The aim of the study was to evaluate the serum concentration of selected cytokines- tumor necrosis factor alfa (TNF-alfa), interleukin 2 (IL-2) and soluble interleukin 2 receptor (sIL-2R) in children with primary nephrotic syndrome (NS) in different disease stages and the correlation with particular clinical and biochemical parameters. The prognostics of cytokines concentrations for progression of morphological changes and for treatment results, especially with Cyclosporine A (CsA), were evaluated. 98 children with primary NS, aged 1-16,5 years, 56 boys and 42 girls, treated in the Dpt. of Pediatric Nephrology, were enrolled into the study. Cytokines were determined in 141 relapses of NS and in different stages of remission. The kidney biopsy was made in 51 patients, and repeated in 22. The control group consisted of 31 healthy children aged 0,6-16,5 years, 18 boys and 13 girls. The TNF- alfa and sIL-2R concentrations were determined by ELISA kits and IL-2 by EIA kits. TNF- alfa serum concentration increased in NS relapse and depended on clinical and biochemical status. The risk of glomerular sclerosis was higher with increased TNF- alfa concentrations. IL-2 concentration increased in NS relapse, decreased gradually in remission, and correlated with lipids and immunoglobulin G levels. Patients with low IL-2 concentrations showed higher proportion of staying in remission in the ; first year of CsA treatment. The risk of CsA dependency increased with higher IL-2 levels. Serum sIL-2R concentration correlated with lipid concentrations and blood morphology. The probability for achieving the total remission was higher among patients with higher sIL-2R concentrations measured in NS relapse. Lower sIL-2R concentrations increased the risk for steroid resistance and glomerular sclerosis. Respiratory or urinary tract infection in NS relapse did not influence the cytokines concentrations. The cytokines concentrations did not correlate with relapse frequency, the time from the previous relapse and the up to now treatment. This study suggests, that the measurements of TNF- alfa, interleukin 2 and the soluble interleukin 2 receptor may be valuable in the prognosis of the primary NS in children and in the optimal treatment selection.
Jul 7, 2022
Nov 21, 2012
|ZB-100565||Jul 7, 2022|
Kędra,Edyta (red nauk ). Kowalak,Czesław (współpraca)