Unlabelled: The severity and duration of immunosuppression caused by corticosteroids (CSs) usage have not been extensively studied. We aimed to investigate the effects of CSs on the various compartments of immune system in relation to timing of initiation and persistence of therapy. Pediatric patients with idiopathic nephrotic syndrome (NS) treated with 2 mg/kg/day prednisolone and healthy control (HC) were enrolled. Blood samples were drawn for immunologic analyses at baseline and at the first and second weeks and first, second, and third months of CS therapy in addition to first and second weeks and first, second, and third months of discontinuation. Fourteen patients (M/F, 7/7) between 1 and 8 years old were evaluated. Untreated NS exhibited high absolute lymphocyte count (ALC)(p = 0.010), absolute CD3(+) T cells (p = 0.020) and absolute CD8(+) T cells (p = 0.006) compared to HC. Suppression in ALC was observed and nadir value was noted at first month of therapy compared to baseline (p = 0.002). The CD4(+) (p = 0.036) and CD8(+) T cell (p = 0.013) counts decreased significantly at the first week of treatment compared to baseline. While baseline B cell counts was indifferent from HC, gradually increased in 2 weeks of CS initiation and decreased during the treatment with a statistical significance compared to HC (p = 0.010). However, after cessation of CS, B cell counts continued to decline and found to be significantly different than baseline at first week (p = 0.008) and at third month (p = 0.040).
Conclusion: Apart from baseline lymphocyte subset changing observed in untreated NS patients, our data implies that T cells were suppressed very early in the CS treatment. Interestingly, depressed B cell counts were detected later but persisted even after CS cessation. Due to early decrease in T cells, it would be beneficial to assume the patients as immunosuppressed at the very beginning of CS treatment to avoid infections.
What Is Known: • Corticosteroids (CSs) are widely used for a variety of diseases including nephrotic syndrome, which is related with complex immune disturbance including T and B cells dysfunctions. • CSs induce neutrophilic leukocytosis concomitant with lymphopenia and eosinopenia leading to immunosupression. What is New: • T cell subsets and proliferation are susceptible to CSs more than B cells; however, the reversibility is faster with dose reduction in CS. • The change of B cells and B cell subtypes (CD27 (+) memory) shows prolonged effect of CSs on B cells which may alter antibody production even after 3 months of CSs cessation.
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http://dx.doi.org/10.1007/s00431-016-2694-x | DOI Listing |
Life (Basel)
December 2024
Department of Nephrology, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
Background: Despite extensive research on proteinuria's impact on chronic kidney disease progression, there is no direct comparison of outcomes in biopsy-diagnosed glomerular disease (GD) patients with nephrotic syndrome (NS) or nephrotic range proteinuria (NRP). Our study addresses this gap, comparing long-term outcomes between NS and NRP.
Methods: We conducted a retrospective study on 240 kidney biopsy-proven GD patients, tracked from 2010 to 2015 until end-stage kidney disease (ESKD), death, or the study end in January 2022.
Biomedicines
December 2024
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan.
Nephrotic syndrome (NS) is characterized by massive proteinuria, hypoproteinemia, and edema [...
View Article and Find Full Text PDFArch Esp Urol
December 2024
Pediatric Surgery, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China.
Background: Doxorubicin (DOX) is a widely used anticancer drug; However, its nephrotoxicity limits its therapeutic efficacy. This study investigates the protective effects of Perilla Alcohol (PA) against DOX-induced nephrotic syndrome (NS), focusing on its antioxidant and anti-inflammatory properties through the nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathways.
Methods: A DOX-induced nephrotic syndrome (NS) rat model and a DOX-treated Mouse Podocyte Cell line 5 (MPC5) cell model were used to evaluate the renal protective effects of PA.
Front Pediatr
December 2024
Department of Pediatrics, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
Cureus
December 2024
Nephrology, Archbold Hospital, Alabama College of Osteopathic Medicine, Thomasville, USA.
Membranous nephropathy due to a positive PLA2R marker is an idiopathic cause of membrane nephropathy, characterized as an autoimmune attack on the kidney at the PLA2R receptor. Autoantibodies attack the PLA2R receptor, leading to nephrotic syndrome and eventually leading to end-stage renal failure, as in our case. We present a case that involves a patient who presented to the nephrology clinic with nephrotic range proteinuria and a history of HIV.
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