Date
April 16-17, 2025 | 09:30 AM GMT
Location
Tokyo, Japan
Tokyo, Japan
The Jikei University School of Medicine, Tokyo, Japan
Biography:
Kensuke Joh, Professor, Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan. Licensure in Medicine, Dissertation, Visiting Professor, Department of Pathology, Tohoku University Graduate School of Medicine. Current and previous research interests as clinicopathological study on IgA nephropathy. Councilor, Japanese Society of Pathology, Councilor, Japanese Society of Nephrology. Memberships of Renal Pathology Society, USA. My complete biography is available from my ORCID https://orcid.org/0000-0002-9334-3664
Tonsillectomy with steroid pulse therapy (SPT) has been established as an effective treatment for immunoglobulin A nephropathy (IgAN) in Japan. However, the underlying mechanisms supporting tonsillectomy remain unclear. This study assessed palatine tonsils from 77 patients with　IgAN, including 14 and 63 who received SPT before and after tonsillectomy, respectively. Tonsils from　21 patients with chronic tonsillitis were analyzed as controls. Specific tonsillar lesions were confirmed in patients with IgAN, correlating with active or chronic renal glomerular lesions and SPT. T-nodule and involution of lymphoepithelial symbiosis scores in tonsils correlated with the incidence of active crescents and segmental sclerosis in the glomeruli, respectively. The study revealed an essential role of the tonsil–glomerular axis in early active and late chronic phases. Moreover, the SPT-preceding group demonstrated no changes in the T-nodule score, which correlated with active crescent formation, but exhibited a considerable shrinkage of lymphatic follicles that produced aberrant IgA1. The study underscores the involvement of innate and cellular immunity in IgAN and advocates for tonsillectomy as a necessary treatment alongside SPT for IgAN, based on a stepwise process.