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Pediatric Nephrology

, 21:603 | Cite as

A case of unfulfilled expectations. Cytokines in idiopathic minimal lesion nephrotic syndrome

  • Carlos E. Araya
  • Clive H. Wasserfall
  • Todd M. Brusko
  • Wei Mu
  • Mark S. Segal
  • Richard J. Johnson
  • Eduardo H. Garin
Review

Abstract

Idiopathic minimal lesion nephrotic syndrome (IMLNS) was proposed to be a disorder of T-cell dysfunction by Shalhoub in 1974. The mechanisms by which T-cells increase glomerular permeability have remained elusive (and unproven). There is evidence that IMLNS may be due to a circulating factor released from activated T-cells. In recent years, efforts have been made to identify this pathogenetic cytokine as well as to understand the mechanism(s) for the increased release of this factor. This review attempts to critically analyze the available published data. Using different methodologies, investigators have focused on the production of cytokines in patients with IMLNS during relapse and remission. This has resulted in a plethora of data without definitive conclusions. The pathogenetic cytokine has not been identified, and it is questionable whether there is a Th2 dominance in IMLNS. The review of the available data illustrates the difficulties encountered when one is studying the cytokine secretory pattern in patients with IMLNS. Differences in patient population, type of cells studies, sample preservation, and methodology used to measure cytokines are some of the factors that could account for the disparity of observed results.

Keywords

Cytokines Idiopathic minimal lesion nephrotic syndrome Glomerular permeability Th1/Th2 

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Copyright information

© IPNA 2006

Authors and Affiliations

  • Carlos E. Araya
    • 1
  • Clive H. Wasserfall
    • 2
  • Todd M. Brusko
    • 2
  • Wei Mu
    • 3
  • Mark S. Segal
    • 3
  • Richard J. Johnson
    • 3
  • Eduardo H. Garin
    • 1
  1. 1.Department of Pediatrics, College of MedicineUniversity of FloridaGainesvilleUSA
  2. 2.Department of Pathology, Immunology and Laboratory Medicine, College of MedicineUniversity of FloridaGainesvilleUSA
  3. 3.Division of Nephrology, Hypertension and Renal Transplantation, College of MedicineUniversity of FloridaGainesvilleUSA

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