小児特発性ネフローゼ症候群における頻回再発予測指標としてのヘルパーT2細胞によるインターロイキン4産生能の検討 : 初発未治療例における前向きコホート研究

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We examined the pathogenic role of the balance of helper T1 (Th1) and T2 (Th.2) cells and their cytokines in children with idiopathic nephrotic syndrome (INS). Ten children with INS treated with steroids were divided into frequent relapsers (FR) (n=5) and non-FR (n=5). Five children with normal urinalysis and renal function who had a history of hemolytic uremic syndrome served as controls. Peripheral blood mononuclear cells and serum were obtained. Thl and Th2 cells were enumerated by flow cytometry. Serum IFN-γ and IL-4 were measured by ELISA. The number of Th2 cells at onset was higher in FR than in non-FR and control. Serum IL-4 level was lower in both FR and non-FR than control at onset and one week after remission. Thereafter the level recovered to control level in non-FR but remained low in FR at 4 weeks after remission. Serum IL-4 per Th2 cell showed the same trend. The number of Th1 cells did not differ between groups. Serum IFN-γ was mostly undetectable. Our data indicate that decreased number of Th2 cells and impaired IL-4 production by Th2 cells may be involved in the pathogenesis of INS, and predict a subsequent frequently relapsing course in children with INS.
東京女子医科大学の論文