Logo-jnp
J Nephropathol. 2017;6(3): 187-195.
doi: 10.15171/jnp.2017.32
PMID: 28975100
PMCID: PMC5607982
Scopus ID: 85019917752
  Abstract View: 3017
  PDF Download: 2001

Original Article

Impact of Τh1 and Τh2 cytokines in the progression of idiopathic nephrotic syndrome due to focal segmental glomerulosclerosis and minimal change disease

Maria Stangou 1*, Μichael Spartalis 1, Dimitra-Vasilia Daikidou 1, Theodora Kouloukourgiotou 1, Erasmia Sampani 1, Ioanna-Theologia Lambropoulou 1, Afroditi Pantzaki 2, Αikaterini Papagianni 1, George Efstratiadis 1

1 Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
2 Department of Pathology, Hippokration Hospital, Thessaloniki, Greece Original Article
*Corresponding Author: *Corresponding author: Maria Stangou, Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece. , Email: mstangou@auth.gr

Abstract

Background: Differential diagnosis between primary focal segmental glomerulosclerosis
(FSGS) and minimal change disease (MCD) is sometimes difficult as nephrotic syndrome
is the main clinical symptom in both diseases.

Objectives: This study has attempted to evaluate the urinary excretion of Th1 and Th2
cytokines as potential biomarkers in distinguishing the two types of nephrotic syndrome,
and predicting outcome of renal function.

Patients and Methods: Thirty-six patients with FSGS (M/F 22/14, Age; 41.9 ± 17 years,
SCr=1.7 ± 0.8 mg/dL, UProt=4.7 ± 5.5 g/24 h), and 21 with MCD (M/F 5/16, Age;
41.4 ± 15 years, SCr = 1 ± 0.4 mg/dL, UProt = 7.9 ± 9.3 g/24 h) were included in the study.
Τh1 (IL-2, IL-12, GM-CSF, INF-γ, TNF-α) and Th2 cytokines (IL-4, IL-5, IL-10, IL-13)
were measured by multiple cytokine assay, Luminex technology, in first morning urinary
samples collected at the day of renal biopsy.

Results: No significant differences in urinary excretion of all cytokines were found between
FSGS and MCD patients. In FSGS however, IL-12 urinary levels were independent factor
correlated with both global sclerosis (R = 0.5, P = 0.009) and interstitial fibrosis (R = 0.5,
P = 0.02). Th1 cytokines (IL-2 and GM-CSF) were significantly increased in FSGS patients
who did not respond to treatment (P = 0.03 and P = 0.007, respectively). Th2 cytokines
(IL-4, IL-5, IL-10, IL-13) were significantly increased in MCD patients with frequent
relapses (P = 0.05, P = 0.001, P = 0.01, P = 0.03).

Conclusions: Urinary excretion of Th1 and Th2 cytokines cannot discriminate FSGS from
MCD. Th1 cytokines, especially IL-12, IL-2 and GM-CSF, may be involved in pathology
and progression of FSGS, while Th2 cytokines are implicated in frequent relapses of
nephrotic syndrome in MCD.


Implication for health policy/practice/research/medical education:

Many different glomerular diseases can present as nephrotic syndrome, the most common being FSGS and MCD. In clinical
practice very often it is becoming difficult to differentiate between these two primary glomerulopathies, as histology of FSGS
includes focal and segmental lesions, that can be missed, and histology of MCD consists of podocyte injury, which is common
in both disorders. Many efforts have been made to define serum or urinary biomarkers which may help in the differentiation of
FSGS and MCD. In this study we evaluated the urinary excretion of Th1 and Th2 cytokines and found that although urinary
excretion of the cytokines could not discriminate between two entities, they had different roles and could predict renal function.
Th1 cytokines seem to participate in histology and outcome of FSGS, while Th2 cytokines play significant role in MCD.

Please cite this paper as: Stangou M, Spartalis M, Daikidou DV, Kouloukourgiotou T, Sampani E, Ioanna- Lambropoulou
LT, et al. Impact of Τh1 and Τh2 cytokines in the progression of idiopathic nephrotic syndrome due to focal segmental
glomerulosclerosis and minimal change disease. J Nephropathol. 2017;6(3):187-195. DOI: 10.15171/jnp.2017.32.


First Name
 
Last Name
 
Email Address
 
Comments
 
Security code


Abstract View: 3018

Your browser does not support the canvas element.


PDF Download: 2001

Your browser does not support the canvas element.

Submitted: 02 Oct 2016
Accepted: 10 Dec 2016
ePublished: 25 Dec 2016
EndNote EndNote

(Enw Format - Win & Mac)

BibTeX BibTeX

(Bib Format - Win & Mac)

Bookends Bookends

(Ris Format - Mac only)

EasyBib EasyBib

(Ris Format - Win & Mac)

Medlars Medlars

(Txt Format - Win & Mac)

Mendeley Web Mendeley Web
Mendeley Mendeley

(Ris Format - Win & Mac)

Papers Papers

(Ris Format - Win & Mac)

ProCite ProCite

(Ris Format - Win & Mac)

Reference Manager Reference Manager

(Ris Format - Win only)

Refworks Refworks

(Refworks Format - Win & Mac)

Zotero Zotero

(Ris Format - Firefox Plugin)