High renal DC‐SIGN+ cell density is associated with severe renal lesions and poor prognosis in patients with Immunoglobulin A Nephropathy

Abstract

Background and objectives

In this observational cohort study, we assessed the prognostic value of DC‐SIGN⁺ cells in pathogenesis and progression of IgA nephropathy (IgAN).

Design, setting, participants, & measurements

A total of 139 adult IgAN patients were enrolled in this study from June 2009 to June 2010. We characterized DC‐SIGN⁺ cells by immunohistochemistry or immunofluorescence in renal biopsy tissue. Correlations between the DC‐SIGN, ICAM‐3, CD4, and CD8 were evaluated. Patients were classified into the DC‐SIGN^high and DC‐SIGN^low group. Depending on a 100‐month follow‐up, the predictive value of DC‐SIGN⁺ cells in IgAN progression was analyzed.

Results

DC‐SIGN⁺ cells were found popular in IgAN kidneys while rarely observed in normal kidneys and almost all of DC‐SIGN⁺ cells expressed MHCII. We also found DC‐SIGN+ cells were adjacent to ICAM‐3 positive CD4⁺ and CD8⁺ lymphocytes. The density of DC‐SIGN⁺ cells was positively and linearly correlated with the density of ICAM‐3⁺ cells, CD4⁺ cells, CD8⁺ cells in renal biopsy tissues. In DC‐SIGN^high group, the degree of renal lesion and inflammatory cells infiltration were severer compared to DC‐SIGN^low group. Patients in DC‐SIGN^high group also had increased incidences of descending renal function over a 100‐month follow‐up compared to patients in DC‐SIGN^low group.

Conclusions

DC‐SIGN⁺ cells probably served as a potential contributor to exacerbate local inflammatory response. The density of DC‐SIGN⁺ cells was associated with severity of renal lesions of the patients. High renal DC‐SIGN+ cell density DC‐SIGN⁺ cells might be used as a predictor factor of poor prognosis in patients with IgAN.

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