J Korean Med Sci.  2013 Feb;28(2):261-267. 10.3346/jkms.2013.28.2.261.

Predictive Value of Conjointly Examined IL-1ra, TNF-R I, TNF-R II, and RANTES in Patients with Primary Glomerulonephritis

• Zwiech R

• KMID: 1429194
• DOI: http://doi.org/10.3346/jkms.2013.28.2.261

Abstract

Interleukin-1 receptor antagonist (IL-1ra), tumor necrosis factor soluble receptors (sTNF-R) type I and II, and regulated upon activation, normal T-cell expressed and secreted (RANTES) play an important role in the modulation of primary glomerulonephritis (GN) course. The aim of the study was to assess whether pre-treatment measurements of IL-1ra, sTNF-R, and RANTES assessed conjointly may be useful as predicting factors in patients with GN. In 84 patients (45 males and 39 female) serum concentration (pg/mL) and urinary excretion (pg/mgCr) of cytokines were measured. After 12 months of therapy with steroids and cyclophosphamide the patients were divided into two subgroups: Responders (R) and Non-Responders (NR) according to the treatment results. The urinary IL-1ra, TNF-RI and RII were significantly higher in R than NR (1,732 vs 646 with P < 0.001, 13.1 vs 6.3 with P = 0.005, and 33.6 vs 14.4 with P = 0.012). The urinary RANTES excretion was increased in NR (79.6 vs 28.5; P < 0.001). The multivariable analysis showed that if conjointly assessed, only urinary IL-1ra, TNF-R I and R II, RANTES with 85% probability pointed the feature remission (R). In conclusion, the urinary excretion of IL-1ra, TNF-R I and R II, and RANTES examined conjointly are effective in predicting favorable response to immunosuppressive treatment in patients with GN.

Keyword

Immunosuppressive Treatment Outcomes; Interleukin-1 Receptor Antagonist; Primary Glomerulonephritis; RANTES; Receptors, Tumor Necrosis Factor

MeSH Terms

Adult
Cyclophosphamide/therapeutic use
Female
Glomerulonephritis/drug therapy/*metabolism/pathology
Humans
Immunosuppressive Agents/therapeutic use
Interleukin 1 Receptor Antagonist Protein/*analysis/blood/urine
Lymphocyte Activation
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Receptors, Tumor Necrosis Factor, Type I/*analysis/blood/urine
Receptors, Tumor Necrosis Factor, Type II/*analysis/blood/urine
Steroids/therapeutic use
T-Lymphocytes/immunology/metabolism
Immunosuppressive Agents
Interleukin 1 Receptor Antagonist Protein
Receptors, Tumor Necrosis Factor, Type I
Receptors, Tumor Necrosis Factor, Type II
Steroids
Cyclophosphamide

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