Abstract
Forkhead box P3 (Foxp3) functions as a master regulator in the development and function of T-regulatory (Treg) cells. Recent studies have shown that autoimmune diseases including systemic lupus erythematosus (SLE) are associated with an imbalance with the Treg cells and T helper (Th) subtypes. To evaluate immunohistochemical expression of Foxp3 positive Treg cells in lupus nephritis (LN) and analyze its association with clinicopathologic parameters. Renal biopsy specimens of 50 patients with LN were studied. Specimens were divided into; group A; 25 LN cases without proliferative activity (Class II and V) and group B: 25 cases with proliferative activity (Class III and IV). Immunohistochemical staining for anti-human Foxp3 antibody and grading from grade 0 to grade 3 was done. Foxp3 expression in group A was (grade 0 in 14 [56.0%], grade +1 in 11 [44.0 %]) in comparison to group B (grade +1 in 6 [24.0%], grade +2 in 11 [44.0%] and grade +3 in 8 [32.0%]) (P < 0.001). Foxp3 expression was significantly correlated to National Institutes of Health (NIH) activity and chronicity indices (P < 0.05), as well as serum creatinine (P < 0.01) in both groups A and B and there was a highly significant correlation with proteinuria (P < 0.01) in group B with proliferative LN. Immunohistochemical Foxp3 expression in renal tissue was higher in proliferative versus non-proliferative LN and is associated with activity and severity of LN. Further studies are needed to determine its prognostic value in LN.
Highlights
Forkhead box P3 (Foxp3) functions as a master regulator in the development and function of T-regulatory (Treg) cells
This study shows that this marker is highly expressed in proliferative lupus nephritis and correlated with National Institutes of Health (NIH) activity and chronicity indices indicating that Treg cells are implicated in disease progression
Immunohistochemical expression of Foxp3 among studied groups is shown in Table 2 and Figures 1, 2 and 3
Summary
Forkhead box P3 (Foxp3) functions as a master regulator in the development and function of T-regulatory (Treg) cells. Recent studies have shown that autoimmune diseases including systemic lupus erythematosus (SLE) are associated with an imbalance with the Treg cells and T helper (Th) subtypes. Objectives: To evaluate immunohistochemical expression of Foxp positive Treg cells in lupus nephritis (LN) and analyze its association with clinicopathologic parameters. Foxp expression was significantly correlated to National Institutes of Health (NIH) activity and chronicity indices (P < 0.05), as well as serum creatinine (P < 0.01) in both groups A and B and there was a highly significant correlation with proteinuria (P < 0.01) in group B with proliferative LN. Conclusions: Immunohistochemical Foxp expression in renal tissue was higher in proliferative versus non-proliferative LN and is associated with activity and severity of LN. The deposited immune complexes and dendritic cells trigger the release of type I interferon and induce activation of infiltrating T cells, and this leads to intensification of T cell subgroups including the CD4+ T helper (Th) subtypes.
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