[Serum levels and urinary excretion of soluble receptors for tumor necrosis factor (sTNF R) in patients with primary glomerulonephritis].
Tumor necrosis factor alpha (TNF-alpha) is a pro-inflammatory cytokine and has multiple physiological function. Its binding to specific receptors produced the reactions of TNF. In sera and urine of healthy persons and diseased patients two soluble types of TNF receptors--p55--sTNF I and p 75--sTNF RII have been detected. They can protect cells against excessive cytotoxic activity TNF-alpha in vitro and in vivo. The aim of the work was to investigate the prognostic significance and role of sTNF R in various types of glomerular diseases. We studied 49 patients with primary glomerular diseases (5 minimal change--MC; 4 focal glomerulosclerosis--FS; 4 membranous nephropathy--MN; 12--mesangial proliferative GN--MesPGN; 18 IgA nephropathy--IgAN; and 6 membranoproliferative GR--MPGN) and 10 healthy persons. Renal biopsies were evaluated by light and immunofluorescence microscopy. sTNF RI and sTNF RII concentrations were measured by ELISA (BIOSOURCE International kits). The treatment of patients consisted of 3 to 5 i.v. methylprednisolone pulses (1.0 g per single dose, average total 1.0 g/20 kg given alternate days) followed by oral prednisone 20 to 25 mg/day and six monthly i.v. cyclophosphamide 0.6 g/l m2/month. The study groups showed a significantly higher concentration of sTNF RI and sTNF RII in their sera and urine compared with the control. In patient groups serum Cr showed significant correlations with interstitial volume in renal biopsy, correlation serum Cr with serum sTNF RI, serum sTNF RI with serum sTNF RII and with urinary sTNF RI, serum sTNF RII with urinary sTNF RI and with urinary sTNF RII. The ratio of serum sTNF RI to serum sTNF RII in patients was unchanged compared to the controls but ratio urinary sTNF RI to sTNF RII was higher in all patient groups except patients with MC. In patients with renal sufficiency (Cr < 1.3 mg%) and reduction of proteinuria > 50% after 1 year treatment urinary secretion of sTNF RII was higher before treatment than in patients with protein reduction < 50%. In patients with renal insufficiency and reduction of proteinuria > 50% urinary excretion of sTNF RI was lower than in patients with lower reduction of proteinuria (< 50%) after 1 year treatment. These results suggest that serum sTNF R could be useful as indicator of clinical disease activity but urinary excretion permits prediction of reduction in proteinuria.
Kacprzyk
Feliks
F
Klinika Nefrologii Instytutu Medycyny Wewnetrznej AM w Łodzi.
D000328:Adult; D015703:Antigens, CD / Q000097:blood / Q000652:urine; D001706:Biopsy; D016022:Case-Control Studies; D003520:Cyclophosphamide / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005921:Glomerulonephritis / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D013997:Time Factors
D015703:Antigens, CD; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D003520:Cyclophosphamide; D011241:Prednisone; D008775:Methylprednisolone