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Abstract: FR-PO833

B Cell and Monocyte Phenotyping in IGA Nephropathy: A Quick Asset to Investigate the Immune Status in Patients with IGA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1202 Glomerular Diseases: Immunology and Inflammation

Authors

  • Sendic, Senka, Karolinska Institutet, Stockholm, Sweden
  • Mansouri, Ladan, Karolinska Institutet, Stockholm, Sweden
  • Lundberg, Sigrid, Danderyd Hospital, Stockholm, Sweden
  • Nopp, Anna, Karolinska Institutet, Stockholm, Sweden
  • Jacobson, Stefan H., Danderyd Hospital, Stockholm, Sweden
  • Lundahl, Joachim, Karolinska Institutet, Stockholm, Sweden
Background

IgA nephropathy (IgAN) is the most common glomerulonephritis. Naive and adaptive immune cells play a major role in the development and progression of disease, therefore unraveling a correlation between changes in the immune status of the patient and clinical outcomes is of great value. We aimed to investigate B cell and monocyte phenotype, comparing the IgAN patients with disease controls (patients with polycystic kidney disease) and healthy individuals.

Methods


IgAN patients (n = 13) were recruited from Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. Patients (men 46%,) with median age of 45 years (IQR 38-60), median eGFR of 57 ml/min x1.73m2 (IQR 42-84) and median urine albumin-to-creatinine ratio of 74 mg/mmol (IQR 18-116). Disease controls with polycystic kidney disease (n=13) were matched for eGFR, gender- and age (±10 years). Healthy controls (n = 13) were gender- and age-matched (±5 years) with patients. CD3+ cells were isolated from freshly separated peripheral blood mononuclear cells by positive selection using a magnetic cell sorting system. CD3+ and CD3- cells were then divided and stained for different subsets of B cells and analyzed by flowcytometry. Cytokines were analyzed by ELISA.

Results

We report an increase in the proportion of CD14+ CD16++ cells (non-classical monocytes) in patient with IgAN comparing to healthy individuals and disease controls. Decrease in the proportion of CD19+ CD27+ IgD+ cells (pre switched B), CD19+ CD27+ CD38+ cells (plasmablasts) in the peripheral circulation of IgAN patients. IgAN and disease control showed an increase in CD19- CD27hi CD38 hi (transitioned plasma cells). We report a higher proportion naïve/pre switched in IgAN patients compared to healthy- and disease controls. We report significantly higher IL-6 in IgAN compared to helathy controls.

Conclusion

The decrease in the number of circulatory pre-switched B cells and plasmablasts, but an increase of transitioned plasma cells in our study suggests trafficking of subsets of B cells in IgAN patients between peripheral blood and extravascular lymphoid tissues. The increase in the proportion of inflammatory monocytes in IgAN patients may play a role in the high inflammatory state and possible crosstalk between different sectors of the immune system through the IL-6 axis.