The pro- and antiinflammatory cytokines, SLPI participate in antiinfective immunity, that is why it is necessary study their peculiarities in determination of the role in the immunopathogenesis of pyelonephritis and efficiency of treatment.
In the work was determined the HLA-phenotype specificities in patients with different morphologic forms of chronic glomerulonephritis and nephrotic syndrome (CGN, NS) to define the additional predictors of a disease course. Materials and methods. There was studied the HLA-antigens distribution in the 264 CGN, NS patients and 350 healthy donors by typing the lymphocytes with the aid ofstandard microlymphocytotoxic test (Terasaki’s test). The diagnosis was confirmed morphologically using the thin needle nephrobiopsy. Results. It is advisable to associate CGN, NS (RR > 2) with antigens HLA- A23, 24, 28; B8, 38, 41, 44 in patients; the causal role (a > 0.1) was determined for A24, 28; B8. In proliferative GN was additionally revealed the etiologic role of B27 known as antigen associated with risk ofautoimmune diseases. In patients with various morphologic forms is advisable the association of some antigens with development of chronic renal failure (CRF) – A30, B41 in FSGS, A10 – MGN; and also hormone resistance (HR) – A19+31+32 in FSGS, B8 – MGN and MC. Conclusion. The revealed reliable associations ofHLA types both with CGN, NS and its separate morphologic forms with the risk of CRF and/or HR allow take into consideration the availability ofsuch antigens in phenotype ofpatients with confirmed by biopsy diagnosis as the additional diagnostic and prognostic markers.
The purpose of study was determination of HLA -antigens I and II classes as predictors of ineffectiveness of initial steroid therapy, and according prognozonegative markers of chronic glomerulonephritis with nephrotic syndrome. Methods. In 59 chronic glomerulonephritis with nephrotic syndrome patients (steroid sensitive n=33 (1 gr.) and steroid resistant’s n= 26 (2 gr.)) and 350 healthy donors( control group) studied HLA antigens I and II classes of the special anti- HLA-antigens panel (20 antigens of locus A, 31 – of locus B and 9- of locus DR). Result. In patients with chronic glomerulonephritis, nephrotic syndrome with hormone sensitivity relative risk is high at the presents of A28 (RR=8,5, r р <0,001), it made attributive risk (=0,37). In comparison with a control group, RR>2 for antigens A11 (RR=2,23), A23 (RR=4,28), A24 (RR=3,3), A29 (RR=10,78) that A30 (RR=11,23); attributive risk more than 0,1 for the antigen A11 (=0,16) ; A24 (=0,13), other did not differ from control. Subzero connection is exposed for the antigens of A2 (р<0,001), А9 (р=0,007). In locus antigen B14 (RR=5,65, р =0,001) are exposed, B44 (RR=48,25, р =0,004), B51(RR=12,32, р =0,006) and attributive risk of development of disease (according =0,24, 0,12 ; 0,14); and antigens B38 and B41 (RR=11,57, р=0,05). The steroid sensitivity was associated with the antigens B5 (p=0,033), B12 (p=0,005) and B35 (p=0,021). In locus DR made etiologic faction antigens DR4 (RR=7,0 and =0,24) DRw52 (RR=7,0 and =0,25). Conclusions. For patients with chronic glomerulonephritis with a nephrotic syndrome antigens of HLA-B14,B38, B51, DRw52 are associated with steroid sensitivity. The attributive risk of steroid resistance is high for split A19+31+32, antigens B8, B55.
Introduction. Cytokines and HLA are of important part of immunogenesis of many diseases, therefore the analysis of these indices and this associations in dependence of glomerulonephritis (GN) can define their value as the additional prognostic markers. Aim of the work is to determine the peculiarities of associations the high serum levels ofproinflammatory cytokines (TNF a, MCP-1, IL-18) and some HLA in phenotype to substantiate of chronic glomerulonephritis with nephrotic syndrome (CGN, NS) immunogenesis and to ascertain the additional prognostic markers. Materials and methods. There was studied the HLA-antigens distribution in the 264 CGN, NS adult patients and 350 healthy donors by typing the lymphocytes with the aid of standard microlymphocytotoxic test (Terasaki’s test). Using IFA, the level of the proinflammatory cytokines was studied in the blood serum - MCP-1 in 39, IL-18 – 40 and TNF-a - 96patients. Results. HLA-A23, -24, -B8, -38, -41, -44, DR1, -4, -w52 in adults patients have associations (RR>2) CGN, NS; the attributive risk (a>0,1) to develop GN detected in patients have A24, B8, DR 1, 4, w52. The relative risk (RR) to develop chronic renal failure (CRF) is in detection of HLA-10, -29, -30, -41, -51, DR4; attributive risk (AR) - A10. The CGN, NS patients showed statistically higher level of the serum proinflammatory cytokines – TNF-6, IL-17, MCP-1 with more high indices of the TNF-a in patients with HLA-A23, -A28, -B44 (RR of CGN, NS), -A10 (AR of CRF), IL-18 - A24 (AR of CGN, NS) ma A10 (AR of CRF). The highest levels of MCP-1 detected in adults case have risk antigens - relative B41, attributive - A28, B8, and predictor of CRF B41, wich may be negative marker for prognosis. Conclusion. It was to determine associations the serum levels of some cytokines and HLA in patients with CGN, NS. We think it appropriate to study HLA and proinflammatory cytokines TNF-a, IL-18 and MCP-1 in blood as additional negative prognostic predictors for the differentiating approach to treatment.
Introduction. Cytokines are important to take part in immunogenesis and progression of glomerulonephritis (GN), therefore the analysis of these indices in dependence of type of GN forms as prognosys results of treatment. Aim of the work is to determine the peculiarities of pro-inflammatory cytokines (TNFα, MCP-1, IL-17, -18, -23) and anti-inflammatory TGF- β1 and their association with form GN with nephritic syndrome (NS) and possibility use cytokines as prognostic markers. Materials and methods. Using IFA, the level of the above mentioned cytokines was studied in the blood serum of 117 patients with proliferative (33) and non-proliferative (84) CGN, NS forms. There was also analyzed the changes of these indices in the patients with subsequent clinical laboratory remission (59) and patients without one (58). Results. The GN, NS patients showed statistically higher level of the pro- inflammatory cytokines – TNFα, MCP-1, IL-17 (with more high indices last one in the proliferative forms of GN, and IL-17 in nonsensitive to immunotherapy patients). High level profibrogenic TGFβ, and the ratio TNFα /TGFβ reflect the prevalence of anti-inflammatory reactions and high activity of monocytes - macrophages and T-helpers17. The positive effect of the treatment associates with the statistically decreased TNFα, MCP-1 and TGFβ1 levels in the patients with proliferative forms GN; the TGFβ1 - for patients with non-proliferative GN forms. Conclusion. The changes cytokine profiles may be use as predictors of results the immunosuppressive therapy.
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