Background and aims
In this observational cohort study, we assessed the prognostic value of DC‐SIGN+ cells in the pathogenesis and progression of IgA nephropathy (IgAN).
Methods and results
A total of 139 adult IgAN patients were enrolled into this study from June 2009 to June 2010. We characterised DC‐SIGN+ cells by immunohistochemistry or immunofluorescence in renal biopsy tissue. Correlations between the DC‐SIGN, intercellular adhesion molecule 3 (ICAM‐3), CD4 and CD8 were evaluated. Patients were classified into the DC‐SIGNhigh and DC‐SIGNlow groups. Depending on an average of 100‐month follow‐up, the predictive value of DC‐SIGN+ cells in IgAN progression was analysed. DC‐SIGN+ cells were found frequently in IgAN kidneys while rarely observed in normal kidneys, and almost all DC‐SIGN+ cells expressed MHC‐II. We also found that DC‐SIGN+ cells were adjacent to ICAM‐3‐positive CD4+ and CD8+ lymphocytes. The density of DC‐SIGN+ cells was positively and linearly correlated with the density of ICAM‐3+ cells, CD4+ cells and CD8+ cells in renal biopsy tissues. In the DC‐SIGNhigh group, the degree of renal lesion and inflammatory cell infiltration was more severe compared to the DC‐SIGNlow group. Patients in the DC‐SIGNhigh group also had increased incidences of deteriorating renal function during the follow up compared to patients in the DC‐SIGNlow group.
Conclusions
DC‐SIGN+ cells probably served as a potential contributor to exacerbate local inflammatory response. The density of DC‐SIGN+ cells was associated with the severity of renal lesions of the patients. High renal DC‐SIGN+ cell density might be used as a predictor of poor prognosis in patients with IgAN.