Clinicopathological Analysis Of HBV-GN And The Expression Foxp3in The Renal Tissue

Objectives:To explore the clinicopathological characteristics of hepatitis B virusassociated glomerulonephritis(HBV-GN) and To investigate the expression and itspossible role of Forkhead/winged Helix transcription factor(Foxp3) in the kidney tissue ofHBV-GN.Methods:(1) Collect the clinicopathological materials,laboratory indexes of58cases withHBV-GN confirmed by renal biopsy in our hospital;(2) All patients were diagnosed byrenal biopsy pathologically and were divided into3groups. Group A was hepatitis B virusglomerulonephritis（n=58）, group B was HBsAg-negative nephritis (n=52), group Cwas serum HBsAg-positive （n=24）,with renal tissue HBsAg-negative and creatinineslightly elevated but without renal lesion. The immunohistochemical method was utilizedto detect the expression of Foxp3protein in kidney tissue of the3groups.Results:(1) The average age was (26.7±10.3).the proportion of gender was2.2(male)to1(female).27(46.6%) patients present nephrotic syndrome.24(41.4%) suffered nephriticsyndrome,4（6.9%） cases of chronic renal insufficiency and only3patients (5.2%)wereasympomatic proteinuria or hematuria;The most frequent pathological type of HBV-GN inthis research was membranous nephropathy （43.1%）, Mesangial proliferativeglomerulonephritis (MsPGN) accounted for16cases (27.6%), mesangial proliferativeglomerulonephritis(MPGN) accounted for9cases (15.5%), IgA nephropathy（IgAN）accounted for6cases (10.3%), sclerosing glomerulonephritis（SGN）2cases(3.4%).58patients were divided into two according to the HBeAg positive or not.there were43(74.1%) in the HBeAg (-) group,the average level of C3was（0.99±0.27）g/l,thedepositions of C3and C1q in glomeruli was34.9%and16.3%;Meanwhile,15patients(25.9%) in The HBeAg(+) group,the mean level of C3was （0.19±0.17）g/l, thedepositions of C3and C1q in glomeruli was80%、46.7%;The comparison between the two groups was of great significance(P＜0.05).The average level of24-hour urinary protein inthe HBV DNA moderate replication group was more than that in the lower degree ofreplication group.However, the serum albumin level is the opposite(P＜0.05).(2) Foxp3、CD4、CD25protein expressed mainly in the tubulointerstitial; Btween group A and groupB tubular interstitial,Per HPF Foxp3+lymphocyte、CD4+T cells, CD25+T cell countswere (3.41±1.16) vs (3.52±1.27);(3.12±0.17) vs (2.78±0.15);（2.9±0.2）vs（3.09±0.18）, significantly lower than that in group C Foxp3+lymphocyte、CD4+T cells,CD25+T cell counts (P<0.05).Meanwhile, there was significant difference in Foxp3+lymphocyte、CD4+T cells and CD25+T cell counts between group A and group B(P＜0.05).Conclusions:(1) Male more than female was one of the most common fetures ofHBV-GN. nephrotic syndrome was the main clinical manifestations.The membranousnephropathy was the most common pathological type.The urinary protein excretion andserum albumin levels are related to the HBV-DNA levels.the activation of C3and C1qmight take part in the pathogenesis of HBeAg positive-HBV-GN.(2) The occurrence anddevelopment of the hepatitis B virus associated glomerulonephritis might be related to thereduced expression of Foxp3in the regulatory T cells.