Inflammation Cells Infiltrating Interstitium In IgA Nephropathy In Human

Objective: To investigate interstitial infiltration inflammatory cells in IgA nephropathy(IgAN),including CD4+, CD8+, CD25+, macrophages and acute activated macrophages. The aim is to find the relationship among interstitial infiltration inflammatory cells and renal function and pathology changes, and to know the function of these cells in IgAN. Method: Using PAS and immunohistochemistry method to stain paraffin sections of 36 IgAN patients. Using image analysis system, CD4+, CD8+, CD25+, Mac387+, 27E10+ cells infiltrating interstitium were counted(cells/mm2). Together with pathology changes(including glomerulosclerosis,tubular atrophy and interstitial sclerosis)and renal function both at the time of biopsy and follow-up, the function of all these cells were analysed. Result: In the renal tubulointerstitium, the number of CD4+ cells correlated with interstitial fibrosis(r=0.38, p=0.02), the number of CD8+ cells correlated with degrees of interstitial fibrosis(r=0.37, p=0.03) and glomerular fibrosis(r=0.40, p=0.02). Clinicopathological study showed a relationship between the number of interstitial CD4+, CD8+ cells, macrophages and the level of serum creatinine and GFR at the time of biopsy and follow-up, whereas the number of 27E10+ cells correlated with the change of renal function during the period of follow-up. Moreover, the close relationship among these tubulo-interstitial infiltrating cells was found.Conclusion: Cell-mediated immune reactions exist in the interstitium in IgAN. Interstitial CD4+, CD8+ cells and macrophages may play an important role in functional and pathology damages in IgAN. Interstitial 27E10+ cells could be a predictive factor in IgA nephropathy.