Elevated Levels of Fractalkine Expression and Accumulation of CD16+ Monocytes in Glomeruli of Active Lupus Nephritis

Yoshimoto, Shuhei; Nakatani, Kimihiko; Iwano, Masayuki; Asai, Osamu; Samejima, Ken-ichi; Sakan, Hirokazu; Terada, Miho; Harada, Koji; Akai, Yasuhiro; Shiiki, Hideo; Nose, Masato; Saito, Yoshihiko

doi:10.1053/j.ajkd.2007.04.012

« Previous Next »American Journal of Kidney Diseases
Volume 50, Issue 1 , Pages 47-58, July 2007

Elevated Levels of Fractalkine Expression and Accumulation of CD16⁺ Monocytes in Glomeruli of Active Lupus Nephritis

Shuhei Yoshimoto, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
Kimihiko Nakatani, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
- Address correspondence to Kimihiko Nakatani, MD, First Department of Internal Medicine, Nara Medical University, 840, Shijo-cho, Kashihara-city, Nara, 634-8522, Japan.
Masayuki Iwano, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
Osamu Asai, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
Ken-ichi Samejima, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
Hirokazu Sakan, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
Miho Terada
- Department of Pathology, Division of Pathogenomics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Koji Harada, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
Yasuhiro Akai, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
Hideo Shiiki, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara
Masato Nose, MD
- Department of Pathology, Division of Pathogenomics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Yoshihiko Saito, MD
- First Department of Internal Medicine, Nara Medical University, Kashihara, Nara

Received 2 November 2006; accepted 19 April 2007.

Background

Fractalkine (Fkn) is a chemokine that affects cells expressing its receptor, CX3CR1, including CD16-positive (CD16⁺) monocytes/macrophages (CD16⁺ Mos). The relationship of levels of glomerular Fkn expression and infiltration by CD16⁺ Mos with the severity and diversity of glomerular lesions in human lupus nephritis is not known.

Study Design

Retrospective cross-sectional analysis of variables observed in biopsy specimens.

Settings & Participants

88 patients with systemic lupus erythematosus.

Predictor

Histological class and severity of lupus nephritis according to the International Society of Nephrology/Renal Pathology Society and clinicopathologic factors.

Outcomes

Outcome variables are assays related to the degree of glomerular Fkn expression and CD16⁺ Mo infiltration.

Measurements

Immunohistological grading of Fkn staining, number of CD16⁺ Mos, and messenger RNA levels of Fkn and CD16 in glomeruli.

Results

Patients with proliferative lupus nephritis (class III and IV glomeruli) showed significantly greater glomerular Fkn expression and CD16⁺ Mo counts than those with other classes. Infiltrating CD16⁺ Mos within glomeruli expressed CX3CR1. Moreover, glomerular Fkn expression significantly correlated with the histopathologic activity index and CD16⁺ Mo counts, and CD16⁺ Mo counts significantly correlated with serum levels of blood urea nitrogen, complement (CH₅₀), and anti-DNA antibody; estimated glomerular filtration rate; and urinary protein excretion. Glucocorticoid therapy had a tendency to decrease both glomerular Fkn expression and CD16⁺ Mo counts.