title: Atopy in childhood idiopathic nephrotic syndrome.
abstract: OBJECTIVE
  Aim of the study was to evaluate the immunoallergic pattern and their modulating serum cytokines in children with primary manifestation of nephrotic syndrome, in order to analyse the correlation with disease activity and the outcome of childhood NS.
  
  
  METHODS
  We have evaluated 72 children: 58 steroid-sensitive and 14 steroid-resistant; 42 subjects were the healthy controls. In all were measured serum: T cell-subset, cytokines by Th-1, Th-2, total IgE levels and specific IgE antibodies.
  
  
  RESULTS
  Of the 72 children investigated, 35 (48.6%) had either a history of atopy and/or elevated serum IgE; 14 of these children (40%) had clinical sign of an atopic disease (asthma, rhinitis, dermatitis) and 21 (60%) had elevated sIgE. The atopy was more frequent among SS than SRNS patients (52% versus 36%, p<0.05). The CD19 were significantly increased in nephrotic patients compared with controls. IL-4 levels were not different from those in normal control both in SS and SRNS patients, either in relapse than in remission. There was no correlation between the sIgE and IL-4 levels. Therefore, IL-5 and Il-13 levels were significantly higher in SSNS compared to controls, in both pre than posttreatment, and higher in atopic patients. Interestingly, IL-6 and IL-10 levels were significantly increased in SRNS pretreatment compared to posttreatment and controls and, only for IL-10, significantly higher in atopic patients.
  
  
  CONCLUSIONS
  In our study, only 40% of atopic children had a positive allergic history and 51.4% of the nephrotic children had normal sIgE levels, both pre and posttreatment, indicating different aetiologies, as immune mechanisms, in the pathogenesis of NS. Therefore, specific IgE antibodies were not related to disease activity, suggesting that IgE production might be co-incident in childhood NS. However, the increased production of IL-5 and IL-13 in atopic SSNS may indicate that these cytokines are involved in the enhanced production of sIgE while IL-4 have a role as controlling cytokine.
authors.affiliation: Department of Paediatrics, Unit of Paediatric Nephrology, Second University of Naples, Naples, and Unit of Nephrology and Paediatrics Dyalisis, Paediatrics Hospital Giovanni XXIII, Bari, Italy. maria.espositosalsano@tin.it
authors.forename: Maria Esposito
authors.initials: ME
authors.lastname: Salsano
authors.forename: Luisa
authors.initials: L
authors.lastname: Graziano
authors.forename: Ilaria
authors.initials: I
authors.lastname: Luongo
authors.forename: Paola
authors.initials: P
authors.lastname: Pilla
authors.forename: Mario
authors.initials: M
authors.lastname: Giordano
authors.forename: Giuliana
authors.initials: G
authors.lastname: Lama
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000150:complications*; D007073:Immunoglobulin E / Q000097:blood*; D016130:Immunophenotyping; D018655:Lymphocyte Count; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood* / Q000188:drug therapy / Q000276:immunology
chemical_list: D000305:Adrenal Cortex Hormones; D016207:Cytokines; D007073:Immunoglobulin E; D003404:Creatinine