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Abstract: FR-PO791

Increased Type 2 Innate Lymphoid Cells (ILC2s) in Patients with Idiopathic Nephrotic Syndrome (INS)

Session Information

Category: Glomerular Diseases

  • 1401 Glomerular Diseases: Mechanisms, including Podocyte Biology

Authors

  • Chan, Chang-Yien, National University of Singapore, Singapore, Singapore
  • Lu, Liangjian, Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
  • Teo, Sharon, Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
  • Ng, Kar Hui, National University of Singapore, Singapore, Singapore
  • Yap, Hui Kim, National University of Singapore, Singapore, Singapore
Background

Th2 cytokine producing ILC2s have been implicated in steroid-dependent and resistant allergic asthma. We have previously reported elevated Th2 cytokine production in steroid-dependent nephrotic syndrome (SDNS). This study therefore aimed to characterize ILC2s in INS patients in relapse.

Methods

14 patients with childhood-onset INS (relapse and remission) and 7 age-matched healthy controls were recruited. ILC subsets were analysed using flow cytometry. ILC2s were cultured with IL-33, IL-25, TSLP (10ng/ml) and IL-2 (20ng/ml) for 72h and culture supernatants were harvested for cytokine quantification. To investigate the response of ILC2s to steroids, cells were incubated with or without Dexamethasone (DEX) (0.1µmol/ml). Statistical analysis was done using Mann-Whitney U tests, Wilcoxon signed-rank test for paired samples and ANOVA with repeated measures.

Results

Relapse INS patients had higher proportion of ILC2s compared to controls (19.0±2.2% vs 9.6±2.3%, p=0.01). Paired analysis in INS patients showed significant decrease in ILC2s during remission compared to relapse (p=0.01). Additionally, cytokine profiles in relapse INS patients showed significantly increased Th2 cytokines IL-5 and IL-13, and Th2-related cytokines IL-9, IL-10 and Eotaxin (Table 1). ILC2s in relapse INS patients also had significantly higher levels of IL-12, IFNγ, RANTES and VEGF. Incubation with DEX increased ILC2s by 5.8±1.1% (p<0.001), which was similar in both patients and controls (p=0.83 for interaction).

Conclusion

ILC2s were significantly elevated in relapse INS patients. This was associated with classic Th2 signature following culture in cytokine conditioned medium, which was not suppressible by DEX.

Funding

  • Government Support – Non-U.S.