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Toll-like receptor 3 (TLR-3), TLR-4 and CD80 expression in peripheral blood mononuclear cells and urinary CD80 levels in children with idiopathic nephrotic syndrome

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Abstract

Background

The aims of this study were (1) to detect toll-like receptor (TLR)-3, TLR-4 and CD80 expression in peripheral blood mononuclear cells (PBMCs) and estimate urinary CD80 levels in children with idiopathic nephrotic syndrome and (2) to investigate the utility of these markers to differentiate between biopsy-proven minimal change disease (MCD) and focal segmental glomeruloscelerosis (FSGS).

Methods

The study included 70 patients with idiopathic nephrotic syndrome (NS), of whom 40 had steroid-sensitive NS (SSNS; 25 with active NS, 15 in remission) and 30 had steroid-resistant NS (SRNS) patients, and 23 healthy controls. TLR-3, TLR- 4 and CD80 mRNA expression levels in PBMCs were determined and the urinary CD80 level estimated.

Results

Median TLR-3, TLR-4 and CD80 mRNA expression levels were higher in patients with active SSNS than in those with SRNS, and the latter patient group also had significantly lower expression levels than the controls. The expression levels of these markers were associated with reductions in remission. Patients with biopsy-proven MCD had higher median expression levels of these markers than those with FSGS, but the differences were not statistically significant. Median urinary CD80/creatinine values were significantly higher in patients with SSNS and SRNS than in the controls and steroid-sensitive patients in remission (p < 0.001). CD80 levels were also significantly higher in patients with MCD than in those with FSGS (p = 0.002). A cut-off level of >914.5 ng/g had a sensitivity of 86.6%, specificity 71.4% and area under the curve of 0.828 (95% confidence interval 0.678–0.978, p = 0.002) for the diagnosis of MCD.

Conclusions

Increased expressions of TLR-3, TLR-4 and CD80 mRNA and the level of urinary CD80/creatinine could be useful markers to differentiate patients of SSNS in relapse from those with SRNS. Further these markers can also distinguish biopsy proven MCD from FSGS in SRNS patients.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

    Om P. Mishra, Ravindra Kumar, Abhishek Abhinay, Rajniti Prasad & Ankur Singh

  2. Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi, India

    Gopeshwar Narayan

  3. Department of Biochemical Engineering, Indian Institute of Technology, Banaras Hindu University, Varanasi, India

    Pradeep Srivastava

  4. Department of Pathology, G.B.Pant Hospital, New Delhi, India

    Vineeta V. Batra

Authors
  1. Om P. Mishra
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  2. Ravindra Kumar
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  3. Gopeshwar Narayan
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  4. Pradeep Srivastava
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  5. Abhishek Abhinay
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  6. Rajniti Prasad
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  7. Ankur Singh
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  8. Vineeta V. Batra
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Corresponding author

Correspondence to Om P. Mishra.

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Ethics statement

The protocol of the study was approved by Institute Ethics Committee, study followed ethical guidelines, and informed consent was taken from the parents or authorized representative of each child.

Funding

The study was supported by the Institutional Grants of Department of Pediatrics, Institute of Medical Sciences and School of Biochemical Engineering, Indian Institute of Technology, Banaras Hindu University, Varanasi, India.

Competing interest

None

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Mishra, O.P., Kumar, R., Narayan, G. et al. Toll-like receptor 3 (TLR-3), TLR-4 and CD80 expression in peripheral blood mononuclear cells and urinary CD80 levels in children with idiopathic nephrotic syndrome. Pediatr Nephrol 32, 1355–1361 (2017). https://doi.org/10.1007/s00467-017-3613-8

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  • DOI: https://doi.org/10.1007/s00467-017-3613-8

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