Changes of Plasma and Urine IL-8 and TNF-alpha in Children with Minimal Change Nephrotic Syndrome

Lee, Sun Min; Jang, Hee Jin; Ko, Cheol Woo; Koo, Ja Hoon

Abstract

PURPOSE: Minimal Change Nephrotic Syndrome (MCNS) is one of the most common primary nephrotic syndromes in children. T-cell dysfunction has been thought to be involved in the pathogenesis of MCNS. However, the exact pathogenesis of MCNS has not been proven yet in spite of many studies which support T-cell dysfunction being involved in the pathogenesis of MCNS. A present study was done to determine the role of IL-8 and TNF-alpha in the pathogenesis of MCNS.
METHODS
Study patients consisted of 19 biopsy-proven MCNS children aged 2-15 years old. Ten age-matched healthy children were used as controls. Both plasma and urinary IL-8 and TNF-alpha were measured during relapse and remission period using ELISA kit. Urinary cytokine values were corrected for urinary creatinine.
RESULTS
Each value of urinary IL-8 measured during relapse and remission period in MCNS and controls was 13,996+/-2,811, 2,811+/-3,734 and 5,331+/-6,403ng/mg cr, respectively, and we noted that the value of urinary IL-8 measured during relapse period in MCNS significantly increased compared to those measured during remission period and in controls(p< 0.05). And each value of urinary TNF-alpha measured in the same group was 364.4+/-512.1, 55.3+/-208.0 and 36.0+/-45.0ng/mg cr, respectively, and we also noted that the value of urinary TNF-alpha measured during relapse period in MCNS was signficantly increased compared to those measured during remission period and in controls. The plasma cytokine values measured during relapse and remission period and in controls were 1.19+/-1.23, 0.51+/-0.84 and 0.77+/-0.62ng/mL, respectively, in the case of IL-8 and 2.42+/-3.86, 1.95+/-3.24 and 2.25+/-3.50ng/mL, respectively, in the case of TNF-alpha, and we noted the value of plasma IL-8 measured during relpase was also significantly increased compared to those of remission period and in control(p<0.05), but the change of plasma TNF-alpha values was not significant.
CONCLUSION
It can be said that both IL-8 and TNF-alpha play an important role in the pathogenesis of MCNS in children. The fact that changes of urinary IL-8 and TNF-alpha were more prominent than those of plasma suggests that immune dysregulation may occur intrarenally rather than systemically in MCNS.