Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Yonsei Med J. 2010 Mar;51(2):239-43. doi: 10.3349/ymj.2010.51.2.239. Epub 2010 Feb 12.
The pathophysiology of hypogammaglobulinemia in nephrotic syndrome (NS) remains unknown. We evaluated the differences in the distribution of anti-bacterial antibodies and anti-viral antibodies, and those of immune antibodies and natural antibodies in steroid-sensitive NS.
We examined the antibody status of 18 children who had routine vaccinations. The levels of immnunoglobulin G (IgG), the IgG subclasses, and the antibodies induced by vaccinations such as diphtheria-pertussis-tetanus and measles-mumpsrubella were analyzed in children with steroid-sensitive NS.
There was a positive correlation between the albumin and IgG values (r = 0.6, p < 0.01), and the four IgG subclasses were all evenly depressed in the nephrotic children during the acute stage of the disease. The antibodies induced by bacterial antigens were depressed and the seropositivity of anti-viral antibodies tended to be lower than those of age-matched control children during the acute stage. The depressed immune antibody status recovered rapidly in the remission stage of NS, despite corticosteroid treatment.
IgG levels correlated positively with albumin levels, and all antibodies, including immune and natural antibodies, were depressed in the acute stage of NS. Our results suggest that hypogammaglobulinaemia in NS may be associated with intravascular homeostasis of oncotic pressure.
肾病综合征（NS）低丙种球蛋白血症的病理生理学仍不清楚。我们评估了类固醇敏感型 NS 中抗细菌抗体和抗病毒抗体以及免疫抗体和天然抗体分布的差异。
我们检查了 18 名接受常规疫苗接种儿童的抗体状况。分析了类固醇敏感型 NS 儿童的免疫球蛋白 G（IgG）、IgG 亚类以及白喉-百日咳-破伤风和麻疹-腮腺炎-风疹等疫苗诱导的抗体水平。
白蛋白和 IgG 值之间存在正相关（r = 0.6，p <0.01），并且在疾病的急性阶段，所有四种 IgG 亚类在肾病儿童中均均匀降低。在急性阶段，细菌抗原诱导的抗体被抑制，抗病毒抗体的血清阳性率趋于低于年龄匹配的对照儿童。尽管接受了皮质类固醇治疗，但在 NS 的缓解期，免疫抗体状态的抑制迅速恢复。
IgG 水平与白蛋白水平呈正相关，在 NS 的急性阶段，所有抗体，包括免疫和天然抗体，均受到抑制。我们的结果表明，NS 中的低丙种球蛋白血症可能与血管内胶体渗透压的内稳态有关。
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