Kidney Week

Abstract: SA-PO958

Effects of Rituximab on T Lymphocyte Subsets in the Treatment of Idiopathic Membranous Nephropathy and Its Significance

Session Information

• Glomerular Diseases: Translational Studies and Biomarkers
  November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

• Shen, Lei, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

Lei Shen,

• Zhang, Yuanyuan, Suzhou Hospital, Affiliated Hospital of Medical school, Nanjing Universtiy, Suzhou, Jiangsu, China

Yuanyuan Zhang,

• Yang, Jingjing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

Jingjing Yang,

• Sun, Jiani, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

Jiani Sun,

• Li, Jianzhong, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

Jianzhong Li,

Background

We studied T lymphocyte subsets in patients with idiopathic membranous nephropathy (IMN) and examined the impact and significance of rituximab (RTX) on these subsets.

Methods

We examined peripheral blood lymphocyte subsets in 58 patients with IMN and 25 normal controls by flow cytometry. We followed up the above indicators in 33 patients for 6 months after RTX administration. We also evaluated the changes of anti-PLA2R antibody titers and 24-hour urinary protein before and after treatment.

Results

1. Compared to the control group, peripheral blood CD3-CD19+B cells, CD3+ T cells, CD3+CD4+T cells, CD4+/CD8+, CD4+CD25+ T cells were significantly higher in IMN group before treatment(P<0.05). The levels of peripheral blood Treg cells (CD4+CD25+CD127^lo), CD3+CD8+ T cells in IMN group were lower(P<0.05).
2. After 6 months of RTX treatment, all the above abnormal indicators were reversed，especially Treg and CD4+CD25+ T cells(P<0.05)
3. Before and after RTX treatment, the changes of peripheral blood CD4+ T lymphocyte subsets of IMN patients were not correlated with B lymphocyte counts and anti-PLA2R antibody titers.

Conclusion

IMN patients exhibit an abnormality in T lymphocyte subsets, particularly in CD4+ T cell subsets. RTX could restore the balance of CD4+ T lymphocyte subsets and enhance the levels of Treg cells. Importantly, this effect is not solely dependent on B lymphocyte depletion or changes in anti-PLA2R antibody titers. These findings suggest that RTX may have a beneficial impact on cellular immunity in IMN patients.