Abstract
Background. T follicular helper (TFH) cells are involved in the humoral immune responses. This study is aimed at examining the frequencies of different subsets of CD4+CXCR5+ TFH cells in adult patients with minimal change disease (MCD). Methods. A total of 27 patients and 14 healthy controls (HC) were characterized for the levels of sera cytokines, inducible T-cell costimulator (ICOS), and programmed death 1 (PD-1) of positive TFH cells by flow cytometry. The level of sera IL-21 was examined; 24 h urinary protein and eGFR were calculated. The potential correlation between the frequency of different subsets of TFH cells and the values of clinical measures in MCD patients were analyzed. Results. The frequency of circulating CD4+CXCR5+, CD4+CXCR5+ICOS+, and CD4+CXCR5+PD-1+ TFH cells and the levels of sera IL-17A, IFN-γ, IL-2, IL-10, IL-4, and IL-21 were significantly higher in MCD patients (P < 0.05) than that in the HC group. Furthermore, the percentages of circulating CD4+CXCR5+ TFH cells were negatively correlated with the values of eGFR (r = −0.4849, P < 0.05) and the percentages of CD4+CXCR5+PD-1+ TFH cells were correlated positively with the levels of serum IL-21 (r = 0.6137, P < 0.05) and 24 h urinary protein (r = 0.1410, P < 0.05) in those patients. Also, the percentages of CD4+CXCR5+ICOS+ TFH cells were correlated positively with the levels of serum IL-21 (r = 0.6201, P < 0.05) and 24 h urinary protein (r = 0.7519, P < 0.05). Following standard therapies, the percentages of circulating CD4+CXCR5+, CD4+CXCR5+PD-1+, and CD4+CXCR5+ICOS+ TFH cells and the levels of serum IL-21 were significantly reduced, but the levels of serum IL-4 and IL-10 were increased (P < 0.05). Conclusions. A higher frequency of CD4+CXCR5+ TFH cells that existed in adult patients with MCD could be new target for intervention of MCD.
Highlights
Minimal change disease (MCD) is the major cause of the nephritic syndrome (NS) in children [1, 2], accounting for 70 to 90% in children whereas in adults minimal change disease (MCD) is found in 10 to 15% of cases with primary NS [3]
We found that the concentrations of sera IL-17A, IFN-γ, IL-10, IL4, IL-2, and IL-21 were significantly higher in MCD patients than that in the healthy controls (HC) (P < 0.05, Figures 2(a)–2(f))
T follicular helper (TFH) cells depend on expression of the master regulator transcription factor Bcl6
Summary
Minimal change disease (MCD) is the major cause of the nephritic syndrome (NS) in children [1, 2], accounting for 70 to 90% in children (below 10 years old) whereas in adults MCD is found in 10 to 15% of cases with primary NS [3]. More researches have been devoted to such questions It is still unclear how different types of CD4+ helper T cells regulate the pathogenesis of MCD. This study is aimed at examining the frequencies of different subsets of CD4+CXCR5+ TFH cells in adult patients with minimal change disease (MCD). The frequency of circulating CD4+CXCR5+, CD4+CXCR5+ICOS+, and CD4+CXCR5+PD-1+ TFH cells and the levels of sera IL-17A, IFN-γ, IL-2, IL-10, IL-4, and IL-21 were significantly higher in MCD patients (P < 0.05) than that in the HC group. The percentages of CD4+CXCR5+ICOS+ TFH cells were correlated positively with the levels of serum IL-21 (r = 0.6201, P < 0.05) and 24 h urinary protein (r = 0.7519, P < 0.05). A higher frequency of CD4+CXCR5+ TFH cells that existed in adult patients with MCD could be new target for intervention of MCD
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