Clinical and Pathological Implications of Increases in Tonsillar CD19⁺CD5⁺ B Cells, CD208⁺ Dendritic Cells, and IgA1-positive Cells of Immunoglobulin A Nephropathy

Abstract

Objective

Several studies indicated that tonsillectomy can improve the prognosis of patients with immunoglobulin A nephropathy (IgAN). However, the relationship between tonsillar immunity and IgAN is still unclear.

Methods

A total of 14 IgAN patients were recruited in the current study from May 2015 to April 2016 in Tongji Hospital. B cells, dendritic cells (DCs), and IgA1 positive cells in human tonsils were detected using immunofluorescence and immunohistochemistry. Correlations between these cells and clinicopathologic features were evaluated.

Results

CD19⁺CD5⁺ B cells were predominantly located in germinal centers and mantle zones of lymphoid follicles, the CD208+ DCs were distributed in the interfollicular and subepithelial area, and IgA1-positive cells were predominantly detected in mantle zones of lymphoid follicles and subepithelial tissues. The numbers of CD19⁺CD5⁺ B cells, CD208⁺ DCs, and IgA1-positive cells in tonsillar tissues from IgAN patients were significantly higher than those in the normal controls (P<0.01, respectively). CD19⁺CD5⁺ B cells, CD208⁺ DCs, and IgA1-positive cells in tonsillar tissues were significantly associated with 24-h proteinuria levels and tubular atrophy/interstitial fibrosis of IgAN.

Conclusion

CD19⁺CD5⁺ B cells, CD208⁺ DCs, and IgA1-positive cells in tonsillar tissues might be involved in the pathogenesis of IgAN.

Keywords

IgA nephropathy / tonsil / B cells / dendritic cells / IgA1-positive cells

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