A Study of the Relationship between Childhood Nephrotic Syndrome and Allergic Diseases

Lin, Ching‐Yuang; Lee, Bor-Huey; Lin, Chiou-Chyn; Chen, Wei-Perng

doi:10.1378/chest.97.6.1408

Cited by 43 publications

(40 citation statements)

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“…As it has been stated in the past, the belief today too is that the immune system plays an important role in this condition. [5][6][7][8][9] In particular, there is strong evidence pointing to T-cell disorder mediated by a circulating factor that creates podocyte dysfunction and massive proteinuria. 2,3 In many studies, increased incidence of allergic diseases and high serum IgE levels have been reported in SSNS.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of children with steroid-sensitive nephrotic syndrome in terms of allergies

et al. 2015

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Background: The etiology of minimal-change disease is not fully known, it is believed to be mediated by the immune system. Minimal-change disease also reported as having association with atopy. In this study, atopy history, the levels of serum IgE, and skin prick test in children with steroid-sensitive nephrotic syndrome were investigated. Methods: A group of 30 children (mean age 7.7 ± 2.2 years, 56.6% male) diagnosed with steroid-sensitive nephrotic syndrome were included in the study. Serum immunoglobulin E levels and eosinophil counts were evaluated in children with steroid-sensitive nephrotic syndrome both in relapse and remission. Skin prick test was performed in remission. Results: Of the 30 children investigated, 11 (36.7%) had a history of atopy. The median serum total IgE levels in nephrotic children in relapse, with (445 IU/mL) and without atopy (310 IU/mL) were significantly higher than those in remission (respectively, 200 IU/mL, p ¼ 0.021, and 42 IU/mL, p ¼ 0.001). The skin prick tests for all the allergens were evaluated as negative in all the patients. Conclusion: It was thought that increased IgE may reflect the activation of immune mechanism following various stimuli rather than a direct association with atopy in children with steroid-sensitive nephrotic syndrome.

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Section: Discussionmentioning

confidence: 99%

“…5 Although initial studies indicated high IgE levels in SSNS and in patients with frequent relapses, 6 later investigations reported different results. 7,8 These different results derive from a lack of standardization in the study procedure.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of children with steroid-sensitive nephrotic syndrome in terms of allergies

et al. 2015

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“…Before 1970s, only anecdotal reports described patients who developed INS after allergic events to certain allergens (2-5). Since 1970, several case-control studies revealed that elevated serum IgE were more common in children with INS compared to normal controls (9,(11)(12)(13)(14)(15)(16)(17)27). Subsequently, the levels of T helper 2-associated cytokines such as interleukin (IL)-4 and IL-13 were found to be upregulated in relapsing INS patients (19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have associated INS with allergy risk of clinical and immunological features (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). In the 1950s through the 1970s, few anecdotal reports described patients who developed INS after allergic reactions to inhaled allergens, vaccinations, food, or insect stings (2)(3)(4)(5).…”

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confidence: 99%

“…Children with INS commonly have elevated serum levels of immunoglobulin E (IgE), which also plays a central role in allergic inflammation (11)(12)(13)(14)(15)(16). Although clinical and immunological studies have shown a possible link between allergic diseases and INS for 50 y, human epidemiologic study using a large cohort to investigate the relationship between these disorders are lacking (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Asthma is one of the most common allergic disease in childhood, affects a multitude of patients worldwide (22).…”

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Risk of idiopathic nephrotic syndrome among children with asthma: a nationwide, population-based cohort study

