The utility of biomarkers to predict steroid response in idiopathic nephrotic syndrome

Yıl 2024, , 295 - 299, 30.10.2024

Neslihan Çiçek , İbrahim Gökçe , Serçin Güven , Ali Yaman Harika Alpay

https://doi.org/10.5472/marumj.1571937

Öz

Objective: The most common form of nephrotic syndrome (NS) is minimal change disease (MCD) in children and focal segmental
glomerulosclerosis (FSGS) following it. As, it is important to predict corticosteroid (CS) response at the beginning of the disease, we
aimed to evaluate the efficacy of some biomarkers in terms of predicting steroid response in patients with NS.
Patients and Methods: Twenty patients who met the inclusion criteria for the study were divided into 3 groups and 6 healthy control
participants were included in the analysis as the 4th group. Group-1 included 10 patients at the first episode of idiopathic NS (INS),
group-2 included the same 10 patients in remission, group-3 included 10 patients with steroid resistant NS (SRNS) diagnosed as FSGS
by renal biopsy, and group-4 included six healthy children as controls. Urinary and serum cluster of differentiation (CD) CD80, IL-17,
IL-23, IL-10, TGF-β, CD86, CD28, CTLA-4 levels were measured for all groups.
Results: Urinary CD80 level in INS-relapse group was significantly higher than the levels of the INS-remission, FSGS and control
groups (p<0.001). Urinary CD28 and uIL-10 were significantly increased in INS-remission group than INS-relapse (p<0.05, p<0.001).
Serum IL-17 was significantly higher in INS-relapse group than in INS-remission group (p<0.01). There was no difference in IL-
23,TGF-β,CD86 parameters between groups.
Conclusion: In our study, urinary CD80 levels were significantly higher in the relapse group compared to the other groups. When
supported by more

Anahtar Kelimeler

Biomarkers, CD80, Nephrotic syndrome, Steroid response

Kaynakça

• Shalhoub RJ. Pathogenesis of lipoid nephrosis: disorder of T-cell function. Lancet 1974;2:556-603. doi: 10.1016/s0140- 6736(74)91880-7.
• Kitsou K, Askiti V, Mitsioni A, Spoulou V. The immunopathogenesis of idiopathic nephrotic syndrome: a narrative review of the literature. Eur J Pediatr 2022;181:1395- 404. doi:10.1007/s00431.021.04357-9.
• Reiser J, von Gersdorff G, Loos M, et al. Induction of B7-1 in podocytes is associated with nephrotic syndrome. J Clin Invest 2004;113:1390-7. doi:10.1172/JCI20402.
• Garin EH, Diaz LN, Mu W, et al. Urinary CD80 excretion ıncreases in ıdiopathic minimal change disease. JASN 2009;20:260-6. doi:10.1681/ASN.200.708.0836.
• Gonzalez Guerrico AM, Lieske J et al. Nephrotic syndrome study network consortium (NEPTUNE). Urinary CD80 discriminates among glomerular disease types and reflects disease activity. Kidney Int Rep 2020;5:2021-31. doi:10.1016/j. ekir.2020.08.001.
• Kennedy A, Waters E, Rowshanravan B, et al. Differences in CD80 and CD86 transendocytosis reveal CD86 as a key target for CTLA-4 immune regulation. Nat Immunol 2022;23:1365- 78. doi:10.1038/s41590.022.01289-w.
• Jiang Y, Wang X, Dong C. Molecular mechanisms of T helper 17 cell differentiation: Emerging roles for transcription cofactors. Adv Immunol 2019;144:121-53. doi:10.1016/ bs.ai.2019.09.003.
• Liu LL, Qin Y, Cai JF, et al. Th17/Treg imbalance in adult patients with minimal change nephrotic syndrome. Clin Immunol 2011;139:314-20. doi:10.1016/j.clim.2011.02.018.
• Shimada M, Araya C, Rivard C, Ishimoto T, Johnson RJ, Garin EH. Minimal change disease: a two-hit podocyte immune disorder? Pediatr Nephrol 2011;26:645-9. doi:10.1007/ s00467.010.1676-x.
• Ishimoto T, Cara-Fuentes G, Wang H, et al. Serum from minimal change patients in relapse increases CD80 expression in cultured podocytes. Pediatr Nephrol 2013;28:1803-12. doi:10.1007/s00467.013.2498-4.
• Novelli R, Gagliardini E, Ruggiero B, Benigni A, Remuzzi G. Any value of podocyte B7-1 as a biomarker in human MCD and FSGS? Am J Physiol Renal Physiol 2016;310:335-41. doi:/10.1152/ajprenal.00510.2015.
• Garin EH, Mu W, Arthur JM, et al. Urinary CD80 is elevated in minimal change disease but not in focal segmental glomerulosclerosis. Kidney Int 2010;78:296-302. doi:10.1038/ ki.2010.143.
• Ling C, Liu X, Shen Y, et al. Urinary CD80 levels as a diagnostic biomarker of minimal change disease. Pediatr Nephrol 2015;30:309-16. doi:10.1007/s00467.014.2915-3.
• Liao J, Wu XC, Cheng Q, et al. Predictability of urinary CD80 in the relapse of primary nephrotic syndrome. Biomed Res Int 2017;9429314. doi:10.1155/2017/9429314.
• Ling C, Liu X, Shen Y, et al. Urinary CD80 excretion is a predictor of good outcome in children with primary nephrotic syndrome. Pediatr Nephrol 2018;33:1183-7. doi:10.1007/ s00467.018.3885-7.
• Minamikawa S, Nozu K, Maeta S, et al. The utility of urinary CD80 as a diagnostic marker in patients with renal diseases. Sci Rep 2018;8:17322. doi:10.1038/s41598.018.35798-2.
• Matsumoto K, Kanmatsuse K. Increased urinary excretion of interleukin-17 in nephrotic patients. Nephron 2002;2:243-9. doi:10.1159/000058399.
• Tsuji S, Kimata T, Yamanouchi S, et al. Regulatory T cells and CTLA-4 in idiopathic nephrotic syndrome. Pediatr Int 2017;59:643-646. doi:10.1111/ped.13255.
• Woroniecki RP, Shatat IF, Supe K, Du Z, Kaskel FJ. Urinary cytokines and steroid responsiveness in idiopathic nephrotic syndrome of childhood. Am J Nephrol 2008;28:83-90. doi:10.1159/000109396.
• Youn YS, Lim HH, Lee JH. The clinical characteristics of steroid responsive nephrotic syndrome of children according to the serum immunoglobulin E levels and cytocins. Yonsei Med J 2012;53:715-22. doi:10.3349/ymj.2012.53.4.715.
• Cara-Fuentes G, Lanaspa MA, Garcia GE, Banks M, Garin EH, Johnson RJ. Urinary CD80: a biomarker for a favorable response to corticosteroids in minimal change disease. Pediatr Nephrol 2018;33:1101-3. doi: 10.1007/s00467.018.3886-6.