The roles of urine interleukin-13, CD80, CD28, matrix metalloproteinase-2 and granzyme B in the pathogenesis of childhood minimal change nephrotic syndrome

Abstract

Objective: Minimal change disease (MCD) is the most common cause of nephrotic syndrome in childhood but its pathogenesis remains poorly understood. A T-cell-derived factor or factors were initially alleged as contributing to the disease pathogenesis. However, podocyte CD80 expression is now a commonly discussed theory. The aim of this study was to investigate the pathogenesis of MCD by determining urine interleukin-13, CD80, CD28, matrix metalloproteinase-2 (MMP-2), and granzyme B levels. Methods: Thirty patients and thirty healthy children were evaluated in this study. Six patients had biopsy proven MCD. The remaining patients were considered to have MCD because of their age at time of diagnosis; response to steroid treatment, absence of gross hematuria, hypocomplementemia or renal failure; and normal blood pressures in the active stage. The nephrotic-phase urine interleukin-13, CD80, CD28, MMP-2, and granzyme B levels of all patients were compared with the remission-stage urine levels of the same patients and control subjects. The urine samples were collected immediately before the application of immunosuppressive drugs or other treatment modalities. Results: Significantly higher interleukin-13, CD80, CD28, and MMP-2 levels were observed in the relapse period compared with both the remission period and control subjects. There was a significant positive correlation between the active-stage urine interleukin-13 and CD80 levels (r=0.619, p

Keywords

• Minimal change disease, Interleukin-13, B7 proteins, MMP-2, granzyme B

İdrar interlökin-13, CD80, CD28, matriks metaloproteinaz-2 ve granzim B‘nin çocukluk çağı minimal değişim nefrotik sendrom patogenezindeki rolleri

Öz

Amaç: Minimal değişiklik hastalığı çocuklarda nefrotik sendromun en sık nedenidir ve patogenezi hala aydınlatılamamıştır. Başlangıçta T hücresi kaynaklı faktör ya da faktörlerin hastalığın patogenezinden sorumlu olduğu ileri sürülmüştür. Fakat günümüzde hastalığın patogenezinde podosit CD80 ekspresyonu ön plana çıkmıştır. Bizim bu çalışmada amacımız hastaların idrar interlökin-13, CD80, CD28, matriks metaloproteinaz-2 ve granzim b düzeylerine bakarak hastalığın patogenezini anlamaya çalışmaktır. Yöntemler: Bu amaçla 30 hasta ve 30 sağlıklı çocuktan oluşan kontrol grubu ile çalıştık. 6 hastanın biyopsi sonucu minimal değişiklik hastalığı idi. Diğer hastalara hastalığın ilk aktif dönemindeki başlangıç yaşı, steroid tedavisine verdikleri cevap, hastalığın tanısı sırasında gros hematüri, hipokomplementemi, renal yetmezlik ve hipertansiyon olmaması nedeniyle minimal değişiklik hastalığı tanısı konuldu. Hastaların aktif faz idrar interlökin-13, CD80, CD28, matriks metaloproteinaz-2 ve granzim b düzeyleri aynı hastaların remisyon dönemi ve kontrol grubu ile karşılaştırıldı. İmmünsüpresif ilaçlar ya da diğer tedavi modaliteleri başlamadan hemen önce idrar örnekleri alındı. Bulgular: Hastalığın aktif döneminde remisyon ve kontrol grubuna göre istatistiksel olarak anlamlı idrar interlökin-13, CD80, CD28 ve MMP-2 yüksekliği saptadık. Nefrotik faz idrar interlökin-13 düzeyleri ile CD80 düzeyleri arasında pozitif korelasyon mevcuttu (r=0,619, p

Anahtar Kelimeler

• Minimal değişiklik hastalığı, interlökin-13, B7 proteinleri, MMP-2, granzim B

Kaynakça

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