Abstract
Background and Aim: Idiopathic nephrotic syndrome (INS) is classified according to the response to drug therapy in steroid-sensitive (SS), steroid-dependent (SD), and steroid-resistant (SR) categories. Previous studies showed changes in inflammatory activity of subpopulations of lymphocytes in INS. This study aimed to compare SS and SR patients in regard to subpopulations of leukocytes, profile of regulatory lymphocytes, and migratory activity of lymphocyte subpopulations. Results obtained in INS patients were also compared to age and sex-matched healthy controls.Methods: This is a cross-sectional study including SS patients (n = 30), SR patients (n = 14), and controls (n = 10). Peripheral blood samples were withdrawn for ex-vivo leukocyte flow cytometry analysis.Results: Percentage of B-lymphocytes and natural killer (NK) cells were significantly reduced in SR patients when compared to controls, while the percentage of NKT cells were decreased in SS patients in comparison to controls. Percentages of CD4+ expressing FoxP3 and CTLA4 were significantly higher in SS patients in comparison to SR patients and controls. The expression of integrin CD18 on the surface of T lymphocytes (CD3+) was reduced in SS patients if compared to controls.Conclusion: This study found that SS INS patients have higher levels of regulatory T-lymphocytes and lower expression of adhesion molecules than SR patients.
Highlights
Nephrotic syndrome is a glomerular disease, highly prevalent in children, and characterized by a combination of intense proteinuria, hypoproteinemia, and edema [1,2,3,4]
Percentage of B-lymphocytes and natural killer (NK) cells were significantly reduced in SR patients when compared to controls, while the percentage of NKT cells were decreased in SS patients in comparison to controls
This study found that SS idiopathic nephrotic syndrome (INS) patients have higher levels of regulatory T-lymphocytes and lower expression of adhesion molecules than SR patients
Summary
Nephrotic syndrome is a glomerular disease, highly prevalent in children, and characterized by a combination of intense proteinuria, hypoproteinemia, and edema [1,2,3,4]. Nephrotic syndrome can be secondary to other diseases or, more commonly, due to primary changes in the kidney, not fully elucidated, and named as idiopathic nephrotic syndrome (INS). The response to corticosteroids therapy is still the most important prognostic factor in INS [2]. According to the response to steroids, patients are classified as steroid-sensitive (SS), steroiddependent (SD), and steroid-resistant (SR) [2, 3]. Idiopathic nephrotic syndrome (INS) is classified according to the response to drug therapy in steroid-sensitive (SS), steroid-dependent (SD), and steroid-resistant (SR) categories. Previous studies showed changes in inflammatory activity of subpopulations of lymphocytes in INS. Results obtained in INS patients were compared to age and sex-matched healthy controls
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