1Department of Pediatrics, Kyungpook National University, College of Medicine 2Department of Pediatrics, Kyungpook National University, College of Medicine 3Department of Pediatrics, Kyungpook National University, College of Medicine 4Department of Pediatrics, Kyungpook National University, College of Medicine
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ABSTRACT
Purpose : Minimal Change Disease (MCD) is the most common primary nephrotic syndrome in children. Some suggested that tumor necrosis $factor-{alpha}$ ($TNF-{alpha}$) are involved in the pathogenesis of MCD. Methods : This study was done to see the changes of plasma and urinary $TNF-{alpha}$, and its effect on the determination of permeability of the glomerular basement membrane (BM) contributed by heparan sulfate proteoglycan (HSPG). Study patients consisted of 19 biopsy-proven MCD children aged 2-15 years old. Both plasma and urinary $TNF-{alpha}$ were measured. Employing the Millicell system, $TNF-{alpha}$ was screened for the permeability factors. We examined whether $TNF-{alpha}$ regulated BM HSPG gene expression and HS synthesis in the glomerular epithelial cells (GECs). Results : Urinary $TNF-{alpha}$ during relapse was significantly increased when compared with that of during remission or controls ($364.4{pm}51.2$ vs $155.3{pm}20.8,;36.0{pm}4.5$ ng/mg cr) (P<0.05). However, negative results were obtained in the permeability assay using the Millicell system. No difference was seen in the BM HSPG gene expression and HS synthesis in the GECs. Conclusion : It seems that $TNF-{alpha}$ may not play a disease-specific role in the pathogenesis of MCD.
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