Kidney Week

Abstract: FR-PO850

Study of T-Regulatory Cells and B-Regulatory Cells in Lupus Nephritis: A Prospective Observational Study

Session Information

• Glomerular Diseases: Immunology, Inflammation - I
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1202 Glomerular Diseases: Immunology and Inflammation

Authors

• Girimaji, Niveditha, Post Graduate Institute of Medical Education and Research,Chandigarh, Chandigarh, India

Niveditha Girimaji,

• Gupta, Krishan Lal L., Post Graduate Institute of Medical Education and Research,Chandigarh, Chandigarh, India

Krishan Lal L. Gupta,

• Ramachandran, Raja, Post Graduate Institute of Medical Education and Research,Chandigarh, Chandigarh, India

Raja Ramachandran,

• Rathi, Manish, Post Graduate Institute of Medical Education and Research,Chandigarh, Chandigarh, India

Manish Rathi,

• Rakha, Aruna, Post Graduate Institute of Medical Education and Research,Chandigarh, Chandigarh, India

Aruna Rakha,

• Sharma, Aman, Post Graduate Institute of Medical Education and Research,Chandigarh, Chandigarh, India

Aman Sharma,

• Duseja, Ritambhra Nada, Post Graduate Institute of Medical Education and Research,Chandigarh, Chandigarh, India

Ritambhra Nada Duseja,

Background

Studies in lupus nephritis(LN) have shown impairment in both T regulatory(Treg) number and function.The data on B regulatory (Breg) is limited in LN. We conducted a prospective observational study of Treg and Breg populations in LN and their trend after initiation of immunosuppression.

Methods

Study included 20 patients of treatment-naïve LN of ISN/RPS Class III(±V),IV(±V),V and 10 healthy controls(HC). Immunophenotyping was performed for peripheral blood mononuclear cell samples using flurochrome labelled monoclonal antibodies for identification of Tregs (CD3⁺CD4⁺CD25^hiCD127^loFoxP3⁺), Bregs (CD19 ⁺CD5 ⁺CD1d ^hiIL-10⁺), Immature cells (CD19⁺CD24^hi 38^hi) and B 10 cells (CD19⁺CD24^hiCD27⁺), each expressed as percentage of T and B cells.Each lymphocyte population was analysed at baseline, 2 and 6 months after initiation of immunosuppression. Regulatory cells between groups was analysed by Mann Whitney U test and within groups by Wilcoxon signed rank test and Freidman’s test, as applicable.

Results

Bregs were significantly decreased compared to HC at baseline (p =0.002). With immunosuppression, Bregs showed significant increase at 2 and 6 months (p=0.03). Bregs in responders showed an increasing trend at 2 and 6 months (p=0.05), while they did not in non-responders (p=0.247). The increase in Bregs did not significantly differ between different immunosuppressive regimens given. At baseline, Bregs in responders and non- responders were not significantly different. Immature cells and B10 cells were significantly higher compared to HC (p<0.001).Tregs did not differ significantly from HC and did not show significant increase at 2 and 6 months, in both responders and non-responders.

Conclusion

We observed that Breg populations in treatment-naïve LN were significantly reduced compared to HC and increased significantly with immunosuppression. Responders had a trend toward increase in Bregs over time, whereas non-responders did not.

Bregs in HC and LN