Nephrolic syndrome (NS) defined by massive continued losses of urinary
proteins, resulting in hypoalbuminemia and edema. These are associated with
complications such as increased susceptibility to infections, thromboembolism, altered
lipid and carbohydrate metabolism and losses in binding proteins in the urine. Aim of
the study: To evaluate the cytokines levels in different stages of idiopathic nephrotic
syndrome (INS) and to determine the histepathological pattern of INS.
Methods: Fifty two children with INS were divided into; steroid-sensitive group I (SS)
(18/52) and steroid-resistant group II (SR) (34/52). Both groups subdivided into SS in
relapse IA (8/18), SS in remission IB (10/18), and SR in relapse group IIA (25/34) and
in remission group 11B (9/34). Twenty age-matched controls compared with data. The
following parameters had assessed; serum levels of IFN-y, IL-2, IL-4, IL-13 and 1L-18
by using quantitative colorimetric ELISA test. Renal biopsy specimens were
histopathologicaly studied.
Results: Serum IFN-y levels were significantly lower in the relapse phase of SS
compared with the remission phase and controls. On the contrary, serum IL-4 and IL-13
levels were significantly higher in the relapse phase of SS and SR compared with the
remission phases and controls IL-IS levels were significantly higher in the relapse
phase of SS and SR subgroups compared with the remission phases and the controls
respectively. IL-4 and IL-13 significantly correlated with 1L-18. All 34 SR nephrotic
patients were submitted to renal biopsies, which showed focal segmental
glomeruloscl erosis (FSGS ) (59%) the most common diagnosed entities of INS.
Conclusions: Type-2 cytokines predominate in relapse phase of SS and SR patients and
one could predict a good response to steroid therapy. IL-18 expression significantly
correlated with this type-2 immune response. The primary glomerular diseases in Saudi
children and FSGS are the most common diagnosed entities. |
