The Correlation Between The Degree Of CD68 And CD3 Infiltration And The Clinical And Pathological Features Of Primary IgA Nephropathy In Children

Research background IgA Nephropathy(IgAN)is the most common glomerular disease in clinic.It can be seen in adults and children.The diagnosis is based on the deposition of IgA or its immune complex in the mesangial area of the glomerulus.Various types of hematuria are common,including macroscopic and microscopic hematuria,or and/or proteinuria.The clinical manifestations of IgA nephropathy are obviously heterogeneous,and everyone is different.Children and adults have significant differences in histology.At present,it is generally believed that the probability of children’s IgA nephropathy progressing to end-stage renal disease(ESRD)is lower than that of adults,but early active treatment is an effective way to prevent disease progression.In recent years,there are more and more studies on the relationship between macrophage(CD68)and T cell marker CD3 and the clinical and pathological features of children with primary IgA nephropathy.Purpose By analyzing the relationship between the expression of CD68 and CD3 in the renal interstitium and the clinical and pathological features of children with primary IgA nephropathy,to explore the prognostic value of the infiltration intensity of macrophage CD68 and T cell marker CD3 in children with primary IgA nephropathy.Method The primary IgA nephropathy(72 cases)was definitely diagnosed by Bultrasound-guided nephrocentesis in xxx Hospital during 2015-2022,and other secondary IgA nephropathy were excluded,such as nephritic nephrotic syndrome,lupus nephritis,anaphylactoid purpura nephritis,etc.The expression level of CD68+and CD3+factors in the renal interstitium was recorded by immunohistochemical method.According to the positive expression level,CD68 and CD3 were divided into six grades: negative,individual,small,scattered,small and focal.The negative and individual expressions were defined as negative and were divided into negative groups,and the others were defined as positive and were divided into positive groups.SPSS software was used to analyze the correlation between CD68 and CD3 and clinical pathology.The difference of blood pressure(systolic blood pressure,diastolic blood pressure)between the two groups was compared by t-test CD3 and clinical data and the MEST-C score of Oxford classification was analyzed by Spearman test.Result :In the CD68 group,there were 21 men(72.4%)and 8 women(27.6%)in the positive group,with a ratio of 2.6:1 for men and women.In the negative group,there were 30 men(69.8%)and 13 women(30.2%),with a ratio of 2.3:1 for men and women.The age of the positive group was 8.8 ± 2.1 years old,and the age of the negative group was 8.7 ± 2.8 years old.In the positive group,M1 28(96.6%),E1 21(72.4%),S1 18(62.1%),T1 0(0%),C1+219(65.5%);In the negative group,M1 40(93%),E1 21(48.8%),S1 15(34.9%),T1 0(0%),C1+217(39.5%).In the CD3 group,there were 29 males(65.9%)and 15 females(34.1%)in the positive group,with a ratio of 1.9:1;in the negative group,there were 22 males(78.6%)and 6 females(21.4%),with a ratio of 3.7:1.The age of the positive group was 9 ± 2.5 years old,and the age of the negative group was 8.9 ± 3 years old.In the positive group,M1 42(95.5%),E1 31(70.5%),S1 26(59.1%),T1 0(0%),C1+228(63.6%);In the negative group,M1 26(92.9%),E1 13(46.3%),S1 7(25%),T1 0(0%),C1+210(35.7%).Compared with the negative group,the positive group of CD68 and CD3 had higher blood pressure(systolic blood pressure),more red blood cells in urine,more protein in urine,higher triglycerides and cholesterol(p<0.05),and higher scores of E,S,C1+2 in Oxford classification(P<0.05).There was no significant difference between the two groups in albumin,uric acid,creatinine and M in Oxford classification(P>0.05);CD68+,CD3+and urine protein were correlated with clinical manifestations and pathology(Oxford classification)(p<0.05).Conclusion The positive expression of CD68 and CD3 in children with IgA nephropathy is closely related to the clinical manifestation and pathological classification of urine protein,systolic blood pressure,and the prognosis is also worse.Therefore,CD68 and CD3 can be used to predict the prognosis of children with IgA nephropathy,strive for early treatment,and avoid progression to end-stage renal disease.