J Nephropathol. 2017;6(2):97-102.
doi: 10.15171/jnp.2017.16
PMID: 28491860
PMCID: PMC5418077
Scopus id: 85008466266
  Abstract View: 1773
  PDF Download: 1173

Original Article

Differences in the frequency of macrophage and T cell markers between focal and crescentic classes of anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis

Dana Kidder 1 * , Susan E Bray 2, Stewart Fleming 3

1 Renal Unit, Aberdeen, Royal Infirmary, Aberdeen, Scotland, AB25 2ZN
2 Tayside Tissue Bank, University of Dundee Medical School, Ninewells Hospital, Dundee, Scotland, DD1 9SY
3 Department of Pathology, University of Dundee Medical School, Ninewells Hospital, Dundee, Scotland, DD1 9SY
*Corresponding author: Dana Kidder, Renal Unit, Aberdeen Royal Infirmary, Aberdeen, Scotland, AB25 2ZN. Telephone: +44 1224 -55318; Fax: +44 1224 550713; Email: dana.kidder@nhs.net

Abstract

Background: Anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AAGN) can be classified into; focal, crescentic, mixed and sclerotic classes. Macrophages and T lymphocytes are key players in mediating renal injury. The frequency of macrophage and T lymphocytes in different histological classes is unclear.

Objectives: We examined the frequency of macrophage and T lymphocyte markers in AAGN and assessed their correlation with renal function at presentation.

Patients and Methods: Renal biopsies from 38 patients were included in immunohistochemistry analysis of macrophages (CD68, sialoadhesin [Sn] and mannose receptor [MR]) and T cells (CD4 and CD8) markers. The frequency of these markers in glomerular, periglomerular and interstitial compartments were measured in a blinded fashion. Biopsies were allocated a histological class of focal, crescentic, mixed or sclerotic. Scores were then matched to histological class and assessed for correlation with renal function.

Results: The biopsies were crescentic 19 (50%), focal 10 (26.3%), mixed 6 (15.7%) and sclerotic 3 (8%). Interstitial CD68+ macrophages and CD8+ T lymphocytes showed best correlation with renal function at the time of presentation. CD68+ macrophages were significantly increased in crescentic compared to focal AAGN. MR+ macrophages, CD4 and CD8 T cells were also elevated in the interstitium of crescentic compared to focal group.

Conclusions: In this study interstitial CD68 and CD8 showed the highest association with the renal function at presentation. Differences in the cellular infiltrate between focal and crescentic AAGN were related to CD68+ macrophages and to interstitial MR+ macrophages and T lymphocytes. Further studies are needed to assess these differences across all four histological categories.

Implication for health policy/practice/research/medical education:

This study highlights that in AAGN, the frequency of  interstitial CD68+ macrophages and CD8+ lymphocytes show the highest correlation with renal function at presentation. Differences in the cellular infiltrate between focal and crescentic classes of AAGN are primarily related to CD68+ macrophages.

Please cite this paper as: Kidder D, Bray SE, Fleming S. Differences in the frequency of macrophage and T cell markers between focal and crescentic classes of anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis. J Nephropathol. 2017;6(2):97-102. DOI: 10.15171/jnp.2017.16.

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First published online: 25 Dec 2016
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