Non-invasive Markers of their Activity of Glomerulonephritis in Childhood

Overview

Glomerulonephritis (GN) is a heterogeneous group of disease of the glomerulus with a different pathogenesis, clinical course and prognosis. In the development of progression of GN a crucial role is played by cytokines which are formed in TH1 and TH2 lymphocytes. Growth factors, in particular TGF-beta and PDGF, are important for the development of tubulointerstitial fibrosis which is decisive for the prognosis of GN and the transformation of the disease into renal insufficiency. The activity of immune processes in the glomerulus is indirectly suggested by examination of interleukins and the antioxidant system. The authors examined IL-2 and IL-6 in serum and urine of 20 children with GN and nephrotic syndrome. An elevated excretion of IL-6 was found in children with proliferative GN (23.82 pg/ml). In children with NS they found a negative correlation between s-IL-2R in urine and CD8+ lymphocytes (r = -0.7309, p < 0.05). As another marker of activity they evaluated the antioxidant system (superoxidismutase -⁠ SOD, glutathione peroxidase -⁠ GHPx and catalase -⁠ KAT) and its interrelations with the metabolism of trace elements (Zn, Se, Cu) in a group of 34 children with GN and chronic renal insufficiency. The highest SOD and KAT activity in erythrocytes was found in children with nephrotic syndrome (p < 0.01). A higher Zn excretion was found in children with chronic GN. A causal association between impaired Zn and Se metabolism was found in children with renal insufficiency.

Key words:
glomerulonephritis, cytokines, growth factors, antioxidants, trace elements