[TNF-alpha and soluble interleukin-2 receptor and glomerular sclerosis in primary nephrotic syndrome in children].

A great number of evidence showed, that primary immunological dysfunctions play a role in the etiopathology of primary nephrotic syndrome (NS) in children. The aim of the study was to evaluate the serum concentration of tumor necrosis factor alpha (TNF-alpha) and soluble interleukin 2 receptor (slL-2R) in children with relapse of primary NS and the prognostic of cytokines concentrations for progression of renal morphological changes. Ninety eight children with relapse of primary NS, aged 1-16.5 years, 56 boys and 42 girls were enrolled into the study. Cytokines were determined in 141 relapses of NS. The kidney biopsy was performed in 51 patients, and repeated in 22. The control group consisted of 31 healthy children aged 0.6-16.5 years, 18 boys and 13 girls. The TNF-alpha and sIL-2R concentrations were determined by ELISA kits. TNF-alpha serum concentration increased in NS relapse. The risk of glomerular sclerosis was 3 times higher with increased over 2.35 pg/ml TNF-alpha concentrations. SIL-2R serum levels in a whole group did not differ from the control group. Lower sIL-2R concentrations increased the risk (2.5 times) for glomerular sclerosis.