Predominance of CD8+ T lymphocytes among periglomerular infiltrating cells and link to the prognosis of class III and class IV lupus nephritis.
OBJECTIVE
Recent studies have revealed a potential implication of CD8+ T lymphocytes in the pathogenesis of systemic lupus erythematosus (SLE) through their ability to induce tissue damage. The aim of the present study was to analyze the localization of CD8+ cells in the kidneys of patients with class III and class IV lupus nephritis and to establish correlations with histologic, biologic, and clinical features of SLE.


METHODS
Twenty-five consecutive SLE patients with class III or class IV lupus nephritis were enrolled. Phenotype analyses of blood lymphocytes and renal immunohistochemistry studies were performed.


RESULTS
CD8+ T cells were the predominant kidney-infiltrating subset of cells. The mean +/- SD numbers of CD8+ T cells and CD4+ T cells were 66.2 +/- 65.2/mm(2) and 19.3 +/- 29.4/mm(2), respectively. There was a significant correlation between the percentage of blood CD3+,CD8+,DR+ cells and the total number of renal CD8+ T cells (r = 0.42, P = 0.039). Renal CD8+ T cell infiltration correlated well with the renal activity index (r = 0.63, P = 0.0007) and with high serum creatinine levels (r = 0.75, P = 0.0001). This CD8+ T cell infiltrate, which was predominantly in the periglomerular area, was correlated with cellular crescents and Bowman's capsule rupture and was associated with a poor response after conventional induction therapy.


CONCLUSIONS
CD8+ T lymphocytes infiltrate the periglomerular area in patients with severe (class III and class IV) lupus nephritis and are linked to a poor outcome after induction therapy. These results reveal a new potential effector pathway operant in lupus nephritis.
Couzi
Lionel
L
CHU, and UMR-CNRS 5164, Université Victor Segalen Bordeaux 2, Bordeaux, France.
Merville
Pierre
P
Deminière
Colette
C
Moreau
Jean-François
JF
Combe
Christian
C
Pellegrin
Jean-Luc
JL
Viallard
Jean-François
JF
Blanco
Patrick
P
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D006417:Hematuria / Q000276:immunology / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000276:immunology / Q000473:pathology; D007678:Kidney Glomerulus / Q000276:immunology* / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000473:pathology; D008181:Lupus Nephritis / Q000276:immunology* / Q000473:pathology; D018655:Lymphocyte Count; D008297:Male; D009404:Nephrotic Syndrome / Q000276:immunology / Q000473:pathology; D011379:Prognosis