title: Type 1/type 2 cytokine serum levels and role of interleukin-18 in children with steroid-sensitive nephrotic syndrome.
abstract: BACKGROUND
  In view of the conflicting evidence of helper T cell type 1 (Th1) or type 2 (Th2) pattern of cytokine synthesis in steroid sensitive nephrotic syndrome (SSNS), this study aimed to assess type-1/type-2 cytokines level in different stages of SSNS and to evaluate the role of IL-18.
  
  
  METHODS
  We prospectively studied thirty children with SSNS, aged 2-12 years. The children were evaluated in the active stage before treatment initiation and re-evaluated again during remission while still on steroid treatment. A subgroup of children (21/30) was also evaluated during remission after steroid withdrawal. The control group included 30 healthy age- and sex-matched siblings. Serum levels of IL-2, IFN-γ, ΙL-4, IL-13 and IL-18 were measured by ELISA.
  
  
  RESULTS
  IL-2 levels were not significantly different between children in different stages of SSNS and controls (p>0.05). Levels of IL-4, IL-13 and IL-18 were significantly higher during the active stage of SSNS compared to remission and controls (p<0.05). Serum IFN-γ was significantly lower in children with active disease compared to remission stages and controls (p<0.05). In children with SSNS, serum levels of IL-18 correlated significantly with both IL-4 and IL-13 during all stages (r=0.72 and p<0.0001, r=0.82 and p<0.0001, respectively).
  
  
  CONCLUSIONS
  Children with active SSNS seem to have a shift to type-2 cytokine production, and IL-18 expression is significantly correlated with this type-2 immune response.
authors: College of Medicine, Taibah University, and Maternity and Children Hospital, AL-Madinah AL-Munawarah, Kingdom of Saudi Arabia. shalaby25@hotmail.com
authors: Sherein A
authors: SA
authors: Shalaby
authors: Howaida M
authors: HM
authors: Al-Edressi
authors: Shereen A
authors: SA
authors: El-Tarhouny
authors: Mohamed
authors: M
authors: Fath El-Bab
authors: Mohamed A
authors: MA
authors: Zolaly
mesh_terms: D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D020382:Interleukin-18 / Q000097:blood*; D007376:Interleukin-2 / Q000097:blood*; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood* / Q000188:drug therapy / Q000276:immunology; D011446:Prospective Studies; D018417:Th1 Cells / Q000276:immunology*
chemical_list: D007375:Interleukin-1; D020382:Interleukin-18; D007376:Interleukin-2