Journal Article

Th1/Th2 predominance and proinflammatory cytokines determine the clinicopathological severity of IgA nephropathy

Chun Soo Lim, Shouhuan Zheng, Yon Su Kim, Curie Ahn, Jin Suk Han, Suhnggwon Kim, Jung Sang Lee, Dong‐Wan Chae, Ja Ryong Koo, Roh Won Chun and Jung Woo Noh

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 2, pages 269-275
Published in print February 2001 | ISSN: 0931-0509
Published online February 2001 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/16.2.269
Th1/Th2 predominance and proinflammatory cytokines determine the clinicopathological severity of IgA nephropathy

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Background. IgA nephropathy is one of the most common forms of primary glomerulonephritis in adults. Its pathogenesis is complex. The nature of infiltrating and proliferating cells and of cellular mediators could contribute to the progression of IgA nephropathy towards end‐stage renal failure.

Methods. To evaluate this hypothesis, we attempted to quantify the magnitude of intrarenal gene expression of various cytokines (IL‐1β, TNF‐α, IL‐6, IL‐15, IL‐2, IFN‐γ, IL‐10) and chemokines (IL‐8, RANTES, MCP‐1) in 48 renal core biopsy specimens, diagnosed as IgA nephropathy by immunofluorescence microscopy. Semi‐quantitative reverse‐transcriptase polymerase chain reaction using internal competitors was used for the quantification of gene transcripts.

Results. The expression of intrarenal gene transcripts of various cytokines and chemokines was closely interrelated, but not associated with the pathological grading system. The IFN‐γ/IL‐10 ratio was higher in patients with renal dysfunction than in those with normal renal function (P=0.0483). Gene transcript levels of proinflammatory cytokines were related to the amount of proteinuria. In patients with severe glomerular sclerosis, the ratio of IFN‐γ/IL‐10 gene transcripts was high (P=0.04). IL‐10 gene transcript level was related to the severity of tubulointerstitial damage. The levels of gene expression of IL‐10 (P=0.009), IFN‐γ (P=0.03), and TNF‐α (P=0.005) were related to the degree of mesangial matrix expansion and the extent of intrarenal arteriolar changes correlated with the expression of the IL‐8 gene transcript (r=0.43, P=0.004).

Conclusions. We propose that Th1/Th2 predominance and the level of proinflammatory cytokines could determine the pathogenetic processes and the severity of the clinical manifestations of IgA nephropathy.

Keywords: cytokine; IgA nephropathy; interferon‐γ; interleukin‐8; interleukin‐10; semi‐quantitative reversetranscriptase polymerase chain reaction

Journal Article.  4125 words. 

Subjects: Nephrology

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