Oxidative stress and macrophage infiltration in IgA nephropathy

Caliskan Y., Demir E., Karatay E., Ozluk Y., Mirioglu Ş., Dirim A. B., ...More

JOURNAL OF NEPHROLOGY, no.4, pp.1101-1111, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1007/s40620-021-01196-7
  • Journal Name: JOURNAL OF NEPHROLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.1101-1111
  • Keywords: IgA nephropathy, Inflammation, Kidney disease, Macrophages, Oxidative stress, IMMUNOGLOBULIN-A NEPHROPATHY, GALACTOSE-DEFICIENT IGA1, OXFORD CLASSIFICATION, COMPLEMENT ACTIVATION, GLOMERULAR DEPOSITION, IMMUNE-COMPLEXES, CIRCULATING IGA, PROGRESSION, VALIDATION, GLYCOSYLATION
  • Istanbul University Affiliated: Yes

Abstract

Background The aim of this study was to evaluate the interactions among serum levels of galactose-deficient IgA1 (GdIgA1), oxidative stress and macrophage infiltration and their clinical correlates in patients with IgA Nephropathy (IgAN). Methods A total of 47 patients with biopsy-proven primary IgAN, aged between 16 and 79 years, with a follow-up period >= 1 year or who showed progression to end stage kidney disease (ESKD) regardless the duration of follow-up were included. Study endpoint was the progression to ESKD. Serum Gd-IgA1 and advanced oxidation protein product (AOPP) levels were measured using ELISA assays. Kidney biopsies were evaluated according to the Oxford MEST-C scoring, with C4d and CD68 staining. Results Seventeen patients (36%) experienced ESKD during a median follow-up time of 6 years (IQR 3.7-7.5). Serum AOPP levels were correlated with the intensity of glomerular C3 deposition (r = 0.325, p = 0.026), glomerular (r = 0.423, p = 0.003) and interstitial CD68 + cell count (r = 0.298, p = 0.042) and Gd-IgA1 levels (r = 0.289, p = 0.049). Serum Gd-IgA1 levels were correlated with the intensity of C3 deposition (r = 0.447, p = 0.002). eGFR at biopsy (adjusted HR ( aHR) 0.979 p = 0.011), and E score ( aHR, 8.305, p = 0.001) were associated with progression to ESKD in multivariate analysis. 5-year ESKD- free survival rate was significantly lower in patients with higher E score compared to patients with E score 0 [p = 0.021]. Conclusions An increased number of macrophages in the glomerular and tubulointerstitial area may play a role in oxidative stress and complement system activation. Endocapillary hypercellularity is a predictive factor for poor prognosis in IgAN.