Coincident Activation of Th2 T Cells with Onset of the Disease and Differential Expression of GRO-Gamma in Peripheral Blood Leukocytes in Minimal Change Disease

Adrogué, Horacio E.; Borillo, Jason; Torres, Lisa; Kale, Arundhati S.; Zhou, Cindy; Feig, Daniel I.; Merszei, Justin; Johnson, Richard F.; Lou, Yahuan

doi:10.1159/000101371

Cited by 15 publications

(12 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, studies examining IL-4 expression have been conflicting. Thus, although T cells have been reported to express high levels of IL-4 either spontaneously60 or after stimulation,61-63 other studies59,64,65 have not confirmed these findings.…”

Section: Alternative Views Of the Role Of Allergy In MCDmentioning

confidence: 89%

Idiopathic Nephrotic Syndrome and Atopy: Is There a Common Link?

Abdel-Hafez

Shimada

Lee

et al. 2009

American Journal of Kidney Diseases

116

108

View full text Add to dashboard Cite

Numerous reports during the last 60 years have reported a strong association between idiopathic nephrotic syndrome and atopic disorders. Idiopathic nephrotic syndrome can be precipitated by allergic reactions and has been associated with both aeroallergens (pollens, mold, and dust) and food allergies. Patients with idiopathic nephrotic syndrome also may show increased serum immunoglobulin E (IgE) levels. A review of the literature suggests that although some idiopathic nephrotic syndrome cases may be associated with allergies, evidence that it is a type of allergic disorder or can be induced by a specific allergen is weak. Rather, it is likely that the proteinuria and increased IgE levels in patients with idiopathic nephrotic syndrome are caused by increased levels of interleukin 13 observed in these patients. Recent studies suggest that interleukin 13, a known stimulator of IgE response, may mediate proteinuria in patients with minimal change disease because of its ability to directly induce CD80 expression on the podocyte. KeywordsAtopy; nephrotic syndrome; minimal change disease Idiopathic nephrotic syndrome in children is a clinical syndrome associated with a variety of glomerular lesions. Minimal change disease (MCD) is the most common cause of idiopathic nephrotic syndrome. MCD is often abrupt in onset. It can be dramatic in presentation, yet is one of the most rewarding diseases for a physician to manage because response to corticosteroids often is rapid and complete. Because kidney biopsy usually is not performed when the disease responds to corticosteroid therapy, the term MCD has become synonymous with steroid-sensitive nephrotic syndrome. The mechanism(s) underlying the MCD pathogenesis are unknown, although it is believed to be immunologically mediated. 1 Strong evidence suggests that it may be caused by a circulating factor, possibly T-cell related, that causes podocyte dysfunction resulting in massive proteinuria. 2 However, there also have been numerous reports linking MCD with atopic disorders and increases in serum immunoglobulin E (IgE) levels. In this review, we discuss the evidence supporting the association of atopy and whether there may be a common underlying immune disorder that may predispose patients to both conditions. ATOPYAtopy is a term used to describe IgE-mediated diseases. Persons with atopy have a hereditary predisposition to produce IgE antibodies to common allergens and often manifest with 1 or more atopic diseases (asthma, allergic rhinitis, and atopic eczema). Atopic patients mount an exaggerated immunologic response characterized by production of allergen-specific IgE antibodies and positive reactions to extracts of common aeroallergens on skin-prick tests. Type 2 helper T cells (T H 2) from patients with atopy respond to allergens in vitro by expressing such cytokines as interleukin 4 (IL-4) and IL-13 3 (Fig 1A and B). Early Reports of Atopy With MCDIn 1951, Fanconi et al 4 were among of the first to associate atopy and nephrotic syndrome. Forty-three percent of th...

show abstract

Section: Alternative Views Of the Role Of Allergy In MCDmentioning

confidence: 89%

Idiopathic Nephrotic Syndrome and Atopy: Is There a Common Link?

