title: Toll-like receptor 3 (TLR-3), TLR-4 and CD80 expression in peripheral blood mononuclear cells and urinary CD80 levels in children with idiopathic nephrotic syndrome.
abstract: BACKGROUND
  The aims of this study were (1) to detect toll-like receptor (TLR)-3, TLR-4 and CD80 expression in peripheral blood mononuclear cells (PBMCs) and estimate urinary CD80 levels in children with idiopathic nephrotic syndrome and (2) to investigate the utility of these markers to differentiate between biopsy-proven minimal change disease (MCD) and focal segmental glomeruloscelerosis (FSGS).
  
  
  METHODS
  The study included 70 patients with idiopathic nephrotic syndrome (NS), of whom 40 had steroid-sensitive NS (SSNS; 25 with active NS, 15 in remission) and 30 had steroid-resistant NS (SRNS) patients, and 23 healthy controls. TLR-3, TLR- 4 and CD80 mRNA expression levels in PBMCs were determined and the urinary CD80 level estimated.
  
  
  RESULTS
  Median TLR-3, TLR-4 and CD80 mRNA expression levels were higher in patients with active SSNS than in those with SRNS, and the latter patient group also had significantly lower expression levels than the controls. The expression levels of these markers were associated with reductions in remission. Patients with biopsy-proven MCD had higher median expression levels of these markers than those with FSGS, but the differences were not statistically significant. Median urinary CD80/creatinine values were significantly higher in patients with SSNS and SRNS than in the controls and steroid-sensitive patients in remission (p < 0.001). CD80 levels were also significantly higher in patients with MCD than in those with FSGS (p = 0.002). A cut-off level of >914.5 ng/g had a sensitivity of 86.6%, specificity 71.4% and area under the curve of 0.828 (95% confidence interval 0.678-0.978, p = 0.002) for the diagnosis of MCD.
  
  
  CONCLUSIONS
  Increased expressions of TLR-3, TLR-4 and CD80 mRNA and the level of urinary CD80/creatinine could be useful markers to differentiate patients of SSNS in relapse from those with SRNS. Further these markers can also distinguish biopsy proven MCD from FSGS in SRNS patients.
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. opmpedia@yahoo.co.uk.
authors.forename: Om P
authors.initials: OP
authors.lastname: Mishra
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Ravindra
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi, India.
authors.forename: Gopeshwar
authors.initials: G
authors.lastname: Narayan
authors.affiliation: Department of Biochemical Engineering, Indian Institute of Technology, Banaras Hindu University, Varanasi, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Srivastava
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Abhinay
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Rajniti
authors.initials: R
authors.lastname: Prasad
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Ankur
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Pathology, G.B.Pant Hospital, New Delhi, India.
authors.forename: Vineeta V
authors.initials: VV
authors.lastname: Batra
mesh_terms: D018122:B7-1 Antigen / Q000097:blood / Q000652:urine*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004351:Drug Resistance; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D007677:Kidney Function Tests; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D008297:Male; D009402:Nephrosis, Lipoid / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000652:urine; D009404:Nephrotic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D012333:RNA, Messenger / Q000097:blood; D012372:ROC Curve; D065667:Renal Elimination; D013256:Steroids / Q000494:pharmacology / Q000627:therapeutic use; D051196:Toll-Like Receptor 3 / Q000097:blood*; D051197:Toll-Like Receptor 4 / Q000097:blood*
chemical_list: D018122:B7-1 Antigen; D015415:Biomarkers; D012333:RNA, Messenger; D013256:Steroids; C495344:TLR3 protein, human; C495345:TLR4 protein, human; D051196:Toll-Like Receptor 3; D051197:Toll-Like Receptor 4
keywords: Biomarkers; CD 80; Children; Nephrotic syndrome; Toll like receptor-3; Toll like receptor-4