CD80 and CTLA-4 as diagnostic and prognostic markers in adult-onset minimal change disease: a retrospective study

PeerJ

article

Bing Zhao¹  Hui Han²  Junhui Zhen³  Xiaowei Yang¹  Jin Shang⁴  Liang Xu¹  Rong Wang¹ 

[1] Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong University;Department of Intensive Care Unit, Shandong University Qilu Hospital;School of Medicine, Shandong University;Department of Nephrology, The First Affiliated Hospital of Zhengzhou University

关键词: CD80;    Cytotoxic T-lymphocyte antigen-4;    Minimal change disease;    Idiopathic nephrotic syndrome;   

DOI  :  10.7717/peerj.5400

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

Background Minimal change disease (MCD) is a form of idiopathic nephrotic syndrome. Compared to children, adult-onset MCD patients are reported to have delayed responses to glucocorticoid treatment. Several studies of children have suggested detecting urinary CD80 levels to diagnose MCD. There are no effective diagnostic methods to distinguish steroid-sensitive MCD from steroid-resistant MCD unless treatments are used. Methods In a total of 55 patients with biopsy-proven MCD and 26 patients with biopsy-proven idiopathic membranous nephropathy, CD80 and cytotoxic T-lymphocyte antigen-4 (CTLA-4) levels in serum, urine and renal tissue were analyzed. Results Steroid-sensitive MCD patients in remission had lower urinary CD80 levels and higher CTLA-4 levels than patients in relapse (156.65 ± 24.62 vs 1066.40 ± 176.76 ng/g creatinine; p < 0.0001), (728.73 ± 89.93 vs 151.70 ± 27.01 ng/g creatinine; p < 0.0001). For MCD patients in relapse, mean urinary CD80 level was higher, and CTLA-4 level was lower for those who were steroid-sensitive than those who were steroid-resistant (1066.40 ± 176.76 vs. 203.78 ± 30.65 ng/g creatinine; p < 0.0001), but the mean urinary CTLA-4 level was lower (151.70 ± 27.01 vs. 457.83 ± 99.45 ng/g creatinine; p < 0.0001). CD80 expression in glomeruli was a sensitive marker to diagnose MCD. The absent or minimal expression of CTLA-4 in glomeruli could distinguish steroid-sensitive MCD from steroid-resistant MCD. Conclusions Glucocorticoid treatment may result in complete remission for only MCD patients with strongly positive CD80 expression and negative CTLA-4 expression in glomeruli, or higher urinary CD80 level and lower CTLA-4 level.

【 授权许可】

CC BY