Wasilewska Anna, Zoch-Zwierz Walentyna
1st Department of Paediatrics, Medical University of Białystok, Poland.
J Pediatr Endocrinol Metab. 2005 Aug;18(8):799-806. doi: 10.1515/jpem.2005.18.8.799.
To evaluate the expression of glucocorticoid receptors (GCR) in lymphocytes (CD3/ GCR) and monocytes (CD14/GCR) in children with nephrotic syndrome (NS).
The patients were divided into two groups: group I: 17 children with the first NS attack, and group II: 17 children with a subsequent NS event. In both groups, examinations were carried out before treatment (A) and after albuminuria disappearance during prednisone treatment (B). The control group (C) consisted of 23 healthy children, never treated with glucocorticosteroids.
Flow cytometry was employed twice to determine the number of CD3+ lymphocytes and CD14+ monocytes and the percentage of CD3/GCR+ and CD14/GCR+ cells.
In group I, the expression of CD3/GCR before treatment (A) decreased during prednisone therapy (B) (p < 0.01), but CD14/GCR did not change. In group II, before treatment (A), both CD3/GCR and CD14/GCR were markedly lower compared to the controls and group I. In examination B, both CD3/GCR and CD14/GCR had decreased.
A low number of GCR might confer a worse response to glucocorticoid therapy. Longitudinal studies should be performed on larger groups of children with their first and subsequent nephrotic syndome attacks.
评估肾病综合征（NS）患儿淋巴细胞（CD3/GCR）和单核细胞（CD14/GCR）中糖皮质激素受体（GCR）的表达。
患者分为两组：第一组：17例首次发作NS的患儿；第二组：17例NS复发的患儿。两组均在治疗前（A）以及泼尼松治疗期间蛋白尿消失后（B）进行检查。对照组（C）由23例从未接受过糖皮质激素治疗的健康儿童组成。
采用流式细胞术两次测定CD3+淋巴细胞和CD14+单核细胞的数量以及CD3/GCR+和CD14/GCR+细胞的百分比。
在第一组中，治疗前（A）CD3/GCR的表达在泼尼松治疗期间（B）降低（p<0.01），但CD14/GCR无变化。在第二组中，治疗前（A），与对照组和第一组相比，CD3/GCR和CD14/GCR均明显较低。在检查B中，CD3/GCR和CD14/GCR均降低。
GCR数量低可能导致对糖皮质激素治疗的反应较差。应对更多首次发作及复发的肾病综合征患儿进行纵向研究。
