Biomarkers Predicting Treatment-Response in Nephrotic Syndrome of Children: A Systematic Review

Abstract

Purpose: Nephrotic syndrome (NS) is the most common form of glomerulopathy in children. Most pediatric patients respond to glucocorticosteroid treatment (steroid-sensitive NS, SSNS), while approximately 10–15% will remain unresponsive or later become steroid-resistant. There has been a long-standing effort to find biomarkers that may predict steroid responsiveness.Methods: We systematically reviewed current studies which investigated clinically relevant biomarkers for predicting steroid responsiveness in pediatric NS. We performed a PubMed and EMBASE search to identify eligible articles. We collected data on urinary markers, blood/serum markers (including cellular phenotypes and mRNA expression), genotypes and HLA allele frequency.Results: A total of 659 articles were identified following electronic and manual searches. After reviewing the titles, abstracts, and full texts, 72 eligible articles were finally included. Vitamin D-binding protein (VDBP) seemed to be significantly elevated in SRNS than in SSNS, in both serum and urine specimen, although further validation is required.Conclusions: The present paper narratively illustrates current understandings of potential biomarkers that may help predict steroid responsiveness. Further investigation and collaboration involving a larger number of patients are necessary.

Exposure to airborne particulate matter induces renal tubular cell injury in vitro: the role of vitamin D signaling and renin-angiotensin system

“…They speculated that the RAS activation might occur upstream of oxidative stress and inflammation induced by PM 2.5 exposure. Given that RAS has multiple well-established pathophysiologic effects on the development and progression of various kidney diseases ( Crowley and Rudemiller, 2017 ; Lee et al., 2021 ; Maneesai et al., 2017 ), it is plausible that RAS activation plays a crucial role in renal tubular cell injury after exposure to fine particles in the present study. Impaired vitamin D signaling may contribute to RAS activation, which mediates cellular toxicity by increasing oxidative damage and inflammatory response.…”