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Titolo:
URINARY SOLUBLE HLA CLASS-I ANTIGEN IN PATIENTS WITH MINIMAL CHANGE DISEASE - A PREDICTOR OF STEROID-RESPONSE
Autore:
PARK CW; SONG HC; SHIN YS; AHN SJ; KIM YS; KIM SY; CHOI EJ; CHANG YS; BANG BK;
Indirizzi:
CATHOLIC UNIV KOREA,ST VINCENTS HOSP,DEPT INTERNAL MED,DIV NEPHROL,93CHI DONG,PALDAL KU SUWON 442060 SOUTH KOREA
Titolo Testata:
Nephron
fascicolo: 1, volume: 79, anno: 1998,
pagine: 44 - 49
SICI:
0028-2766(1998)79:1<44:USHCAI>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
IDIOPATHIC NEPHROTIC SYNDROME; FOCAL GLOMERULAR SCLEROSIS; HUMAN GLOMERULONEPHRITIS; MEMBRANOUS NEPHROPATHY; RENAL-TRANSPLANTATION; LIPOID NEPHROSIS; SERUM; QUANTITATION; SECRETION; TOLERANCE;
Keywords:
FOCAL SEGMENTAL GLOMERULOSCLEROSIS; MEMBRANOUS NEPHROPATHY; MINIMAL CHANGE DISEASE; SERUM SHLA-I; URINARY SHLA-I;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
28
Recensione:
Indirizzi per estratti:
Citazione:
C.W. Park et al., "URINARY SOLUBLE HLA CLASS-I ANTIGEN IN PATIENTS WITH MINIMAL CHANGE DISEASE - A PREDICTOR OF STEROID-RESPONSE", Nephron, 79(1), 1998, pp. 44-49

Abstract

In primary minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS), increased lymphocyte reactivity to renal antigens has been defined. Soluble HLA class I antigen (sHLA-I) is actively secreted by T and B lymphocytes when they are stimulated by mitogens, antigens and lymphokines. To determine if serum and urine sHLA-I levels could predict steroid response in patients with MCD and differentiate those from FSGS, we have investigated 45 healthy controls, biopsy-proven 17 patients with MCD (edema and 24-hour urine protein >3.5 g/day), 8 patients with FSGS (24-hour urine protein >1 g/day) and 10 patients with membranous nephropathy (MGN) (24-hour urine protein >1 g/day). Before and after prednisone therapy(1 mg/kg/day or 2 mg/kg/EOD for 8 weeks), the levels of serum and urinary sHLA-I were measured by ELISA (sHLA-STAT; Sangstat Co., Calif., USA). After 8 weeks of treatment, 10 patients with MCD were responders (MCD-CR) while the other 7 patients with MCD were nonresponders (MCD-NR). Three of 7 patients with MCD-NR were re-biopsied and finally diagnosed as FSGS. They were included in the data of patients with FSGS. In healthy controls, serum sHLA-I was detected (415 +/- 256 ng/ml), but urinary sHLA-I was not. At entry, there were no differences in age, sex, serum Cr and 24-hour urine protein among the patients with MCD-CR, MCD-NR and FSGS, but serum albumin was significantly elevated in patients with FSGS and MGN (p < 0.05). Serum sHLA-I levels were notably elevated in MCD-CR(1,040 +/- 1,066 ng/ml), in MCD-NR(668 +/- 315 ng/ml) and in FSGS (713 +/- 790 ng/ml), but not in patients with MGN (444 +/- 86 ng/ml) when compared with controls (p < 0.05). On the other hand, urinary sHLA-I levels in MCD-NR(541 +/- 239 ng/mg Cr) and in FSGS (457 +/- 239 ng/mg Cr) were significantly higher than those in MGN (125 +/- 28 ng/mg Cr) and in MCD-CR(100 +/- 42 ng/mg Cr, p < 0.05) and these substantial differences were maintained for 8 weeks. In all patients, serum and urinary sHLA-I levels were not reduced during 8 weeks of steroid therapy. We conclude that elevated serum and urinary sHLA-I levels reflect increased cellular immune response and disease activity in patients with MCD and FSGS. In patients with MCD, urinary sHLA-I may be an easily measurable indicator of predicting steroid response, while MCD-NR with high urinary sHLA-I levels might be re-evaluated for the possibility of FSGS.

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Documento generato il 15/07/20 alle ore 04:35:25