Frequency of CD4+CXCR5+ TFH cells in patients with hepatitis b virus-associated membranous nephropathy

• The frequencies of CD4+CXCR5+ TFH cells were higher in HBV-MN patients.
• Treatment with prednisone or/and immunosuppressive drugs significantly reduced TFH cells in HBV-MN patients.
• TFH cells can regulate humoral immune responses in HBV-MN patients.
• TFH cells may participate in the pathogenesis of HBV-MN.

The frequency of different subsets of CD4+CXCR5+ TFH cells and serum cytokine levels were analyzed in a total of 14 patients with newly diagnosed hepatitis B virus-associated membranous nephropathy (HBV-MN), 12 individuals with immune-tolerant HBV infection (HBV-IT) and 12 healthy controls (HC). Serum cytokine levels were measured before and 10–12 weeks after treatment. Significantly higher frequency of CD4+CXCR5+, CD4+CXCR5+ICOS+ and CD4+CXCR5+PD-1+ TFH cells, and higher serum levels of IL-17A, IFN-γ, IL-2, IL-10, IL-4 and IL-21 were detected in HBV-MN patients compared to the HC. The percentage of CD4+CXCR5+ TFH cells and serum IL-21 level in HBV-MN patients were also higher than the HBV-IT. The percentage of CD4+CXCR5+ TFH cell was negatively correlated with the value of eGFR, and the percentage of CD4+CXCR5+ICOS+ TFH cells was positively correlated with the 24-h urinary protein concentration. Notably, the percentage of CD4+CXCR5+PD-1+ TFH cells was positively correlated with serum IL-21 level and 24-h urinary protein concentration. Treatment with prednisone or/and immunosuppressive drugs significantly reduced the frequency of CD4+CXCR5+, CD4+CXCR5+PD-1+ TFH cells and serum IL-21 level, but increased IL-4 and IL-10 levels in the patients. CD4+CXCR5+ TFH cells, especially CD4+CXCR5+PD-1+ TFH cells may participate in the pathogenesis of HBV-MN.