Serum and urinary soluble tumor necrosis factor receptors in patients with glomerular diseases: Correlation with disease severity and prognosis
Journal
Dialysis and Transplantation
Journal Volume
26
Journal Issue
11
Pages
762-770
Date Issued
1997
Author(s)
Abstract
Two kinds of soluble tumor necrosis factor receptors-p55 sTNFR and p75 s7NFR-derived from the cell surface are generated during inflammation or immune reaction. In this work, we investigated the participation and prognostic significance of sTNFRs in various glomerular diseases by using the EIA method to measure p55 s TNFR and p 75 s TNFR concentrations in the sera and urine of patients with initial clinical manifestations of glomerulopathy. The first phase of this study included 32 patients with minimal change disease (MCD, n = 7), focal glomerulonephritis (FS, n = 1), mesangial proliferative glomerulonephritis (MesGN, n = 4), membranous glomerulopathy (MN, n = 5), IgA nephropathy (IgAN, n = 3), chronic glomerulonephritis (CGN, n = 1), lupus nephritis (LN, n = 8), and diabetic nephropathy (DMN, n = 2); 1 patient refused renal biopsy. Our results indicated a significant increase of sTNFR concentrations in the sera and urine of patients with FS, MesGN, CGN, and LN, but a minimal increase in patients with MCD or IgAN. The increased sTNFR levels correlated well with kidney survival and many clinical parameters except hematuria. The sTNFR levels also correlated with the extent of tubular atrophy better than did glomerular cellularity in histology. In the second phase, sequential studies were performed in 10 patients with LN (n = 6), IgAN (n = 2), MCD (n = 1), and MN (n = 1) after 1 and 6 months of therapy. Those results demonstrated that changes in urinary p55 sTNFR concentrations may reflect the short-term response to therapy (p = 0.02). Our data suggest that sTNFRs are involved in different ways with some selected, but not all, glomerular diseases. Serum and urinary sTNFRs can function as useful tools in monitoring clinical severity, as well as predicting kidney survival in LN, MesGN, and, possibly, FS.
SDGs
Other Subjects
tumor necrosis factor receptor; adult; article; blood level; chronic glomerulonephritis; clinical article; controlled study; diabetic nephropathy; disease severity; female; focal glomerulonephritis; glomerulopathy; human; human tissue; immunoglobulin a nephropathy; lupus erythematosus nephritis; male; membranous glomerulonephritis; minimal change glomerulonephritis; priority journal; prognosis; proliferative glomerulonephritis; urine level
Type
journal article