T-cells and macrophages in rapidly progressive glomerulonephritis: clinicopathologic correlations

WK Bolton, DJ Innes Jr, BC Sturgill, DL Kaiser - Kidney international, 1987 - Elsevier
WK Bolton, DJ Innes Jr, BC Sturgill, DL Kaiser
Kidney international, 1987Elsevier
T-cells and macrophages in rapidly progressive glomerulonephritis: Clinicopathologic
correlations. We phenotyped with monoclonal antibodies (MAb) the cellular infiltrates in
kidneys of patients with rapidly progressive glomerulonephritis (RPGN) responsive (R) or
nonresponsive (NR) to pulse methylprednisolone therapy (PM)-eight anti-GBM, six no
immune deposits, three immune complex, two vasculitis, and one proliferative GN. There
were glomerular, periglomerular, crescentic, and interstitial T and T-cell subsets. Few …
T-cells and macrophages in rapidly progressive glomerulonephritis: Clinicopathologic correlations. We phenotyped with monoclonal antibodies (MAb) the cellular infiltrates in kidneys of patients with rapidly progressive glomerulonephritis (RPGN) responsive (R) or nonresponsive (NR) to pulse methylprednisolone therapy (PM)-eight anti-GBM, six no immune deposits, three immune complex, two vasculitis, and one proliferative GN. There were glomerular, periglomerular, crescentic, and interstitial T and T-cell subsets. Few interstitial and no glomerular B and NK cells were observed. TH cells were much more common than TS. Phenotypes were quantitatively evaluated in 221 nephritic and 32 control glomeruli.T and/or TH cells were positively correlated with MΦ, r = 0.30 to 0.74,P < 0.05 to 0.0005. Although differences in phenotypes were observed, these differences were insufficient to distinguish between subtypes. Analysis of R and NR revealed no relationship to percent crescents, entry serum creatinine, oliguria, or need for dialysis. NR was related to presence of anti-GBM disease,P = 0.001, as was ability to stop dialysis, 0 of 7 GBM versus 9 of 10 other,P < 0.001. Mild infiltrates of lymphocytes and MΦ correlated with R,P ≤ 0.02. R had fewer numbers of TH and MΦ in glomeruli,P = 0.0001, in crescents,P < 0.02, and total TH and MΦ compared to NR, P < 0.001. Crescentic and total TH/S ratios were lower in NR than R, P < 0.05. These findings demonstrate that components of the cell-mediated immune (CMI) system are present by MAb analysis, that subtypes cannot be differentiated by CMI constitution, and R to PM is related to intensity and composition of CMI involvement. Independence of the CMI system relative to anti-GBM disease remains to be clarified.
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