T-Regulatory Cells and B-Regulatory Cells in Lupus Nephritis

Previous studies in patients with lupus nephritis have shown impairment in both the number and function of T-regulatory cells. Data on B-regulatory cells are limited in that patient population. Researchers at the Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India, conducted a prospective observational study of T-regulatory and B-regulatory populations in lupus nephritis as well as their trend following initiation of immunosuppression.

The cohort included 20 treatment-naïve patients with lupus nephritis of ISN/RPS (International Society of Nephrology/Renal Pathology Society) class III, IV, and V and 10 healthy controls. T-regulatory cells, B-regulatory cells, immature cells, and B 10 cells were identified using immunophenotyping for peripheral blood mononuclear cell samples using flurochrome labelled monoclonal antibodies, each expressed as a percentage of T and B cells. Lymphocyte population was assessed at baseline, 2 months, and 6 months following initiation of immunosuppression.

At baseline, B-regulatory cells were significantly decreased in patients with lupus nephritis compared with the healthy controls. At 2 and 6 months after initiation of immunosuppression, B-regulatory cells showed significant increase (P=0.03). B-regulatory cells in responders showed an increasing trend at 2 and 6 months after immunosuppression therapy initiation (P=0.05) compared with no increasing trend observed in nonresponders (P=0.247). B-regulatory cells were not significantly different at baseline in responders and nonresponders.

Compared with healthy controls, immature cells and B10 cells were significantly higher (P<0.001) in patients with lupus nephritis. There were no significant differences in T-regulatory cells between healthy controls and patients with lupus nephritis. There was no significant increase in T-regulatory cells at 2 months and 6 months after initiation of immunosuppression in both responders and nonresponders.

In conclusion, the researchers said, “We observed that B-regulatory populations in treatment-naïve lupus nephritis were significantly reduced  compared to health controls and increased significantly with immunosuppression. Responders had a trend toward increase in B-regulatory cells over time, whereas nonresponders did not.”

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Source: Girimaji N, Gupta KLL, Ramachandran R, et al. Study of T-regulatory cells and B-regulatory cells in lupus nephritis: A prospective observational study. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2019 (Abstract FR-PO850), November 8, 2019, Washington, DC.