Circulating regulatory B-cell subsets in type 2 diabetic nephropathy.
Diabetic nephropathy (DN) is a major microvascular complication of diabetes mellitus (DM) driven by immune activation and chronic inflammatory cascades. Human regulatory B (Breg) cells modulate immune homeostasis and are downregulated in glomerulonephritis. We aim to evaluate B cell subsets counts in type 2 DM patients with and without nephropathy in comparison to normal control individuals. Sixty participants comprising twenty-four patients with type 2 DM without kidney injury, twenty-four patients with DN diagnosed via KDIGO guidelines, and twelve matched healthy controls underwent clinical, biochemical, and flow cytometric evaluations. CD19+ B cell subsets count, including Breg cells (CD19+CD24hiCD38hi) and memory B cell counts (CD19+CD24+CD38-) were quantified using multi-parametric flow cytometry. B cell count was significantly lower in patients with DN compared to DM and healthy control groups. Moreover, Breg and memory B cell counts were significantly lower in the DN group compared to the DM group. However, no significant difference was observed regarding B cell subsets between the DM and healthy control groups. Breg cells could predict DN (AUC = 0.720, p = 0.017) at a cut-off of ≤13.5% with 95% sensitivity and 95% specificity. In conclusion, Breg cells serve a vital role in suppressing aberrant immune reactivity, meaning that their insufficiency can trigger heightened autoimmune processes. Ultimately, the Breg subpopulation holds substantial promise as a significant biomarker for predicting both the onset and progression of DN with no correlation with the severity of DN.
Authors
Mohamed Mohamed, OKba OKba, Amin Amin, Sabry Sabry, Tawfik Tawfik, Ibrahim Ibrahim, Sayed Sayed
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