls.

Main Methods:

• Assessed delayed hypersensitivity skin test responses to PPD and Candida.
• Measured circulating lymphocyte subsets, including T lymphocytes, T gamma cells, and Tmu cells.
• Compared immune parameters across patient groups and healthy controls.

Main Results:

• Patients with LN in relapse exhibited reduced skin test reactivity and a lower proportion of positive reactors compared to controls.
• LN patients in relapse showed significant T lymphocytopenia, with decreased T gamma and Tmu cell counts.
• Patients with LN in remission and CGN did not show significant differences in CMI compared to controls.

Conclusions:

• The majority of active LN patients demonstrate impaired cell-mediated immunity.
• Disturbed CMI in LN relapse may be secondary to hypoproteinemia and nutritional deficits.
• CMI function appears preserved in LN remission and CGN without renal insufficiency.