Background Kidney involvement, especially class IV nephritis, has a large impact on the morbidity and mortality of lupus patients.
Objectives We aimed to understand the role of Th17 and Th1 cells in the pathogenesis and severity of lupus nephritis.
Methods We retrospectively studied the renal biopsies of systemic lupus erythematosus (SLE) patients with nephritis class II, III and IV; who were admitted to our university hospital and biopsied in the last 20 years. The glomeruler and tubuler frequency and intensity of IFN-gama and IL-17 were determined by immunohistochemical analyses of kidney sections. Patient files were analysed for clinical and laboratory data and SLE Disease Activity Index (SLEDAI) scores.
Results Out of 39 patients, 6 (15,38%) were males. 14 of the patients had class II and III lupus nephritis and 25 had class IV. The mean age of diagnosis was 12,5±2,7 years (range 6-17). The SLEDAI score and the level of anti-ds DNA before treatment were higher among the patients with Class IV nephritis compared to classes II and III (p=0,033 and p=0,014, respectively). The glomerular and tubular immunohistochemical frequency and intensity of IL-17 and IFN gamma were statistically significant higher in class 4 nephritis when compared with class 2-3 nephritis group (p=0,00). There were negative correlations between the GFR of the subjects and the extent of both IL17 and IFN gamma. The intensity of the glomerular IL17 staining correlated with the IFN staining. There were also significant correlations between SLEDAI and the extent of the IL17 staining whereas there was a negative correlation between the extent of IFN and the complement 3 levels.
Conclusions The difference in the staining intensity between patients with class IV nephritis and those with milder involvement and the correlations with certain disease activity indices suggest that a Th17 and Th1 dominance may play a role in the progression of the kidney disease.
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Disclosure of Interest None Declared