Abstract
T cells are involved in the pathogenesis of nephrotic syndrome (NS). The aim of the study was to determine whether the activity of T-helper-1 (Th1) and T-helper-2 (Th2) cells and the distribution of the lymphocyte subsets, namely CD45RA+CD4+ (”naive” helper T cells, suppressor-inducer), CD45RA+CD8+ (”naive” suppressor T cells, suppressor-effector), CD45RO+CD4+ (”memory” helper T cells), are predictive for steroid sensitivity in children with primary NS. These parameters were assessed at the onset of disease, before initiation of steroid therapy. Two groups of NS children were retrospectively formed according to steroid sensitivity (SS) or resistance (SR). The activity of Th1 and Th2 cells was defined by the production of interleukin-2 (IL-2), interferon-γ, IL-4, and IL-10 in the supernatants of CD4+ T cell cultures activated with autologous monocytes presenting tetanus toxoid (TT). Peripheral lymphocyte subsets were determined using double- or triple-color flow cytometry. In SS children with NS we found a decreased proliferative response of CD4+ T cells to TT stimulation, cytokine synthesis indicating the predominance of Th2 activity, and an increased percentage of activated suppressor-inducer (CD45RA+ CD4+CD25+, 5.18±0.8, P<0.001) and suppressor-effector (CD45RA+CD8+CD25+, 2.05±0.6, P<0.01) cells, with the concomitant reduction of activated memory cells (CD45RO+CD4+CD25+, 0.2±0.1, P<0.001). In children with SRNS we found an increased proliferative response of CD4+ T cells to TT, a rise in activated memory (CD45RO+CD4+CD25+, 3.82±0.7, P<0.01) and suppressor-inducer peripheral T cells (CD45RA+ CD4+CD25+, 3.85±0.6, P<0.01), but a low percentage of activated suppressor-effector (CD45RA+CD8+ CD25+, 0.5±0.2, P<0.05) T cells. We conclude that prior to treatment the distribution of lymphocyte subpopulations in peripheral blood together with Th1 and Th2 cell activity provides a useful tool for evaluating the likelihood of steroid sensitivity in patients with primary NS.
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Received: 3 November 1998 / Revised: 1 September 1999 / Accepted: 8 September 1999
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Stachowski, J., Barth, C., Michałkiewicz, J. et al. Th1/Th2 balance and CD45-positive T cell subsets in primary nephrotic syndrome. Pediatr Nephrol 14, 779–785 (2000). https://doi.org/10.1007/PL00013437
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DOI: https://doi.org/10.1007/PL00013437
- Key words Primary nephrotic syndrome
- Cytokines
- Flow cytometry
- Suppressor-inducer T cell
- Suppressor-effector T cellRID=""ID="" <E6>Acknowledgements </E6>This work was supported by the research grant KBN 4P05E 046 14 from the Committee of Scientific Research and partially by AM 501-1-05-01 and AM 501-1-05-19 (Poland). These results were, in part, presented at the 27th Annual Meeting of the European Society for Paediatric Nephrology, 5–8 September 1993, Heidelberg and at the 32nd Annual Congress of the European Dialysis and Transplant Association-European Renal Association (EDTA-ERA), 11–14 June, Athens, Greece (Nephrol Dial Transplant 1995,10:929]. We thank Professor K. Schärer and Dr. V. Daniel of the University of Heidelberg for their helpful criticism during the preparation of the manuscript.RID=""ID="" <E5>Correspondence to</E5> J. Stachowski