Abstract
Nowadays, the pathogenesis of minimal change disease (MCD) is still not well‐known, and the current understanding on MCD is mainly based on data derived from children, and very few adults. Here, we comprehensively analysed the correlation between the changes of peripheral basophils and the incidence rate and relapse of adult‐onset MCD. The results showed that in patients at the onset of MCD, the ratio and activation of basophils were all higher than those of healthy controls (all P < .05). In vitro test results showed that basophils from healthy controls can be activated by the serum taken from patients with MCD. Among 62 patients at the onset of MCD, with complete remission after treatment and 1 year of follow‐up, the relative and absolute basophil counts before treatment were higher in the long‐term remission group (n = 33) than that of the relapse group (n = 29). The basophil counts were significantly higher in the infrequent relapse group (n = 13) than that of the frequent relapse group (n = 16; P < .05). These findings suggested that basophil may play a pathogenic role in adult‐onset MCD, and the increased number and activation of peripheral basophils could predict recurrence in adult MCD.
Highlights
Minimal change disease (MCD) is a combination of glomerular diseases that presents with nephrotic syndrome
We examined the effect of the serum from adult patients with MCD on the activation of basophils from normal individuals in vitro
IgE and basophils maybe involved in the pathogenesis of MCD,[14,18] and T helper (Th) cells may lead to the onset of MCD by up-regulating Th2 cells, which express high levels of Th2 cytokines, including IL-4 and IL-13.7-12,24 basophils are the dominant cell type producing Th2 cytokines in the early phase of Th2 response
Summary
Minimal change disease (MCD) is a combination of glomerular diseases that presents with nephrotic syndrome. MCD is responsive to glucocorticoid therapy and can be treated; there is an extremely high relapse rate.[2] MCD may transform into even focal segmental glomerulonephritis and end-stage renal disease.[3,4] The pathogenic mechanisms of MCD are currently unclear. Mack et al[19] suggested that basophils ‘should be analysed in minimal change disease and focal segmental glomerulonephritis’. By detecting the quantity and activation of peripheral basophils in adult patients with MCD, we comprehensively analysed the relationship between basophils, MCD onset and MCD relapse for the first time. We examined the effect of the serum from adult patients with MCD on the activation of basophils from normal individuals in vitro
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