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Disease activity prediction and prognosis of anti-GBM nephritis based on T lymphocyte subset ratios
INTRODUCTION: Cell-mediated autoimmunity, especially the autoreactivity of T cells, is known to underlie the initiation of anti-glomerular basement membrane disease. However, the T lymphocyte subsets that determine the disease activity, renal fibrosis, and prognosis of anti-GBM disease have not been...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489752/ https://www.ncbi.nlm.nih.gov/pubmed/34595959 http://dx.doi.org/10.1177/20587384211039391 |
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author | Zhang, Dan Zhang, Fan Liu, Meiling Zhang, Mingchao Zhang, Jiong Wang, Jinquan |
author_facet | Zhang, Dan Zhang, Fan Liu, Meiling Zhang, Mingchao Zhang, Jiong Wang, Jinquan |
author_sort | Zhang, Dan |
collection | PubMed |
description | INTRODUCTION: Cell-mediated autoimmunity, especially the autoreactivity of T cells, is known to underlie the initiation of anti-glomerular basement membrane disease. However, the T lymphocyte subsets that determine the disease activity, renal fibrosis, and prognosis of anti-GBM disease have not been clearly elucidated. METHODS: The T lymphocyte subsets (CD4+ and CD8+) were examined on peripheral blood and renal biopsy tissues from 65 patients with biopsy proven anti-GBM disease. Patients were divided into the high ratio group and low ratio group according to the cutoff values in the receiver operating characteristic curve analysis. The correlations of T lymphocyte subsets with clinical, pathological data, and renal outcome were analyzed. RESULTS: By the end of follow-up, 45 patients (69.2%) developed end-stage renal disease (ESRD). In peripheral blood, the CD4+/CD8+ ratio showed a predictive ability with a sensitivity and specificity of 91.3% and 52.9%, respectively, which gave rise to a cutoff value of 0.89. There was a significant difference in the activity index between these two groups (3.91 ± 1.38 vs. 2.89 ± 1.13, p = 0.007). In the renal tissues, the CD4+/CD8+ ratio had the optimal cutoff point of 0.82 with a sensitivity of 57.8% and specificity of 85%. The renal activity index was higher for the renal tissues with high CD4+/CD8+ ratios than that of tissues with low CD4+/CD8+ ratios (4.32 ± 1.55 vs. 3.37 ± 1.41, p = 0.016). Peripheral blood CD4+/CD8+ ratios of ≥0.89 or renal tissue CD4+/CD8+ ratios of < 0.82 positively correlated with poor renal prognosis in patients with anti-GBM nephritis. CONCLUSIONS: The CD4+/CD8+ ratio was associated with renal activity index both in peripheral blood and renal tissue and predicts the renal prognosis of patients with anti-GBM nephritis. |
format | Online Article Text |
id | pubmed-8489752 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-84897522021-10-05 Disease activity prediction and prognosis of anti-GBM nephritis based on T lymphocyte subset ratios Zhang, Dan Zhang, Fan Liu, Meiling Zhang, Mingchao Zhang, Jiong Wang, Jinquan Int J Immunopathol Pharmacol Original Research Article INTRODUCTION: Cell-mediated autoimmunity, especially the autoreactivity of T cells, is known to underlie the initiation of anti-glomerular basement membrane disease. However, the T lymphocyte subsets that determine the disease activity, renal fibrosis, and prognosis of anti-GBM disease have not been clearly elucidated. METHODS: The T lymphocyte subsets (CD4+ and CD8+) were examined on peripheral blood and renal biopsy tissues from 65 patients with biopsy proven anti-GBM disease. Patients were divided into the high ratio group and low ratio group according to the cutoff values in the receiver operating characteristic curve analysis. The correlations of T lymphocyte subsets with clinical, pathological data, and renal outcome were analyzed. RESULTS: By the end of follow-up, 45 patients (69.2%) developed end-stage renal disease (ESRD). In peripheral blood, the CD4+/CD8+ ratio showed a predictive ability with a sensitivity and specificity of 91.3% and 52.9%, respectively, which gave rise to a cutoff value of 0.89. There was a significant difference in the activity index between these two groups (3.91 ± 1.38 vs. 2.89 ± 1.13, p = 0.007). In the renal tissues, the CD4+/CD8+ ratio had the optimal cutoff point of 0.82 with a sensitivity of 57.8% and specificity of 85%. The renal activity index was higher for the renal tissues with high CD4+/CD8+ ratios than that of tissues with low CD4+/CD8+ ratios (4.32 ± 1.55 vs. 3.37 ± 1.41, p = 0.016). Peripheral blood CD4+/CD8+ ratios of ≥0.89 or renal tissue CD4+/CD8+ ratios of < 0.82 positively correlated with poor renal prognosis in patients with anti-GBM nephritis. CONCLUSIONS: The CD4+/CD8+ ratio was associated with renal activity index both in peripheral blood and renal tissue and predicts the renal prognosis of patients with anti-GBM nephritis. SAGE Publications 2021-10-01 /pmc/articles/PMC8489752/ /pubmed/34595959 http://dx.doi.org/10.1177/20587384211039391 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Article Zhang, Dan Zhang, Fan Liu, Meiling Zhang, Mingchao Zhang, Jiong Wang, Jinquan Disease activity prediction and prognosis of anti-GBM nephritis based on T lymphocyte subset ratios |
title | Disease activity prediction and prognosis of anti-GBM nephritis based on T lymphocyte subset ratios |
title_full | Disease activity prediction and prognosis of anti-GBM nephritis based on T lymphocyte subset ratios |
title_fullStr | Disease activity prediction and prognosis of anti-GBM nephritis based on T lymphocyte subset ratios |
title_full_unstemmed | Disease activity prediction and prognosis of anti-GBM nephritis based on T lymphocyte subset ratios |
title_short | Disease activity prediction and prognosis of anti-GBM nephritis based on T lymphocyte subset ratios |
title_sort | disease activity prediction and prognosis of anti-gbm nephritis based on t lymphocyte subset ratios |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489752/ https://www.ncbi.nlm.nih.gov/pubmed/34595959 http://dx.doi.org/10.1177/20587384211039391 |
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