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The role of the immune system in idiopathic nephrotic syndrome: a review of clinical and experimental studies

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Abstract

Idiopathic nephrotic syndrome (INS) is a multifactorial disease, characterized by proteinuria, hypoalbuminemia, edema and hyperlipidemia. Studies in humans and animal models have associated INS with changes in the immune response. The purpose of this article is to review clinical and experimental findings showing the involvement of the immune response in the pathogenesis of INS. The role of the immune system in INS has been shown by clinical and experimental studies. However, the pattern of immune response in patients with INS is still not clearly defined. Many studies show changes in the dynamics of T lymphocytes, especially the regulatory T cells. Alternatively, there are other reports regarding the involvement of the complement system and B lymphocytes in the pathophysiology of INS. Indeed, none of the immunological biomarkers evaluated were undeniably linked to changes in glomerular permeability and proteinuria. On the other hand, some studies suggest a link between urinary chemokines, such as IL-8/CXCL8 and MCP-1/CCL2, and changes in glomerular permeability and/or the deterioration of glomerulopathies. To understand the pathophysiology of INS, longitudinal studies are clearly needed. The characterization of the profile of the immune response might help the development of specific and individualized therapies, leading to clinical improvement and better prognosis.

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Acknowledgments

This study was partially supported by CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil) and FAPEMIG (Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Brazil) by the Grant INCT-MM (Instituto Nacional de Ciência e Tecnologia—Medicina Molecular: FAPEMIG: CBB-APQ-00075-09/CNPq 573646/2008-2). Dr. AC Simões e Silva received a research productivity grant from CNPq.

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  1. Immunology Laboratory of Integrated Center for Health Research, Federal University of Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil

    Wagner de Fátima Pereira, Gustavo Eustáquio Alvim Brito-Melo & Fábio Tadeu Lourenço Guimarães

  2. Pediatric Nephrology Unit, Department of Pediatrics, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil

    Thiago Guimarães Rosa Carvalho, Elvis Cueva Mateo & Ana Cristina Simões e Silva

  3. Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, UFMG, Avenida Alfredo Balena, 110, 2nd floor, room# 281, Bairro Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil

    Elvis Cueva Mateo & Ana Cristina Simões e Silva

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  1. Wagner de Fátima Pereira
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de Fátima Pereira, W., Brito-Melo, G.E.A., Guimarães, F.T.L. et al. The role of the immune system in idiopathic nephrotic syndrome: a review of clinical and experimental studies. Inflamm. Res. 63, 1–12 (2014). https://doi.org/10.1007/s00011-013-0672-6

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  • DOI: https://doi.org/10.1007/s00011-013-0672-6

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