THE ROLE OF COMPLEMENT RECEPTOR CR4-POSITIVE MACROPHAGES IN ENDOCAPPILLALY PROLIFERATIVE GLOMEULAR LESIONS OF CHRONIC GLOMERULONEPHRITIS

 

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https://storage.unitedwebnetwork.com/files/1099/8dac8f34e81b407a4eb9316689248d4b.pdf
THE ROLE OF COMPLEMENT RECEPTOR CR4-POSITIVE MACROPHAGES IN ENDOCAPPILLALY PROLIFERATIVE GLOMEULAR LESIONS OF CHRONIC GLOMERULONEPHRITIS

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Tomomi
Kondoh
Tomomi Kondoh tomomi-h@fujita-hu.ac.jp Fujita Health University School of Medicine Department of Pediatrics Toyoake Japan *
Takuma Ando tkm10007@gmail.com Fujita Health University School of Medicine Department of Pediatrics Toyoake Japan -
Yuji Matsumoto ymatsumo@fujita-hu.ac.jp Fujita Health University School of Medicine Department of Pediatrics Toyoake Japan -
Naonori Kumagai nkumagai-npr@umin.ac.jp Fujita Health University School of Medicine Department of Pediatrics Toyoake Japan -
Yohei Ikezumi ikezumi@fujita-hu.ac.jp Fujita Health University School of Medicine Department of Pediatrics Toyoake Japan -
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Recent studies have revealed that complement activation plays a key role in various forms of chronic proliferative glomerulonephritis (GN), and complement inhibitors targeting different points along the activation cascade have shown therapeutic efficacy. We previously reported that activated macrophages (MΦs) are critically involved in the pathogenesis of proliferative GN. In this study, we examined the role of complement receptor CR4 (CD11c/CD18)-positive activated MΦs in different types of proliferative GN.

Renal biopsy from patients diagnosed with proliferative GN, including IgA nephropathy (IgAN; n = 48), IgA vasculitis-associated nephritis (IgAV-N; n = 25), lupus nephritis (LN; grade III or higher; n = 18), and membranoproliferative GN (MPGN; n = 9). To evaluate glomerular accumulation of CD11c+ MΦ, multiplex immunostaining using antibodies against CD11c, CD68 (pan-macrophage marker), and CD86 (M1 activation marker) was performed, and the association with clinicopathological findings was analyzed.

The mean number of CD11c+ MΦs per glomerular cross-section was 1.1 in IgAN, 3.4 in IgAV-N, 9.0 in LN, and 3.9 in MPGN. A significant positive correlation was observed between CD11c+ MΦ count and both proteinuria (g/gCr) and the percentage of glomeruli exhibiting endocapillary proliferation across all disease groups (IgAN: p < 0.001; IgAV-N: p < 0.001; LN: p < 0.01; MPGN: p < 0.05). Notably, all CD11c+ MΦs were also positive for CD86, indicating M1-type activation.

CR4 (CD11c/CD18)+ MΦs exhibit M1-type inflammatory activation and are likely to contribute to the development of acute and active glomerular lesions in proliferative GN. These findings suggest that CR4+ MΦs may serve as potential therapeutic targets in complement-mediated glomerular diseases.

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