The study on the effect of tonsillectomy combined with steroid pulse therapy against IgA nephropathy

2016 Fiscal Year Final Research Report

• Project/Area Number: 26460449
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Human pathology
• Research Institution: Tohoku University
• Principal Investigator: Joh Kensuke 東北大学, 医学系研究科, 客員教授 (10057086)
• Research Collaborator: Muto Masahiro 順天堂大学, 腎臓内科 ; Meng M 山形大学, 病理診断学講座
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: IgA腎症 / 寛解 / 扁桃摘出 / 扁桃炎 / 樹状細胞 / 腎生検

Outline of Final Research Achievements

Tonsillectomy (TL) combined with steroid pulse therapy (SPT) has become a major choice against IgA nephropathy (IgAN) in Japan. The purpose was to figure out the factors preventing proteinuric remission（PUR）at 1 yr after the therapy and to contribute the indication of TL with SPT. PUR was found in 119 pts out of 194 pts (81%) at 1 year after. ROC analysis showed that cut off points, which were critical for a dichotomous classification of proteinuric remission, were 25% of interstitial fibrosis and 0.43 g/day of a grade of proteinuria, respectively. With these 2 parameters, PUR was predicted with 78% of probability.
Tonsil is an unique organ causing initial and progressive events to generate IgAN. Comparing the features of the IgAN tonsilitis with chronic tonsillitis, the number of T lymphocyte nodules with assembly of CD208-positive dendritic cells and the grade of lymphoepithelial involution correlated with frequency of crescent and segmental sclerosis in the kidney, respectively.

Free Research Field

人体病理学