Clinical and Pathological Implications of Increases in Tonsillar CD19+CD5+ B Cells, CD208+ Dendritic Cells, and IgA1-positive Cells of Immunoglobulin A Nephropathy.

OBJECTIVE: Several studies indicated that tonsillectomy can improve the prognosis of patients with immunoglobulin A nephropathy (IgAN). However, the relationship between tonsillar immunity and IgAN is still unclear. METHODS: A total of 14 IgAN patients were recruited in the current study from May 2015 to April 2016 in Tongji Hospital. B cells, dendritic cells (DCs), and IgA1 positive cells in human tonsils were detected using immunofluorescence and immunohistochemistry. Correlations between these cells and clinicopathologic features were evaluated. RESULTS: CD19+CD5+ B cells were predominantly located in germinal centers and mantle zones of lymphoid follicles, the CD208+ DCs were distributed in the interfollicular and subepithelial area, and IgA1-positive cells were predominantly detected in mantle zones of lymphoid follicles and subepithelial tissues. The numbers of CD19+CD5+ B cells, CD208+ DCs, and IgA1-positive cells in tonsillar tissues from IgAN patients were significantly higher than those in the normal controls (P<0.01, respectively). CD19+CD5+ B cells, CD208+ DCs, and IgA1-positive cells in tonsillar tissues were significantly associated with 24-h proteinuria levels and tubular atrophy/interstitial fibrosis of IgAN. CONCLUSION: CD19+CD5+ B cells, CD208+ DCs, and IgA1-positive cells in tonsillar tissues might be involved in the pathogenesis of IgAN.

[Distribution of Antibiotic Concentration in Domestic Wastewater Treatment Facilities in Villages and Towns].

Antibiotics discharged into the environment cause increased environmental resistance. Four types of antibiotics (quinolones, tetracyclines, macrolides, and ß-lactams) were selected for this study. In a comparison with the municipal wastewater plant, the concentration and removal of antibiotics in influent and effluent of domestic wastewater treatment facilities of different scales in villages and towns was investigated using high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS). The results showed that the highest amount of ofloxacin in rural wastewater treatment facilities reached 32663.5 ng·L-1. Due to the different situations of influent fluctuation, discharge requirements, and management between urban and rural wastewater plants, only 33% of the rural domestic wastewater facilities detected an antibiotics removal rate of more than 60%. The effective removal of some antibiotics can be achieved when the rural domestic wastewater treatment facilities maintain the standard discharge of conventional pollutants.

[Distribution and Treatment of Antibiotics in Typical WWTPs in Small Towns in China].

As a new, persistent pollutant in the environment, antibiotics are one of the most important pollutants in sewage treatment plants. The objective of this work was to investigate the concentration distribution and removal efficiency of antibiotics for three typical wastewater treatment technologies applied in small towns (CASS, A2/O, and Orbal oxidation ditch) using solid phase extraction-liquid chromatography-tandem mass spectrometry. Sixteen typical antibiotics, including four tetracyclines, three ß-lactams, four macrolides, three quinolones, and two sulfonamides, were analyzed in the influent and effluent. In addition, the relationship between the presence of antibiotics and the basic water quality (NH4+-N, TN, COD, pH, etc.) in the WWTPs was analyzed. The results showed that ofloxacin (OFX) and norfloxacin (NOR) were the main antibiotics in the WWTPs in this study. However, the concentrations of these two antibiotics in the effluent were low, indicating effective antibiotic removal efficiency. The antibiotic removal efficiency was higher than 60% in five of the WWTPs. Compared with the A2/O process, the CASS and Orbal oxidation ditch technologies resulted in higher removals of most of the antibiotics. In addition, the CASS and A2/O processes worked best for the removal of ß-lactam [ampicillin (AMP) and penicillin (PCN)], quinolones (ENR, NOR, and OFX), and macrolide (CLR), while the Orbal oxidation ditch worked best for the removal of tetracyclines (TC and OTC) and sulfonamides [sulfadiazine (SD)]. The correlation between antibiotic concentration and the basic parameters of water quality (NH4+-N, TN, COD, pH, etc.) was analyzed, and it was found that the water quality parameters had some effect on the concentration of antibiotics. With higher concentrations of the basic water quality parameters, higher the concentration of erythromycin (EM), roxithromycin (ROX), 4-epi-Tetracycline (E-TC), clarithromycin (CLR), ciprofloxacin (CIP), ofloxacin (OFX), epioxytetracycline (E-OTC), tetracyclines (TC), oxytetracycline (OTC), and norfloxacin (NOR) were observed. In summary, it is important to ensure the stable operation of small town WWTPs to reduce the ecological risk of antibiotics.

Soluble Urokinase Receptor Levels Are Correlated with Focal Segmental Glomerulosclerosis Lesions in IgA Nephropathy: A Cohort Study from China.

BACKGROUND: Soluble urokinase receptor (suPAR) may be involved in the pathological mechanisms of focal segmental glomerulosclerosis (FSGS) changes. However, it remains unclear whether suPAR is correlated with the FSGS-like lesions in IgA nephropathy (IgAN). METHODS: We measured the plasma suPAR levels in 138 patients with IgAN, and then their clinical and pathological relationships were analyzed. RESULTS: We found that the plasma suPAR levels were significantly correlated with age and renal function by both univariate and multivariate analysis in our IgAN patient cohort. Female had higher plasma suPAR levels and no significant correlation was observed between plasma suPAR levels and 24-h urine protein and highly sensitive C-reaction protein with multivariate analysis. In our cohort, sixty of these IgAN patients could be diagnosed with a type of FSGS lesions. The plasma suPAR levels were higher in the IgAN patients with FSGS lesions than in the IgAN patients without FSGS lesions by univariate (P < 0.0001) and multivariate (P < 0.001) analysis adjusting for other predictor variables, which might be helpful to differentiate the pathological changes with and without FSGS lesions. And the optimal cutoff value was 1806 pg/ml in this study. The plasma suPAR concentrations were also associated with the degree of tubular atrophy/interstitial fibrosis in both univariate and multivariate analysis. In multivariate analysis, the plasma suPAR levels were correlated with the percentage of crescents, not global sclerosis and arterial lesions. CONCLUSIONS: Our study suggested that the plasma suPAR levels were associated with age, gender, renal function, the degree of tubular atrophy/interstitial fibrosis and the percentage of crescent formation. The plasma suPAR might be a potential predictor for the presence of FSGS pathological lesions in Chinese patients with IgAN.