Background Henoch-Schönlein Purpura (HSP) is the most frequent vasculitis of childhood and mainly affects vessels of the skin, gastrointestinal system and kidneys. Kidney involvement is an important factor for morbidity and affects about 1/3 of the patients. Recently the role of Th1 on autoimmune diseases was challenged by the discovery of another subgroup of CD4+ T cells, namely Th17 cells. There has been increasing evidence for the role of Th17 cells in a number of rheumatic and autoimmune diseases.
Objectives The aim of the study is to investigate the role of Th17 cells in the pathogenesis of HSP nephritis.
Methods We retrospectively studied the renal biopsies of 23 HSP patients with nephritis; who were admitted to our university hospital and biopsied in the last 30 years. Patient files were retrospectively analysed for clinical and laboratory data. On kidney biopsy sections, crescent formation was investigated. The glomeruler and tubuler frequency and intensity of IL-17 were determined by immunohistochemical analyses of kidney sections.
Results Out of 23 HSP patients, 13 patients were female and 10 patients were male. Mean age of diagnosis was 10.0±3.4 years (minimum 4, maximum 15.8). Proteinuria at the time of kidney biopsy correlated with the glomerular extent and intensity of IL-17 (rs:0.62, p: <0.05 and 0.67, p: <0.05, respectively). Furthermore the glomerular intensity and extent of IL17 correlated with crescent formation (rs: 0,52, p: 0.018; rs: 0,69, p: 0.001, respectively).
Conclusions This is the first study suggesting that IL17 participates in the glomerular injury and that is maybe important in determining the severity of kidney disease in HSP.
Turner JE, Paust HJ, Steinmetz OM, Panzer U. The Th17 immune response in renal inflammation. Kidney Int 2010; 77: 1070-1075
Ooi JD, Kitching AR, Holdsworth SR. Review: T helper 17 cells: their role in glomerulonephritis. Nephrology (Carlton) 2010; 15: 513-521
Disclosure of Interest None Declared