Korean Journal of Nephrology 1987;6(1):64-72.

소아 신사구체 질환에서 T - 임파구 및 B - 임파구의 역할

이종균 , 김병길

Abstract

An immunological factor in the pathogenesis of the nephrotic syndrome has been suggested for several years. In an attempt to investigate the pathogenic role of lymphocyte subsets in childhood glomerulopathies, we studied 58 children with various glomerulopathies in the acute phase including minimal change nephrotic syndrome (MCNS) and 14 children with MCNS in remis- sion who were admitted at Young-dong Severance Hospital from March, 1986 to February, 1987. These patients included 24 cases of minimal change nephrotic syndrome (MCNS), 12 cases of acute post-streptococcal glomerulonephritis (APSGN), 6 cases of Honoch- Scholein purpura nephritis (H-SP N), 4 cases of IgA nephropathy (IgA N) and 12 cases of benign recurrent hematuria (BRH). There were no significant differences in the total lymphocyte count and its subpopulations (T-cell and B-cell). When T-cell subsets were tested, T-helper cells (T,-cell) were significantly increased in APSGN and IgA N, but T-suppressor cells (T-cell) were significant- ly decreased only in IgA N with a resultant increase in the T/Ts ratios. When the MCNS nephrotic phase was compared with the remission phase, the T'-cell levels were observed to be 42.1±5.2% and 37.5±7.5% re- spectiviely and the T-cell leveIs were 38.5±5.6% and 43.9±5,6%, revealing that the T,-cell levels were signifi- cantly decreased during the nephrotic phase rather than the remission phase. From the above results, immunological factors are thought to be involved in the pathogenesis of glomer- ulopathies. However in order to obtain a further under- standing of the pathogenic role, longitudinal and func- tional tests should be performed because of the heter- ogeneity in the immunopathogenesis of the glomer- ulopathies.