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Clinical and Experimental Nephrology
Published in: Clinical and Experimental Nephrology 3/2019

Open Access 01-03-2019 | Review article

T cells in IgA nephropathy: role in pathogenesis, clinical significance and potential therapeutic target

Authors: Jakub Ruszkowski, Katarzyna A. Lisowska, Małgorzata Pindel, Zbigniew Heleniak, Alicja Dębska-Ślizień, Jacek M. Witkowski

Published in: Clinical and Experimental Nephrology | Issue 3/2019

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Abstract

Background

Immunoglobulin A nephropathy (IgAN), the most frequent cause of primary glomerulonephritis worldwide, is an autoimmune disease with complex pathogenesis. In this review, we focus on T cells and summarize knowledge about their involvement in pathophysiology and treatment of IgAN

Methods

We reviewed the literature for (1) alterations of T cell subpopulations in IgAN, (2) experimental and clinical proofs for T cells’ participation in IgAN pathogenesis, (3) clinical correlations with T cell-associated alterations, and (4) influence of drugs used in IgAN therapy on T cell subpopulations.

Results

We found that IgAN is characterized by higher proportions of circulatory Th2, Tfh, Th17, Th22 and γδ T cells, but lower Th1 and Treg cells. We discuss genetic and epigenetic makeup that may contribute to this immunological phenotype. We found that Th2, Th17 and Tfh-type interleukins contribute to elevated synthesis of galactose-deficient IgA1 (Gd-IgA1) and that the production of anti-Gd-IgA1 autoantibodies may be stimulated by Tfh cells. We described the roles of Th2, Th17, Th22 and Treg cells in the renal injury and summarized correlations between T cell-associated alterations and clinical features of IgAN (proteinuria, reduced GFR, hematuria). We detailed the impact of immunosuppressive drugs on T cell subpopulations and found that the majority of drugs have nonoptimal influence on T cells in IgAN patients.

Conclusions

T cells play an important role in IgAN pathogenesis and are correlated with its clinical severity. Clinical trials with the drugs targeting the reported alterations of the T-cell compartment are highly desirable.
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Metadata
Title
T cells in IgA nephropathy: role in pathogenesis, clinical significance and potential therapeutic target
Authors
Jakub Ruszkowski
Katarzyna A. Lisowska
Małgorzata Pindel
Zbigniew Heleniak
Alicja Dębska-Ślizień
Jacek M. Witkowski
Publication date
01-03-2019
Publisher
Springer Singapore
Published in
Clinical and Experimental Nephrology / Issue 3/2019
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-018-1665-0

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