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J Nephropathol. 2016;5(3): 105-110.
doi: 10.15171/jnp.2016.19
PMID: 27540538
PMCID: PMC4961819
Scopus ID: 84978933468
  Abstract View: 3823
  PDF Download: 1693

Original Article

Value of Foxp3 expressing T-regulatory cells in renal tissue in lupus nephritis; an immunohistochemical study

Marwa M Shakweer 1*, Maha Behairy 2, Nadia G Elhefnawy 1, Tamer W Elsaid 2

1 Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
*Corresponding Author: *Corresponding author: Marwa Mosaad Shakweer, Department of pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Email: shakweer_13@yahoo.com

Abstract

Background: Forkhead box P3 (Foxp3) functions as a master regulator in the development and function of T-regulatory (Treg) cells. Recent studies have shown that autoimmune diseases including systemic lupus erythematosus (SLE) are associated with an imbalance with the Treg cells and T helper (Th) subtypes.

Objectives: To evaluate immunohistochemical expression of Foxp3 positive Treg cells in lupus nephritis (LN) and analyze its association with clinicopathologic parameters. 

Materials and Methods: Renal biopsy specimens of 50 patients with LN were studied. Specimens were divided into; group A; 25 LN cases without proliferative activity (Class II and V) and group B: 25 cases with proliferative activity (Class III and IV). Immunohistochemical staining for anti-human Foxp3 antibody and grading from grade 0 to grade 3 was done. Results: Foxp3 expression in group A was (grade 0 in 14 [56.0%], grade +1 in 11 [44.0 %]) in comparison to group B (grade +1 in 6 [24.0%], grade +2 in 11 [44.0%] and grade +3 in 8 [32.0%]) (P < 0.001). Foxp3 expression was significantly correlated to National Institutes of Health (NIH) activity and chronicity indices (P < 0.05), as well as serum creatinine (P < 0.01) in both groups A and B and there was a highly significant correlation with proteinuria (P < 0.01) in group B with proliferative LN.

Conclusions: Immunohistochemical Foxp3 expression in renal tissue was higher in proliferative versus non-proliferative LN and is associated with activity and severity of LN. Further studies are needed to determine its prognostic value in LN.


Implication for health policy/practice/research/medical education:

T regulatory (Treg) cells are an important subset of T cells with important immunomodulatory effects. Foxp 3 is a key transcription factor of Treg cells. Its immunohistochemical expression has been shown to correlate with a number of clinical and histological parameters in a number of immune-mediated diseases. It is important to analyze the role of these cells in lupus nephritis, which is one of the common immune-mediated disorders. This study shows that this marker is highly expressed in proliferative lupus nephritis and correlated with NIH activity and chronicity indices indicating that Treg cells are implicated in disease progression.

Please cite this paper as: Shakweer MM, Behairy M, Elhefnawy NG, Elsaid TW. Value of Foxp3 expressing T-regulatory cells in renal tissue in lupus nephritis; an immunohistochemical study. J Nephropathol. 2016;5(3):105-110. DOI: 10.15171/jnp.2016.19

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ePublished: 02 Jul 2016
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