Immunohistochemical evaluation of cd4, cd8, sma, tgf-β expressions in renal biopsy and comparison with prognostic factors

Kidney diseases are diseases with high morbidity. Many progressive renal disease types result with tubulointerstitial fibrosis ultimately. The severity of interstitial fibrosis is a exact sign of renal survival. At the onset of post-injury renal fibrosis, inflammatory cells have a very important role. We studied CD4+ and CD8+ that inflammatory microenvironment forming and have a regulatory role on in renal fibrosis; TGF-β which which increases the production of extracellular matrix components and mesenchial cells in the renal tissue, have a critical role in renal injury and provides epithelial-mesenchymal transition; SMA is an active fibroblast marker that have a role in renal fibrosis. It is aimed to investigate the correlation between these immunohistochemistry stains and clinical prognostic parameters such as hemoglobin, proteinuria, serum creatinine and GFR. 62 non-amyloidosis kidney biopsies aged 18 years and over which came to our clinic between 01.01.2014 and 01.01.2018 with the clinical diagnosis of nephrotic / nephritic syndrome was included in our study. These biopsies consist of 52 glomerulonephritis and 10 tubulointerstitial nephritis biopsies. Immunohistochemical stains of TGF-β, SMA, CD4 and CD8 were performed in this case. The cases were evaluated by using microscope. Clinical data of the cases were obtained from central information system of our hospital. Correlation of the obtained data was calculated using SPSS v20. In glomerulonephritis there is direct correlation between SMA staining at the interstitial level, glomerular staining of TGF-β, CD4 and CD8 positive T lymphocyte quantities and serum creatinine; inverse correlation between GFR. There is correlation between interstitial staining of SMA and interstitial CD4 and CD8 positive T lymphocyte counts. These findings suggest that inflammation and fibrosis are related. It is determined that there is a significant relation between immunohistochemical stains which is marker of inflammation and fibrosis, and clinical datas that shows poor prognosis of the diseases.