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. 2019 Apr 2:7:114.
doi: 10.3389/fped.2019.00114. eCollection 2019.

Pediatric Patients With Steroid-Sensitive Nephrotic Syndrome Have Higher Expression of T Regulatory Lymphocytes in Comparison to Steroid-Resistant Disease

Fabio Tadeu Lourenço Guimarães  1 , Rodrigo Novaes Ferreira  2 , Gustavo Eustáquio Alvim Brito-Melo  1 , Etel Rocha-Vieira  1 , Wagner de Fátima Pereira  1 , Sérgio Veloso Brant Pinheiro  3 , Aline Silva Miranda  2   4 , Ana Cristina Simões E Silva  3   4
Affiliations

Pediatric Patients With Steroid-Sensitive Nephrotic Syndrome Have Higher Expression of T Regulatory Lymphocytes in Comparison to Steroid-Resistant Disease

Fabio Tadeu Lourenço Guimarães et al. Front Pediatr. .

Abstract

Background and Aim: Idiopathic nephrotic syndrome (INS) is classified according to the response to drug therapy in steroid-sensitive (SS), steroid-dependent (SD), and steroid-resistant (SR) categories. Previous studies showed changes in inflammatory activity of subpopulations of lymphocytes in INS. This study aimed to compare SS and SR patients in regard to subpopulations of leukocytes, profile of regulatory lymphocytes, and migratory activity of lymphocyte subpopulations. Results obtained in INS patients were also compared to age and sex-matched healthy controls. Methods: This is a cross-sectional study including SS patients (n = 30), SR patients (n = 14), and controls (n = 10). Peripheral blood samples were withdrawn for ex-vivo leukocyte flow cytometry analysis. Results: Percentage of B-lymphocytes and natural killer (NK) cells were significantly reduced in SR patients when compared to controls, while the percentage of NKT cells were decreased in SS patients in comparison to controls. Percentages of CD4+ expressing FoxP3 and CTLA4 were significantly higher in SS patients in comparison to SR patients and controls. The expression of integrin CD18 on the surface of T lymphocytes (CD3+) was reduced in SS patients if compared to controls. Conclusion: This study found that SS INS patients have higher levels of regulatory T-lymphocytes and lower expression of adhesion molecules than SR patients.

Keywords: chemokines; flow cytometry; integrins; nephrotic syndrome; regulatory T cells.

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Figures

Figure 1
Figure 1
Analysis of cellular balance in peripheral blood lymphocytes of health controls and children with INS steroid-sensitive (SS) and steroid-resistant (SR): (A) percentage of B-lymphocytes (CD3−CD19+), (B) NKT (CD3+CD56+), and (C) NK (CD3−CD56+) suggestive cells. Results are expressed as bar graphs with mean values and standard deviation. P-values are displayed above lines that indicate each comparison.
Figure 2
Figure 2
Analysis of regulatory T cells in peripheral blood lymphocytes of health controls and children with INS steroid-sensitive (SS) and steroid-resistant (SR): (A) TCD4+FoxP3+ lymphocytes and (B) TCD4+CTLA-4+ lymphocytes. Results are expressed as bar graphs with mean values and standard deviation. P-values are displayed above lines that indicate each comparison.
Figure 3
Figure 3
Analysis of the expression of CD18 on T lymphocytes and subpopulations in peripheral blood lymphocytes of health controls and children with INS steroid-sensitive (SS) and steroid-resistant (SR): (A) CD3+CD18+ lymphocytes; (B) CD3+CD8+CD18+ lymphocytes; (C) CD3+CD4+CD18+ lymphocytes. Results are expressed as bar graphs with mean values and standard deviation. P-values are displayed above lines that indicate each comparison.
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