title: A higher frequency of CD4⁺CXCR5⁺ T follicular helper cells in adult patients with minimal change disease.
abstract: BACKGROUND
  T follicular helper (TFH) cells are involved in the humoral immune responses. This study is aimed at examining the frequencies of different subsets of CD4(+)CXCR5(+) TFH cells in adult patients with minimal change disease (MCD).
  
  
  METHODS
  A total of 27 patients and 14 healthy controls (HC) were characterized for the levels of sera cytokines, inducible T-cell costimulator (ICOS), and programmed death 1 (PD-1) of positive TFH cells by flow cytometry. The level of sera IL-21 was examined; 24 h urinary protein and eGFR were calculated. The potential correlation between the frequency of different subsets of TFH cells and the values of clinical measures in MCD patients were analyzed.
  
  
  RESULTS
  The frequency of circulating CD4(+)CXCR5(+), CD4(+)CXCR5(+)ICOS(+), and CD4(+)CXCR5(+)PD-1(+) TFH cells and the levels of sera IL-17A, IFN-γ, IL-2, IL-10, IL-4, and IL-21 were significantly higher in MCD patients (P < 0.05) than that in the HC group. Furthermore, the percentages of circulating CD4(+)CXCR5(+) TFH cells were negatively correlated with the values of eGFR (r = -0.4849, P < 0.05) and the percentages of CD4(+)CXCR5(+)PD-1(+) TFH cells were correlated positively with the levels of serum IL-21 (r = 0.6137, P < 0.05) and 24 h urinary protein (r = 0.1410, P < 0.05) in those patients. Also, the percentages of CD4(+)CXCR5(+)ICOS(+) TFH cells were correlated positively with the levels of serum IL-21 (r = 0.6201, P < 0.05) and 24 h urinary protein (r = 0.7519, P < 0.05). Following standard therapies, the percentages of circulating CD4(+)CXCR5(+), CD4(+)CXCR5(+)PD-1(+), and CD4(+)CXCR5(+)ICOS(+) TFH cells and the levels of serum IL-21 were significantly reduced, but the levels of serum IL-4 and IL-10 were increased (P < 0.05).
  
  
  CONCLUSIONS
  A higher frequency of CD4(+)CXCR5(+) TFH cells that existed in adult patients with MCD could be new target for intervention of MCD.
authors.affiliation: Key Laboratory of Zoonosis Research, Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Zoonosis Research, Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Pingwei
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Department of Pediatrics, First Affiliated Hospital of Jiamusi University, Jiamusi 154002, China.
authors.forename: Amrita
authors.identifier: 0000-0002-8721-6327
authors.initials: A
authors.lastname: Shrestha
authors.affiliation: Key Laboratory of Zoonosis Research, Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Zoonosis Research, Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Qu
authors.affiliation: Key Laboratory of Zoonosis Research, Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China ; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China.
authors.forename: Mingyuan
authors.initials: M
authors.lastname: Liu
authors.affiliation: Key Laboratory of Zoonosis Research, Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Songling
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Zoonosis Research, Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China ; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China.
authors.forename: Yanfang
authors.identifier: 0000-0002-2478-1521
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000737:chemistry / Q000166:cytology; D015704:CD4 Antigens / Q000097:blood*; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology*; D011239:Prednisolone / Q000627:therapeutic use; D054380:Receptors, CXCR5 / Q000097:blood*; D006377:T-Lymphocytes, Helper-Inducer / Q000737:chemistry* / Q000166:cytology; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D015704:CD4 Antigens; C095085:CXCR5 protein, human; D016207:Cytokines; D054380:Receptors, CXCR5; D011239:Prednisolone