B-cell clonal expansion has been sporadically described in the blood and/or renal tissue of patients with glomerulonephritides, albeit with unclear pathogenetic role. Herein, using spectratyping analysis, we observed oligoclonal intrarenal B-cell populations in 59% of glomerulonephritis patients with podocyte injury (6/7 with focal segmental glomerulosclerosis, 1/3 minimal change disease, 1/3 idiopathic membranous nephropathy, 3/4 IgA nephropathy, 2/5 membranous lupus nephritis), 20% of glomerulonephritis patients without podocyte involvement (4/13 with mesangial or proliferative lupus nephritis, 0/3 idiopathic membranoproliferative glomerulonephritis, 0/4 pauci-immune vasculitis) and 17% of control patients with renal cancer. In multivariate analysis, oligoclonal B-cells were associated with podocyte injury and the grade of glomerulosclerosis (both p = .009). B-cell oligoclonal expansions were not found in the paired peripheral blood samples. We postulate that B-cell expansion in the kidney results from local stimuli, including antigens expressed on podocytes. Further studies to unravel the role of oligoclonal B-cells in (auto)immune-mediated kidney disease are warranted.

尽管具有不清楚的致病作用，但已经在患有肾小球素的患者的血液和/或肾脏组织中零星地描述了B细胞的克隆扩增。在这里，我们使用光谱分型分析，观察到59％足细胞损伤（6/7伴有局灶性节段性肾小球硬化，1/3微小改变疾病，1/3特发性膜性肾病，3/4 IgA的肾小球肾炎患者的肾小管内B细胞群体的克隆）肾病，2/5膜性狼疮性肾炎），20％的没有足细胞受累的肾小球性肾炎患者（4/13伴有肾小球或增生性狼疮性肾炎，0/3特发性膜增生性肾小球性肾炎，0/4免疫球蛋白性血管炎）和17％的对照患者患有肾癌。在多元分析中，p  = .009）。在配对的外周血样本中未发现B细胞寡克隆扩增。我们假设肾脏中的B细胞扩增是由局部刺激引起的，包括在足细胞上表达的抗原。有必要进行进一步的研究以阐明寡克隆B细胞在（自身）免疫介导的肾脏疾病中的作用。