Abdel-Hafez

Shimada

Lee

et al. 2009

American Journal of Kidney Diseases

116

108

View full text Add to dashboard Cite

show abstract

“…Regarding the MCD patients, our findings suggest an interesting role of Th2 cytokines in the outcome of disease, and particularly a strong association of increased urinary levels of Th2 cytokines at time of renal biopsy, with recurrent episodes of relapse during follow up. Association of MCD with allergic reactions is well-known, as is the shift to Th2 type immune response, especially in atopic children with MCD ( 32 , 33 ). IL-4 and IL-13 are increased during active phase of the disease.…”

Section: Discussionmentioning

confidence: 99%

Impact of Τh1 and Τh2 cytokines in the progression of idiopathic nephrotic syndrome due to focal segmental glomerulosclerosis and minimal change disease

Stangou¹,

Spartalis²,

Daikidou³

et al. 2016

J Nephropathol

View full text Add to dashboard Cite

Background: Differential diagnosis between primary focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) is sometimes difficult as nephrotic syndrome is the main clinical symptom in both diseases. Objectives: This study has attempted to evaluate the urinary excretion of Th1 and Th2 cytokines as potential biomarkers in distinguishing the two types of nephrotic syndrome, and predicting outcome of renal function. Patients and Methods: Thirty-six patients with FSGS (M/F 22/14, Age; 41.9 ± 17 years, SCr=1.7 ± 0.8 mg/dL, UProt=4.7 ± 5.5 g/24 h), and 21 with MCD (M/F 5/16, Age; 41.4 ± 15 years, SCr = 1 ± 0.4 mg/dL, UProt = 7.9 ± 9.3 g/24 h) were included in the study. Τh1 (IL-2, IL-12, GM-CSF, INF-γ, TNF-α) and Th2 cytokines (IL-4, IL-5, IL-10, IL-13) were measured by multiple cytokine assay, Luminex technology, in first morning urinary samples collected at the day of renal biopsy. Results: No significant differences in urinary excretion of all cytokines were found between FSGS and MCD patients. In FSGS however, IL-12 urinary levels were independent factor correlated with both global sclerosis (R = 0.5, P = 0.009) and interstitial fibrosis (R = 0.5, P = 0.02). Th1 cytokines (IL-2 and GM-CSF) were significantly increased in FSGS patients who did not respond to treatment (P = 0.03 and P = 0.007, respectively). Th2 cytokines (IL-4, IL-5, IL-10, IL-13) were significantly increased in MCD patients with frequent relapses (P = 0.05, P = 0.001, P = 0.01, P = 0.03). Conclusions: Urinary excretion of Th1 and Th2 cytokines cannot discriminate FSGS from MCD. Th1 cytokines, especially IL-12, IL-2 and GM-CSF, may be involved in pathology and progression of FSGS, while Th2 cytokines are implicated in frequent relapses of nephrotic syndrome in MCD.

show abstract

“…Growth regulated protein (GRO)-γ is a potential candidate for the Th2-associated GPF in MCNS, as implicated in the function of endothelial cells. Furthermore, Adrogue et al (26) observed markedly higher levels of CD4 + T cells in patients with MCNS and hypothesized that the levels of IL-4, IL-8 and GRO were also higher in individuals with MCNS. An increase in the level of IL-8 was shown to change the permeability of the glomerular basement membrane (GBM) via reducing the synthesis of heparan sulfate proteoglycans (HSPGs) on the GBM, which eventually induced proteinuria in rats (27).…”

Section: Imbalance Of the Th1/th2 Response And The Role In Mcnsmentioning

confidence: 99%

Role of basophils in the pathogenesis of minimal change nephrotic syndrome: A literature review

Tao

Chen

et al. 2014

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

A number of studies have verified that minimal change nephrotic syndrome (MCNS) may result from the dysfunction of T cells and B cells, although the precise mechanisms are yet to be elucidated. It is widely recognized that MCNS is a T helper (Th)2-dominant glomerular disease caused by an imbalanced Th1/Th2 immune response. Increased levels of the Th2 cytokines, interleukin (IL)-4 and IL-13, have been demonstrated to be closely associated with disease activity. In addition, basophils can affect the Th1/Th2 balance by enhancing the Th2 response and impairing the Th1 response, which are then involved in the development of numerous diseases. However, whether basophils are vital in the pathogenesis of MCNS remains unknown. Frequent positivity of the human basophil degranulation test in patients with MCNS has been observed. Thus, basophils should be analyzed in order to determine their role in the pathogenesis of MCNS.

show abstract

Coincident Activation of Th2 T Cells with Onset of the Disease and Differential Expression of GRO-Gamma in Peripheral Blood Leukocytes in Minimal Change Disease

Cited by 15 publications

References 56 publications

Idiopathic Nephrotic Syndrome and Atopy: Is There a Common Link?

Idiopathic Nephrotic Syndrome and Atopy: Is There a Common Link?

Impact of Τh1 and Τh2 cytokines in the progression of idiopathic nephrotic syndrome due to focal segmental glomerulosclerosis and minimal change disease

Role of basophils in the pathogenesis of minimal change nephrotic syndrome: A literature review

Contact Info

Product

Resources

About