Abstract

Children with idiopathic nephrotic syndrome (INS) have an increased risk of developing life-threatening infections. Several studies have demonstrated functional abnormalities in the T lymphocytes of patients with nephrotic syndrome. Although T cells are activated in INS during relapse, as indicated by an increased expression of interleukin (IL)-2 receptor, these cells have a decreased ability to proliferate. The T-cell receptor (TCR) plays an important role in signal transduction and T cell activation, with the TCR-zeta (TCRzeta) chain being a key element in early signaling. We measured the expression of the TCRzeta chain in patients with INS (steroid resistant and steroid sensitive) during relapse and remission by flow cytometry and by PCR ELISA. The results showed a significant decrease in the expression of the TCRzeta chain at both the protein and mRNA level in INS patients during relapse as compared with normal controls (p < 0.05). In contrast, when patients with INS achieved remission, the expression of TCRzeta normalized and was similar to that expressed in normal controls. Therefore, a decreased expression of the TCRzeta chain may explain the abnormal function of T cells in patients with INS, and it may also contribute to the increased risk for infections seen in these patients.

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