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NDT Advance Access originally published online on November 22, 2007
Nephrology Dialysis Transplantation 2008 23(2):612-620; doi:10.1093/ndt/gfm595
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org


Immuno-histological analysis of dendritic cells in nasal biopsies of IgA nephropathy patients

Jan-Willem Eijgenraam1, Susanne M. Reinartz2, Sylvia W. A. Kamerling1, Vanessa J. van Ham1, Kim Zuidwijk1, Cornelis M. van Drunen2, Mohamed R. Daha1, Wytske J. Fokkens2 and Cees van Kooten1

1Department of Nephrology, Leiden University Medical Centre, Leiden and 2Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands

Correspondence to: Dr C. van Kooten, Department of Nephrology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Email: kooten{at}lumc.nl



  Abstract

Background. IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Intranasal vaccination of patients with IgAN has shown mucosal and systemic IgA hyporesponsiveness. Here, we investigated whether this IgA hyporesponse in IgAN patients can be explained by reduced numbers or altered subset distribution of dendritic cells (DCs) in nasal mucosa.

Methods. Eighteen IgAN patients and 18 healthy volunteers were recruited for this study. Nasal biopsies were taken, after local anaesthesia, from the lower edge of the inferior turbinate. Staining for different subsets of DCs was performed using specific monoclonal antibodies. To detect myeloid DCs, we used CD1a, DC-SIGN and blood dendritic cell antigen-1 (BDCA-1) as a marker and for plasmacytoid DCs we used BDCA-2. DC-cell numbers in the epithelium and in lamina propria were counted separately and expressed as positively stained cells per mm2.

Results. Both myeloid and plasmacytoid DC could be demonstrated in nasal biopsies. Quantification showed that IgAN patients contained significantly more DC-SIGN-positive cells in the lamina propria compared to controls. In addition, in IgAN patients, we observed more CD1a-positive cells in the epithelium. No differences in BDCA-1 and BDCA-2-positive cells were found between patients and controls. The number of positively stained cells in the epithelial layer correlated strongly with the number of positively stained cells in the lamina propria.

Conclusions. Patients with IgAN have higher numbers of CD1a-positive cells in the epithelial layer and more DC-SIGN-positive cells in the lamina propria. Therefore, the earlier observed IgA hyporesponsiveness in IgAN patients after mucosal vaccination cannot be explained by lower numbers of nasal DCs.

Keywords: BDCA; DC-SIGN; dendritic cells; IgA nephropathy; mucosa; nasal biopsy

Received for publication: 12. 1.07
Accepted in revised form: 1. 8.07


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