THE BALANCE OF PROINFLAMMATORY CYTOKINES AND TREG CELLS IN CHRONIC GLOMERULONEPHRITIS
- Natalia Chebotareva, Russian Federation
Abstract
Background and Aims
Chronic glomerulonephritis (CGN) with nephrotic syndrome (NS) is a disease with high activity of immune inflammation. An imbalance of proinflammatory and anti-inflammatory mediators may underlie the progression of CGN. Aim: to determine the clinical significance of the Th17, Th1, and Treg cytokines to assess the activity and progression of CGN.
Methods
The study included 98 patients with CGN. The laboratory data were compared with the clinical and histological features of nephritis activity. The levels of IL-6, IL-10, IL-17, tumor necrosis factor α (TNFα) in the urine were determined using ELISA. The number of FoxP3-positive cells in the inflammatory interstitial infiltrate of the cortical layer was determined using immunohistochemistry.
Results
There was an increase in the levels of Th17, Th1, and T reg cytokines in urine - TNFα and IL-10 in patients with CGN, compared with healthy individuals. An imbalance between the proinflammatory cytokines (TNF-α, IL-6 and IL-17A) and anti-inflammatory factors (IL-10 and Treg in the tissue) in patients with NS was demonstrated. There was a decrease in the number of T-reg cells in the interstitium of the kidney and a decrease in the production of IL-10 in CGN patients with NS, compared with patients without NS. The most pronounced changes in the cytokine profile were observed in patients with focal segmental glomerulosclerosis (FSGS).
Conclusions
The data indicate that cytokine imbalance was the most pronounced in the activation of IL-17 and TNF-α; a decrease in the regulatory anti-inflammatory link (Treg) in the kidney tissue was observed in FSGS, the most severe form of CGN.