et al. 2015

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Background:Although clinical and immunological studies have shown a possible link between allergy and idiopathic nephrotic syndrome (INS), the nature of the relationship remains unclear. Asthma is the most common chronic allergic airway inflammation. However, no study has used a longitudinal design with a population cohort to investigate INS in children with asthma. Methods: Using nationwide claims data from 2000 through 2007, we randomly selected 251,698 asthma cases and 1,006,791 frequency-matched controls. Incidence rates of INS and hazard ratios (HRs) were calculated. results: The INS incidence was 3.36-fold greater in the asthma cohort than in the nonasthma control (9.26 vs. 2.76 per 100,000 person-years; 95% confidence interval (CI): 2.65-4.26). The HR for INS increased for those with more asthma-related medical visits per year, from 1.49 (95% CI: 1.06-2.11) for <3 visits to 15.7 (95% CI: 11.5-21.5) for ≥6 visits (trend test, P < 0.0001). The HR for INS slightly decreased during the follow-up period, from 3.41 (95% CI: 2.66-4.38) for ≤5.5 y to 2.90 (95% CI: 1.33-6.30) for >5.5 y. conclusion: We conclude that children with asthma had an increased incidence rate of INS, and increased incidence rate correlated with asthma-related medical visits.i diopathic nephrotic syndrome (INS) is among the most common chronic kidney diseases occurring in childhood (1). Numerous studies have associated INS with allergy risk of clinical and immunological features (2-11). In the 1950s through the 1970s, few anecdotal reports described patients who developed INS after allergic reactions to inhaled allergens, vaccinations, food, or insect stings (2-5). Since 1970, several case-control studies revealed that elevated serum IgE and atopic diathesis were more common in children with INS than non-INS controls (9,(11)(12)(13)(14)(15)(16)(17). Recently, levels of T helper 2 (Th2)-associated cytokine such as interleukin (IL)-4 and IL-13 were found to be elevated in relapsing INS patients (18-21). Children with INS commonly have elevated serum levels of immunoglobulin E (IgE), which also plays a central role in allergic inflammation (11)(12)(13)(14)(15)(16). Although clinical and immunological studies have shown a possible link between allergic diseases and INS for 50 y, human epidemiologic study using a large cohort to investigate the relationship between these disorders are lacking (2-11). Asthma is one of the most common allergic disease in childhood, affects a multitude of patients worldwide (22). It is unknown whether childhood onset asthma would increase the subsequent risk of INS. Therefore, we conducted a nationwide, population-based cohort study to examine the hypothesis that asthma may have positive influence on the development of INS in children. RESULTSA total of 251,698 subjects in the asthma cohort and 1,006,791 in the nonasthma cohort were enrolled in this study (Table 1). Most (67.6%) of the subjects were aged ≤5 y. The asthma cohort had more boys (59.4%), residents of highly urbanized areas (59.8%), and white-collar pa...

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Involvement of interleukin (IL)‐13, but not IL‐4, in spontaneous IgE and IgG4 production in nephrotic syndrome

1995

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Nephrotic syndrome (NS) is a renal disease characterized by proteinuria and hypoalbuminemia. In NS patients without any allergic disease, serum IgE and IgG4 levels were selectively increased, and peripheral blood mononuclear cells (MNC) spontaneously produced IgE and IgG4. T cells produced interleukin (IL)-13 spontaneously, and B cells constitutively expressed IL-13 receptors (IL-13R). In addition, T cells stimulated surface IgE-negative (sIgE-) and sIgG4- B cells to produce IgE and IgG4, respectively, and IgE and IgG4 production was specifically blocked by anti-IL-13 antibody (Ab). MNC from atopic dermatitis (AD) patients also produced IgE and IgG4 spontaneously. However, in AD patients, T cells spontaneously produced IL-4, but not IL-13, and B cells constitutively expressed IL-4R, but not IL-13R. T cells stimulated sIgE- and sIgG4- B cells to produce IgE and IgG4, respectively, and the production was specifically blocked by anti-IL-4 Ab. On the other hand, sIgE+ and sIgG4+ B cells from both NS and AD patients spontaneously produced IgE and IgG4, respectively, and this production was not affected by T cells, anti-IL-4 Ab, or anti-IL-13 Ab. These results indicate that IL-13 is involved in the enhanced production of IgE and IgG4 in NS, while IL-4 is involved in these responses in AD.

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A Study of the Relationship between Childhood Nephrotic Syndrome and Allergic Diseases

Cited by 43 publications

References 14 publications

Evaluation of children with steroid-sensitive nephrotic syndrome in terms of allergies

Evaluation of children with steroid-sensitive nephrotic syndrome in terms of allergies

Risk of idiopathic nephrotic syndrome among children with asthma: a nationwide, population-based cohort study

Involvement of interleukin (IL)‐13, but not IL‐4, in spontaneous IgE and IgG4 production in nephrotic syndrome

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