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International Journal of Nephrology
Volume 2017 (2017), Article ID 3095425, 13 pages
https://doi.org/10.1155/2017/3095425
Research Article

Analysis of T Cell Subsets in Adult Primary/Idiopathic Minimal Change Disease: A Pilot Study

1Tregs and HLA Research Force, Singapore General Hospital, The Academia, 20 College Road, Singapore 169856
2Renal Medicine Department, Singapore General Hospital, The Academia, 20 College Road, Singapore 169856
3Department of Pathology, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074
4Kompetenznetz Vorhofflimmern e.V. (AFNET), Münster, Germany
5Singapore Immunology Network (SIGN), Agency for Science, Technology and Research (ASTAR), Biopolis, Singapore
6Department of Pathology and Laboratory Medicine, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899
7Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, The Academia, 20 College Road, Singapore 169856
8Department of Pathology, Singapore General Hospital, The Academia, 20 College Road, Singapore 169856

Correspondence should be addressed to Francisco Salcido-Ochoa

Received 16 March 2017; Revised 15 May 2017; Accepted 14 June 2017; Published 15 August 2017

Academic Editor: Jochen Reiser

Copyright © 2017 Francisco Salcido-Ochoa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To characterise infiltrating T cells in kidneys and circulating lymphocyte subsets of adult patients with primary/idiopathic minimal change disease. Methods. In a cohort of 9 adult patients with primary/idiopathic minimal change recruited consecutively at disease onset, we characterized (1) infiltrating immune cells in the kidneys using immunohistochemistry and (2) circulating lymphocyte subsets using flow cytometry. As an exploratory analysis, association of the numbers and percentages of both kidney-infiltrating immune cells and the circulating lymphocyte subsets with kidney outcomes including deterioration of kidney function and proteinuria, as well as time to complete clinical remission up to 48 months of follow-up, was investigated. Results. In the recruited patients with primary/idiopathic minimal change disease, we observed (a) a dominance of infiltrating T helper 17 cells and cytotoxic cells, comprising cytotoxic T cells and natural killer cells, over Foxp3+ Treg cells in the renal interstitium; (b) an increase in the circulating total CD8+ T cells in peripheral blood; and (c) an association of some of these parameters with kidney function and proteinuria. Conclusions. In primary/idiopathic minimal change disease, a relative numerical dominance of effector over regulatory T cells can be observed in kidney tissue and peripheral blood. However, larger confirmatory studies are necessary.