Glomerular CD8(+) cells predict progression of childhood IgA nephropathy

The aim of this study was to evaluate whether the infiltrating T-lymphocyte can be a predictor in the disease progression of IgA nephropathy (IgAN). T wenty children with IgAN, followed for more than 5 years, were divided into progressive (n=5) and non-progressive groups (n=15). We assessed glomerula r and interstitial infiltration of T-lymphocytes (CD4(+) and CD8(+) cells) and expression of a-smooth muscle actin (a-SMA) and transforming growth fac tor-beta (TGF-beta) using an indirect immunofluorescence method on the rena l biopsies. We analyzed their relationship to the degree of proteinuria, hi stological changes, and prognosis. The number of CD8(+) cells in glomeruli and in interstitium was higher in the progressive group than in the non-pro gressive group. The glomerular a-SMA staining was more intensive in the pro gressive group than in the non-progressive group. Urinary protein and the d egree of histological changes were also higher in the progressive group tha n in the non-progressive group. Among these markers, the number of glomerul ar CD8+ cells was the most apparent difference between the two groups. In c onclusion, these results indicate that the number of glomerular CD8(+) cell s is the most sensitive predictor of disease progression in childhood IgAN.