title: In vitro sensitivity to methyl-prednisolone is associated with clinical response in pediatric idiopathic nephrotic syndrome.
abstract: The aim of this study was to evaluate the in vitro steroid sensitivity as a predictor of clinical response to glucocorticoids in childhood idiopathic nephrotic syndrome (INS). Seventy-four patients (median age 4.33, interquartile range [IQR] 2.82-7.23; 63.5% male) were enrolled in a prospective multicenter study: in vitro steroid inhibition of patients' peripheral blood mononuclear cell proliferation was evaluated by [methyl-(3) H] thymidine incorporation assay at disease onset (T0) and after 4 weeks (T4) of treatment. Steroid dependence was associated with increased in vitro sensitivity at T4 assessed both as drug concentration inducing 50% of inhibition (IC50 ; odds ratio [OR] = 0.48, 95% confidence interval [CI] = 0.24-0.85; P = 0.0094) and maximum inhibition at the highest drug concentration (Imax ; OR = 1.13, 95% CI = 1.02-1.31; P = 0.017). IC50 > 4.4 nM and Imax < 92% at T4 were good predictors for optimal clinical response. These results suggest that this test may be useful for predicting the response to glucocorticoid therapy in pediatric INS.
authors.affiliation: PhD, School in Sciences of Reproduction and Development, University of Trieste, Trieste, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Cuzzoni
authors.affiliation: Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: S
authors.initials: S
authors.lastname: De Iudicibus
authors.affiliation: Department of Life Sciences, University of Trieste, Trieste, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Stocco
authors.affiliation: Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Favretto
authors.affiliation: Department of Life Sciences, University of Trieste, Trieste, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Pelin
authors.affiliation: Policlinico Giovanni XIII di Bari, Bari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Messina
authors.affiliation: Pediatric Nephrology and Dialysis Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Ghio
authors.affiliation: Nephrology and Dialysis Unit, Department of Pediatrics, Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Monti
authors.affiliation: Nephrology and Dialysis Unit, Department of Pediatrics, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pasini
authors.affiliation: Pediatric Nephrology and Dialysis Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Montini
authors.affiliation: Department of Life Sciences, University of Trieste, Trieste, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Decorti
mesh_terms: D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D007963:Leukocytes, Mononuclear / Q000187:drug effects*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D008775:Methylprednisolone