Stem cell mobilization in idiopathic steroid-sensitive nephrotic syndrome

作者：Lapillonne Helene; Leclerc Annelaure; Ulinski Tim; Balu Laurent; Garnier Arnaud; Dereuddre Bosquet Nathalie; Watier Herve; Schlageter Marie Helene; Deschenes Georges^*

来源：Pediatric Nephrology, 2008, 23(8): 1251-1256.

DOI：10.1007/s00467-008-0793-2

• pediatrics
• lymphocytes
• thymus
• progenitors

Steroid-sensitive nephrotic syndrome (SSNS) is classically thought to be a T-cell disorder. The aim of this study was to examine whether or not thymus homeostasis was affected in SSNS. Mature and naive T cell recent thymic emigrants were quantified in the peripheral blood of nephrotic patients and controls. Because the generation of new T cells by the thymus ultimately depends on hematopoietic stem cells, CD34+ cells were also included in the study. Nineteen patients with SSNS during relapse, 13 with SSNS during proteinuria remission, and 18 controls were studied. Cell- surface markers (CD3, CD4, CD8, CD19, CD16, CD56, CD45RA, CD62L, CD34, and CD38) were analyzed by flow cytometric analysis. T-cell rearrangement excision circles ( TRECs) were quantified in CD2+ cells by real- time polymerase chain reaction. Stroma cell- derived factor-1 (SDF-1) genotype and metalloproteinase- 9 ( MMP- 9) plasma levels were also determined. Mature T cells (CD4+ and CD8+), circulating naive T cells (CD62L+ and CD3+ CD62L+), and recent thymic emigrants (CD45RA+) as well as TRECs, that measure thymus production, had a similar level in the three groups of patients. Conversely, CD34+ hematopoietic stem cells displayed a two- fold increase in SSNS patients during relapse either compared with controls or SSNS patients at remission. In addition, compared with controls, SSNS patients at remission displayed (1) a decrease in CD19+ cells (B cells) and (2) an increase in CD16CD56+ cells [natural killer (NK) cells]. In conclusion, thymus homeostasis is not significantly affected in nephrotic patients. Hematopoietic stem-cell mobilization at proteinuria relapse, as well as changes in B and NK cells during remission, suggest that SSNS might be due to a general disturbance of hematopoietic and immune cell trafficking.

• 出版日期2008-8
• 单位中国地震局