Skip to main content

ORIGINAL RESEARCH article

Front. Immunol.
Sec. T Cell Biology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1474377

Higher density of CD4+T cells infiltration predict severe renal lesions and renal function decline in patients with diabetic nephropathy

Provisionally accepted
qian qian Han qian qian Han *Huan Xu Huan Xu Lin Li Lin Li Song Lei Song Lei yao Zi Li yao Zi Li Lijun Zhao Lijun Zhao Fang Liu Fang Liu *
  • West China Hospital, Sichuan University, Chengdu, China

The final, formatted version of the article will be published soon.

    Background: More evidence showed that the combination of immune and inflammatory mechanism was critical in diabetic nephropathy (DN). But the relationship between CD4 +T cells and the development of DN is still unclear. Therefore, this study will focus on this issue from the perspective of clinicopathology. Methods: From September 2019 to December 2022, a total of 112 adult patients with DN were enrolled in the study. According to the density of CD4+T cells infiltration based on immunostaining, patients were divided into high-CD4 group (56 patients) and low-CD4 group (56 patients). Another 25 diabetic patients with minimal change disease (non-diabetic nephropathy, NDN) was reviewed as control group in clinical and molecular analysis. The clinical parameters, morphological features and molecular characteristics were compared. The predictive value of CD4+T cells for DN prognosis was also investigated. Results: DN patients in high-CD4 group suffered higher proteinuria and lower estimated glomerular filtration rate (eGFR) level than those in low-CD4 group and NDN patients. Renal biopsy in high-CD4 group presented with more severe glomerular lesions, higher density of interstitial inflamation and more severe tubular atrophy/interstitial fibrosis than in low-CD4 group. Multivariate logistic analysis indicated that the density of CD4 +T cell infiltration could independently predict the severity of tubular atrophy/interstitial fibrosis. In addition, more severe mitochondrial damage of renal tubular epithelial cells and more obvious expression of Bcl6, IL-6, STAT3 and TGFβ1 were observed in DN patients of high-CD4 group, indicating the possible mechanism of CD4+T cells involving in the progression of DN. Multivariate Cox regression analysis revealed that higher intensity of interstitial CD4+T cells deposition remained as an independent predictor of the double endpoint with doubling of baseline serum creatinine or end-stage renal disease. Conclusion: The high density of CD4+T cells infiltration was associated with renal function decline, severity of renal lesions and predicted a poor renal survival for DN patients.

    Keywords: diabetic nephropathy, CD4+T cells, Tubular atrophy, interstitial fibrosis, Clinicopathological analysis

    Received: 01 Aug 2024; Accepted: 04 Nov 2024.

    Copyright: © 2024 Han, Xu, Li, Lei, Li, Zhao and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    qian qian Han, West China Hospital, Sichuan University, Chengdu, China
    Fang Liu, West China Hospital, Sichuan University, Chengdu, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.