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Open Access Highly Accessed Research article

Urinary CD8+ T-cell counts discriminate between active and inactive lupus nephritis

Sebastian Dolff12*, Wayel H Abdulahad1, Suzanne Arends1, Marcory CRF van Dijk3, Pieter C Limburg1, Cees GM Kallenberg1 and Marc Bijl1

Author affiliations

1 Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

2 Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany

3 Department of Pathology and Medical Biology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Citation and License

Arthritis Research & Therapy 2013, 15:R36  doi:10.1186/ar4189

Published: 27 February 2013

Abstract

Introduction

Lupus nephritis (LN) is a severe and frequent manifestation of systemic lupus erythematosus (SLE). Early detection of initial renal manifestations and relapses during follow-up is pivotal to prevent loss of renal function. Apart from renal biopsies, current urinary and serological diagnostic tests fail to accurately demonstrate the presence of active LN. Previously, we demonstrated that effector memory T-cells (CD45RO+CCR7-;TEM) migrate into the urine during active LN. The objective of this study was to assess the diagnostic value of urinary T-cells in comparison with traditional markers of active LN.

Methods

T-cells in the urine during active LN and remission were investigated. Twenty-two, in most cases biopsy-proven, active LN patients and 24 SLE patients without active LN were enrolled and serial measurements were performed in 16 patients.

Results

Analysis of the urinary sediment in active renal disease showed an increased number of CD8+ T-cells and absence of these cells during remission. Enumerating T-cell counts in LN patients with a history of renal involvement was a superior marker of active LN in comparison to traditional markers, such as proteinuria and s-creatinine.

Conclusions

In conclusion, urinary T-cells, in particular CD8+ T cells, are a promising marker to assess renal activity in LN patients, in particular in those with prior renal involvement.