Definition of heat shock proteins in the urine, serum and kidney tissue: significance for the assessment of activity and prognosis of chronic glomerulonephritis


N.V. Chebotareva, N.V. Neprintseva, I.N. Bobkova, L.V. Kozlovskaya, V.A. Varshavsky.

SBEI HPE «First MSMU n.a. I.M. Sechenov" of RMPH, Moscow
Purpose. To evaluate the state of "kidney self-defense" system in patients with chronic glomerulonephritis (CGN) according to the major heat shock protein (HSP) levels in the urine, blood, and kidney; to clarify the significance of the changes of these factors for the assessment of activity and prognosis of CGN.
Material and methods. The study included 75 patients with active CGN: 34 - with severe urinary syndrome (Group I), 41 - with nephrotic syndrome (Group II), including 31 - with moderate nephrotic syndrome (Group IIA) and 10 with severe nephrotic syndrome (Group IIB). Transient impairment of renal function as a manifestation of the high CGN activity was revealed in 7 patients from Group I and in 14 from Group II. Control groups consisted of 10 patients with inactive CGN and 10 healthy individuals. Using the ELISA, urine HSP-27 and HSP-70, interleukin (IL)-10 and IL-6 levels; serum levels of antibodies to HSP-70, and HSP-70 expression in the kidney tissue were evaluated.
Results. With increasing activity of CGN (primarily an increase of proteinuria, development of nephrotic syndrome, especially in combination with impaired renal function), the imbalance of damaging and protective mechanisms develops. Decrease of serum levels of antibodies to HSP-70 and urine IL-10 levels with an increase of urinary HSP-27, HSP-70 and IL-6 excretion indicate the activity of the inflammatory response in renal tissue and severity of cellular damage in patients with CGN. Progression of these disorders is a poor prognostic sign, indicating the risk of chronization of the disease and poor response to treatment. Thus, in 80% of patients with high (greater than 21 pg/ml) levels of antibodies to HSP-79, response to treatment was obtained within 12 months, in 50% of patients - within 5 months. At the same time, in 57% of patients with antibody titers less than 21 pg ml, nephrotic syndrome persisted despite long-term treatment recommended for these forms of the disease
Conclusion. The results of the study demonstrate the significance of HSPs as indicators reflecting the activation of cellular defense mechanisms and extracellular effects of regulation of immune inflammation in the kidney.

About the Autors


Information about the authors:
Chebotareva N.V. – PhD in Medical Sciences, Senior Researcher at the Department of Nephrology SRC SBEI HPE «First MSMU n.a. I.M. Sechenov" of RMPH, E-mail: natasha_tcheb@mail.ru
Neprintseva N.V. – postgraduate student at the Department of Nephrology and Hemodialysis of the Institute of Professional Education SBEI HPE «First MSMU n.a. I.M. Sechenov" of RMPH
Bobkova I.N. – MD, Head of the Department of Nephrology SRC, Professor at the Department of Nephrology and Hemodialysis of the Institute of Professional Education SBEI HPE «First MSMU n.a. I.M. Sechenov" of RMPH
Kozlovskaya L.V. – MD, Professor at the Department of the Internal, Occupational diseases and Pulmonology MPF SBEI HPE «First MSMU n.a. I.M. Sechenov" of RMPH
Varshavsky V.A. – MD, Professor at the Department of Pathological Anatomy of the Medical Faculty SBEI HPE «First MSMU n.a. I.M. Sechenov" of RMPH


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