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NDT Advance Access published online on August 22, 2008

Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn461
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org



CD4+CD25+ T-cell populations expressing CD134 and GITR are associated with disease activity in patients with Wegener's granulomatosis

Benjamin Wilde1, Sebastian Dolff1, Xin Cai1, Christof Specker2, Jan Becker3, Martin Tötsch3, Ulrich Costabel4, Jan Dürig5, Andreas Kribben1, Jan Willem Cohen Tervaert6, Kurt Werner Schmid3 and Oliver Witzke1

1 Department of Nephrology, University Duisburg-Essen 2 Department of Rheumatology and Clinical Immunology, Kliniken Essen Süd 3 Institute of Pathology and Neuropathology, University Duisburg-Essen 4 Department of Pneumology/Allergy, Ruhrlandklinik Essen 5 Department of Hematology, University Duisburg-Essen, Germany 6 Department of Internal Medicine, Division of Clinical and Experimental Immunology, University Hospital Maastricht, The Netherlands

Correspondence and offprint requests to: Oliver Witzke, Department of Nephrology, University Duisburg-Essen, Hufelandstraße 55, 45122 Essen, Germany. Tel: +49-201-723-3955; Fax: +49-201-723-3393; E-mail: oliver.witzke{at}uk-essen.de



  Abstract

Background. An increased CD4+ CD25+ T-cell population is observed in Wegener's granulomatosis (WG). This T-cell population is not well characterized yet and their contribution to the disease pathogenesis remains obscure.

Methods. Thirty patients with WG and 18 healthy controls (HC) were included in this study. The disease activity and extension were measured by the Birmingham Vasculitis Activity Score (BVAS) and the Disease Extent Index (DEI). Lymphocytes from peripheral blood were analysed by FACS for the expression of CD4, CD25, CD134 and GITR. Cytokine expression in these subsets was assessed too. Nasal, lung and renal tissues from WG patients were immunohistochemically stained for CD3 and CD134.

Results. The percentage of CD134+ as well as GITR+ expressing CD4+CD25+ lymphocytes was increased in patients as compared to HC (37 ± 12% versus 27 ± 8%, P = 0.005; 18 ± 9% versus 11 ± 6%, P = 0.003). The expression of CD134 and GITR showed a significant correlation with disease activity (r = 0.5, P = 0.009; r = 0.55, P = 0.001). Most of these displayed the phenotype of effector memory T-cells (94 ± 4% and 91 ± 6%). CD134 T-cells were found in tissues affected by WG.

Conclusions. CD4+CD25+ effector memory T-cells expressing CD134 and GITR seem to play a role in disease mechanisms, as suggested by their close association with disease activity and their participation in inflammatory process.

Keywords: ANCA; CD134; GITR; Treg; Wegener's granulomatosis

Received for publication: 3. 3.08
Accepted in revised form: 22. 7.08


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