O.V. Semeshina, V.N. Luchaninova, E.V. Markelova, A. Ni, O.G. Bykova1 SBHCI "Regional Children’s Clinical Hospital № 1"; Vladivostok, Russia; 2 FSBEI HE "Pacific State Medical University" of RMH, Vladivostok, Russia; 3 FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov" of RMH; Saint-Petersburg, Russia
Aim. To evaluate the state of congenital humoral immunity in children with various kidney diseases in a comparative aspect for the detection of new diagnostic and prognostic markers of nephrosclerosis.
Materials and Methods. 255 children with various kidney diseases were under observation (including 16 with urolithiasis, 174 with microbial inflammatory diseases of the kidneys, and 65 with glomerulopathies). Children with CKD stages 1 and 2 were prevalent in all studied groups (100%, 97.5%, and 95.4%, respectively). Comparison group (healthy controls) included 31 children. Groups were age-matched. In patients of study groups and children of the comparison group, the following urine cytokine levels were quantified: TNF-α, TNFRI and TNFRI, IL-10, TGF-β1 and TGF-β3, IL-2, IL-2-SR and leptin. The study was performed in a licensed laboratory for the chemistry of noninfectious immunity by the sandwich method (USA). Nonparametric and parametric statistics were used to evaluate cytokine levels.
Results. Study has shown that an increase in TNF-α can be considered as a highly specific marker of acute pyelonephritis, while an increase in TGF-β1 and leptin is an early marker of nephrosclerosis, especially in patients with glomerulopathies. The decrease in the TNF-α/IL-10 ratio by more than 1.5 times is also a marker of nephrosclerosis. The increase in urinary TNF-α excretion against the background of a decrease in IL-10 with preservation of stably high TGF-β1 concentrations can be used as a marker of inflammation and fibrosis in microbial inflammatory diseases of the kidneys and glomerulonephritis.
Conclusions. Thus, the diagnostic significance of revealing kidney diseases by the method of cytokine urine profile evaluation with the clarification of some pathogenetic mechanisms of development and progression of chronic kidney disease in children is presented.
Semeshina O.V. – PhD in Medical Science, Head of the Department of Nephrology SBHCI RCCH №1; Vladivostok, Russia. E-mail: firstname.lastname@example.org
Luchaninova V.N. – Doctor of Medical Sciences, Professor at the Department of Pediatrics and Pediatric Cardiology FSBEI HE NWSMU n.a. I.I. Mechnikov of RMH;
St. Petersburg, Russia, Nephrologist at the SBHCI RCCH №1; Vladivostok, Russia
Markelova E.V. – Doctor of Medical Sciences, Professor, Head of the Department of Normal and Pathological Physiology FSBEI HE PSMU of RMH, Vladivostok, Russia
Ni A. – Doctor of Medical Sciences, Professor of the Institute of Pediatrics FSBEI HE PSMU of RMH, Vladivostok, Russia
Bykova O.G. – SBHCI RCCH №1; Vladivostok, Russia