Comparative characteristics of immunological indicators in patients with immunoglobulin A nephropathy and immunemediated glomerulopathies

The objective of the study was to investigate the characteristics of immunological indicators in the peripheral blood of patients with primary immunoglobulin A nephropathy (IgAN) compared to those with immune-mediated glomerulopathies. The immunophenotypic characterization of cellular and humoral immunity in patients with IgAN showed that, alongside similar changes in the immunological indicators of peripheral blood that are characteristic of various immune-mediated glomerulopathies—specifically, a decrease in the level of CD3+CD4+ T-helper cells and an increase in CD3+CD8+ T-cells and CD3+CD4-CD8- T-cells. Patients with IgAN also exhibited an increase in the number of CD56+ NK cells, CD3+CD56+ TNK cells, and γδ T-lymphocytes expressing a cytotoxic phenotype. This represents a functional distinction compared to similar indicators in groups of patients with chronic glomerulonephritis, including focal segmental glomerulosclerosis and minimal change disease, lupus nephritis, and immunoglobulin A vasculitis.

1. Executive summary of the KDIGO 2025 Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV) / J. Floege [et al.] // Kidney Int. – 2025. – Vol. 108, No. 4. – P. 548–554. – DOI: 10.1016/j.kint.2025.04.003.

2. Иммуноглобулина А-нефропатия в белорусской когорте. Клинико-морфологические особенности, факторы, ассоциированные с неблагоприятным исходом / К. С. Комиссаров [и др.] // Клиническая нефрология. – 2022. – Т. 14, № 3. – С. 25–33. – DOI: 10.18565/nephrology.2022.3.25-33.

3. Time-varying proteinuria and progression of IgA nephropathy: a cohort study / C. Tang [et al.] // Am. J. Kidney Dis. – 2024. – Vol. 84, No. 2. – P. 170–178. – DOI: 10.1053/j.ajkd.2023.12.016.

4. Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases / B. H. Rovin [et al.] // Kidney Int. – 2021. – Vol. 100, No. 4. – P. 753–779. – DOI: 10.1016/j.kint.2021.05.015.

5. Возможность прогнозирования неблагоприятного течения идиопатической IgA-нефропатии на основе клинико-лабораторных и иммунологических показателей / М. Ю. Юркевич [и др.] // Лабораторная диагностика. Восточная Европа. – 2014. – № 3 (11). – С. 56–68.

6. Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group / H. Trimarchi [et al.] // Kidney Int. – 2017. – Vol. 91, No. 5. – P. 1014–1021. – DOI: 10.1016/j.kint.2017.02.003.

7. A new equation to estimate glomerular filtration rate / A. S. Levey [et al.] // Ann. Intern. Med. – 2009. – Vol. 150, No. 9. – P. 604–612. – DOI: 10.7326/0003-4819-150-9-200905050-00006.

8. The classification of glomerulonephritis in systemic lupus erythematosus revisited / J. Weening [et al.] // J. Am. Soc. Nephrol. – 2004. – Vol. 15, No. 2. – P. 241–250.

9. Ahn, W. Approach to diagnosis and management of primary glomerular diseases due to podocytopathies in adults: core curriculum 2020 / W. Ahn, A. S. Bomback // Am. J. Kidney Dis. – 2020. – Vol. 75, No. 6. – P. 955–964. – DOI: 10.1053/j.ajkd.2019.12.019.

10. Paul, S. Role of gamma-delta (γδ) T cells in autoimmunity / S. Paul, S. Giri, G. Lal // J. Leukoc. Biol. – 2015. – Vol. 97. – P. 259–271. – DOI: 10.1189/jlb.3RU0914-443R.

11. Crispín, J. C. Interleukin-17-producing T cells in lupus / J. C. Crispín, G. C. Tsokos // Curr. Opin. Rheumatol. – 2010. – Vol. 22. – P. 499–503. – DOI: 10.1097/BOR.0b013e32833c62b0.

12. Роль сывороточного иммуноглобулина Е у пациентов с иммуноглобулин А-нефропатией / К. С. Комиссаров [и др.] // Нефрология. – 2023. – Т. 27, № 2. – С. 47–56. – DOI: 10.36485/1561-6274-2023-27-2-47-56.