T-lymphocyte activation in steroid-sensitive nephrotic syndrome in childhood.
We undertook a sequential study in 29 children with steroid-sensitive nephrotic syndrome (SSNS) off treatment to seek evidence for T-cell activation in relapse. T-cell subsets and activation markers were analysed using two-colour flow cytometry. Soluble IL2 receptor (sIL2R) was measured in serum and urine by enzyme-linked immunosorbent assay (ELISA). Fifteen children were examined in remission and subsequent relapse (group A) and fourteen remained in remission (group B). In group A the proportion of CD4+ cells expressing the activation marker CD25 (alpha-chain of the IL2 receptor) increased significantly from remission to relapse: CD4+25+ cells rose from 5.6 to 7.0% of total lymphocytes, and from 15.8 to 19.1% of CD4+ lymphocytes (paired t test: P < 0.0005 and < 0.001 respectively). No correlations were found between CD4+25+ cells and plasma albumin or cholesterol concentrations. SIL2R concentration in serum did not change in relapse, but increased significantly in urine from 272 to 592 U/mg creatinine (P < 0.01). No significant difference was found in remission between groups A and B. We conclude that early relapse in SSNS is associated with activation of CD4+ (T-helper) cells which is not secondary due to the nephrotic state itself.
Division of Clinical Sciences (Medical Unit), Institute of Child Health, London, UK.
T J
TJ
Neuhaus
V
V
Shah
R E
RE
Callard
T M
TM
Barratt
D000293:Adolescent; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007978:Levamisole / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism*; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000378:metabolism*; D012008:Recurrence; D012074:Remission Induction; D012709:Serum Albumin / Q000378:metabolism; D013256:Steroids / Q000627:therapeutic use; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology / Q000378:metabolism*
D007166:Immunosuppressive Agents; D008055:Lipids; D015375:Receptors, Interleukin-2; D012709:Serum Albumin; D013256:Steroids; D007978:Levamisole; D016572:Cyclosporine