Lymphocyte Subsets in Acute Post-Streptococcal Glomerulonephritis

Authors: YAVUZ TEKELİOĞLU, HİLAL MOCAN, M. ZİYA MOCAN, H. ÖNDER ERSÖZ

Abstract: This prospective study was designed to investigate lymphocyte subsets in acute post-streptococcal glomerulonephritis (APSGN). Peripheral blood lymphocytes were analyzed using fluorescein isothiocyanate (FITC) labeled CD3, CD4, CD8, CD14, CD19, CD45, CD56, CD45RA and CDW29 monoclonal antibodies by flow cytometry. Twenty patients aged 14-22 years who fulfilled the diagnostic criteria for APSGN were evaluated during the 1st and 12th weeks of the of disease. Twenty-four age-matched healthy subjects served as controls. At the onset of the disease, all patients had macroscopic haematuria with red blood cell casts in urine, proteinuria (1.06±0.21 g/d), low complement 3 (C3) levels (<90mg/dl), increased antistreptolysin 0 titer (>200 IU/ml), edema, oliguria and high serum creatinine levels. Hypertension was recorded in 60% of the patients. Twelve weeks after onset, all patients had normal renal functions and serum C3 levels. Only one patient showed mild proteinuria (2+dipstick) and another had borderline hypertension. During the initial phase of the disease, patients demonstrated an increase in the total lymphocyte counts (CD3). The percentages of helper T cell (CD4), T helper 1 cells (Th1) and natural killer cells (CD56) were also significantly higher in the peripheral blood of APSGN patients during the acute stage than in the controls (p<0.05). The CD4/CD8 ratio was also significantly higher than in the controls during the initial stage of the disease (p<0.05). These findings indicate that T cell subsets and monocytes/macrophages might play a role in the pathogenesis of APSGN.

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