کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2542624 1122715 2007 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The effect of steroids on lymphocyte profile in primary chronic glomerulonephritis. Empirical or tailored therapy?
موضوعات مرتبط
علوم زیستی و بیوفناوری ایمنی شناسی و میکروب شناسی ایمونولوژی
پیش نمایش صفحه اول مقاله
The effect of steroids on lymphocyte profile in primary chronic glomerulonephritis. Empirical or tailored therapy?
چکیده انگلیسی

Steroids are still the mainstay of therapy in primary chronic glomerulonephritis (PCGN), regardless of underlying disturbance or pathology. Moreover, relationship between known abnormalities and disease manifestation is stochastic, therefore treatment continues to be empirical. It is not known whether responsiveness is related to immune phenotype. We performed flowcytometric lymphocyte (Ly) phenotyping (CD19, CD3, CD3CD4, CD3CD8, CD56/16) on 16 patients (pts) (12M, 4F), mean age 37.6 ±13 years with primary chronic glomerulonephritis (PCGN): minimal change disease (MCD)—6 pts, focal and segmental glomerulosclerosis (FSGS)—4 pts, mesangial proliferative glomerulonephritis—5 pts, mesangiocapillary glomerulonephritis—1 pt, before and at 7 days of oral Prednisone 1 mg/kg/day (in 2 divided doses). Before steroids: 4/16 pts(25%) had elevated BP; 9/16(56.2) showed nephrotic proteinuria. Serum creatinine was > 1.2 mg% in 6/16(37.5%). At 7 days WBC count increased (13,079.37 ± 4966.4/μl vs. 8021.25 ± 2077.4/μl; p = 0.0007), Ly percentage (%) decreased (20.30 ± 9% vs. 29.9 ± 10.4%; p = 0.0095), while absolute (abs.) Ly count remained unchanged. Both CD19 Ly% and CD19 Ly abs. count increased (16.13 ± 6.5% vs. 9.52 ± 3.7%; p = 0.0015, and 410.012 ±29.7/μl vs. 223.56 ± 123.8/μl; p = 0.0077, respectively). NK (natural killer)% decreased (9.15 ± 5.2% vs. 14.19 ± 7.1%; p = 0.0296). CD3, CD3CD4, CD3CD8 Ly subsets and CD4/CD8 ratio showed no change. Variation in proteinuria (2.88 ± 2.1 g/24 h vs. 3.45 ±1.7 g/24 h; p = 0.4) did not reach statistical significance (Wilcoxon–Mann–Whitney). In 11 pts we performed an additional analysis at 1 month. Compared to levels before steroids, there was an increase in WBC, CD19 Ly% and CD19 Ly abs. count and a decrease in NK% and NK abs. count. Other Ly subsets and CD4/CD8 ratio remained unchanged. Variation in clinical parameters (proteinuria, serum Creatinine, BP) did not reach statistical significance. Changes in Ly profile precede changes in clinical parameters and thus are divergent. While our patients proved to be early non-responders, further studies to elucidate whether profile changes provide for response specification are warranted.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Immunopharmacology - Volume 7, Issue 9, September 2007, Pages 1265–1270
نویسندگان
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