Regulatory T-cell Changes in Patients with Steroid-Resistant Nephrotic Syndrome after Rituximab Therapy

The aim of this study was to investigate the effect of rituximab (RTX) treatment on serum immunoglobulin (Ig) A, G, M levels, and B and CD4(+)CD25(+)FoxP3(+) [T regulatory (Treg)] cell numbers in children who received RTX therapy with steroid-resistant nephrotic syndrome (SRNS). Twenty-three SRNS children who received RTX and 20 healthy children in the control group were included. In this cross-sectional cohort study, 23 children with SRNS levels were determined before and one month after RTX treatment by serum IgA, IgG, IgM, and percentages of CD4(+)CD25(+) FoxP3(+) cells and B CD19(+) cells by flow cytometry (FASCalibur). RTX was administered at a total of four doses of 375 mg/m(2)/week. Before RTX treatment, percentages of Treg and IgG values were significantly lower in the SRNS group compared to the control group, respectively (P = 0.001). B-cells were significantly lower one month after RTX treatment than before RTX treatment, respectively (P = 0.001). One month after RTX treatment percentages of Tregs, it was found to be significantly higher than before treatment level (P = 0.001). Seventy percent (11/23) remission was achieved with RTX treatment. RTX treatment not only depletes the number of B-cells in SRNS patients but also causes an increase in the number of percentages of Treg cells

Interleukin-8 is increased in chronic kidney disease in children, but not related to cardiovascular disease

Introduction: In this study, we aimed to detect the cytokine that is involved in the early stage of chronic kidney disease and associated with cardiovascular disease. Methods: We included 50 patients who were diagnosed with predialytic chronic kidney disease and 30 healthy pediatric patients in Ege University Medical Faculty Pediatric Clinic, Izmir/Turkey. Interleukin-8 (IL-8), interleukin-10 (IL-10), interleukin-13 (IL-13), and transforming grow factor-beta 1 (TGF-beta 1) levels (pg/mL) were measured by ELISA. Carotid-femoral pulse wave velocity (PWV), augmentation index (Aix), carotid intima media thickness (cIMT), and left ventricular mass index (LVMI) were evaluated as markers of cardiovascular disease. The presence of a cardiovascular disease marker was defined as an abnormality in any of the parameters (cIMT, PWV, Aix, and left ventricular mass index (SVKI)). The patient group was divided into two groups as with and without cardiovascular disease. Results: Mean Aix and PWV values were higher in CKD patients than controls (Aix: CKD 32.8 +/- 11.11%, healthy subjects: 6.74 +/- 6.58%, PWV CKD: 7.31 +/- 4.34m/s, healthy subjects: 3.42 +/- 3.01m/s, respectively; p=0.02, p=0.03). The serum IL-8 levels of CKD were significantly higher than of healthy subjects 568.48 +/- 487.35pg/mL, 33.67 +/- 47.47pg/ mL, respectively (p0.05). Discussion: IL-8 is the sole cytokine that increases in pediatric patients with chronic kidney disease among other cytokines (IL-10, IL-13 and TGF-beta 1). However, we did not show that IL-8 is related to the presence of cardiovascular disease

Low-density lipoprotein and blood pressure are important risk factors for vasculopathy in children on dialysis: A single center study

Introduction We searched for risk factors of cardiovascular assessment among children on dialysis. Methods This is a cross-sectional study of cardiovascular assessment of all patients on dialysis at Ege University Children's Hospital. Pediatric patients between the ages of 6 and 21 who were on HD and peritoneal dialysis treatment were included in the study. Cardiovascular evaluation included left ventricular mass index (LVMI), pulse wave velocity (PWV), and carotid intima-media thickness (cIMT) measurements. Results Nineteen patients were included in this study. The LDL had a correlation with the cIMT z-score, but not to PWVz-score. Binary Logistic regression analysis found that only LDL was significantly associated to increased cIMT. Conclusion This study reports an association between high LDL and high BP increased cIMT on dialyzed children. Strategies to reduce LDL and BP in dialysis patients may prevent vasculopathy and long-term cardiovascular complications