title: Implications of serum TNF-beta and IL-13 in the treatment response of childhood nephrotic syndrome.
abstract: The cause of childhood nephrotic syndrome (NS) is unknown and whether it responds to steroid therapy remains unpredictable. In the present study, we measured the Th1/Th2 cytokines, serum tumor necrosis factor-beta (TNF-beta) and interleukin-13 (IL-13), levels in children with NS before and after prednisolone (60 mg/m(2)/day) treatment for 4 weeks, to evaluate their relationships with disease activity and treatment response. Patients with acute NS had higher serum TNF-beta and IL-13 levels than normal controls. After 4 weeks of prednisolone treatment, patients with steroid-resistant NS (SRNS) presented a higher serum TNF-beta level than that before treatment (p=0.008). In contrast, patients with steroid-sensitive NS (SSNS) presented a higher serum IL-13 level than that before treatment (p=0.027). This study demonstrates the significance of serum TNF-beta and IL-13 levels in relation to the disease activity and treatment response of childhood NS. Patients with SRNS appeared to have elevated TNF-beta after steroid therapy, while patients with SSNS tended to have elevated IL-13 after steroid therapy. Thus, an altered Th1/Th2 reaction as demonstrated by TNF-beta/IL-13 imbalance may play a pathophysiologic role in childhood NS.
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Chang Gung Children's Hospital, Kaohsiung, Taiwan, ROC
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Tain
authors.forename: Tsung-Yi
authors.initials: TY
authors.lastname: Chen
authors.forename: Kuender D
authors.initials: KD
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018793:Interleukin-13 / Q000097:blood*; D008233:Lymphotoxin-alpha / Q000097:blood* / Q000378:metabolism; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood* / Q000628:therapy*; D011239:Prednisolone / Q000627:therapeutic use; D018417:Th1 Cells / Q000378:metabolism; D018418:Th2 Cells / Q000378:metabolism
chemical_list: D018793:Interleukin-13; D008233:Lymphotoxin-alpha; D011239:Prednisolone