الفهرس 
Childhood Nephrotic SyndromeOnly 14 pages are availabe for public view
 |  | from | 123 |  |  |
| | | from | 123 | | |
Abstract
I
n this study, we were concerned to identify the presence of CXCR3 in renal biopsies of children suffering from different types of GN correlating it to the severity of the disease and response to therapy. For this purpose, we conducted this study on 22 renal biopsies done for patients seen at pediatric nephrology clinic, Children’s Hospital - Ain Shams University with the diagnosis of nephrotic syndrome, nephritic nephrotic and nephritic syndrome.
Clinical evaluation of patients with assessment of the disease activity using degree mesangial cell proliferation (PGN and non PGN) and routine laboratory investigations of GN: urine pr./cr. ratio,24 hrs urinary protein, s. creat., s.urea, s.BUN, s. albumin, s.TG, s. cholesterol were done.
In a trial to compare glomerular and interstitial expression of CXCR3 among patients with proliferative and those with non proliferative GN, we found that the glom. and int. marker expression was comparable among both groups although it was found that strong glom marker expression was found in 41.7% among proliferative group in comparison to 11.2% among non proliferative group.
In a trial to compare glom. and int. marker expression with response to steroids, no statistically significant variation was found between those with mild/moderate marker expression and those with strong marker expression as regards response to steroids.
Our study showed that glom and int renal expression of CXCR3 did not bear any significant effect on the cumulative dose of corticosteroids used by our patients. However, we found that cumulative steroids dose was found to be higher among those with strong glom marker expression.
In our study, we tried to compare urine pr. /cr. Ratio and 24 hours urinary protein among patients in both glom. and int. renal tissue. However, urinary proteinuria failed to show a significant variation among both groups despite the issue that 24 hours urinary protein was found to be higher among those with strong marker expression on the glom level.
In the same series, comparison of kidney functions namely BUN, S. urea and s. creat. Levels among patients with mild to mod. versus those with strong marker expression on the glom. and the int. levels was accomplished. The mentioned invest. Though statistically non significant were found to be higher among those with glom. strong CXCR3 expression.
In a similar way, serum TG was found to be higher in our group of patients with strong glom. CXCR3 expression as compared to with those with mild /mod. marker expression though statistically non significant.
Among our patients, hypertension was more prevalent among those with mild/mod. glom. CXCR3 expression. A finding which was also statistically non significant.
In our study, age at presentation and gender were comparable among patients with mild/mod. marker expression versus those with strong CXCR3 expression at both the glom. and int. levels. A finding which can suggest that CXCR3 expression might not be correlated with neither patients age nor gender.
And in a trial to find a correlation between CXCR3 renal expression and cumulative dose of steroids used by our GN patients. The finding suggested that there is negative significant correlation between int. CXCR3 renal expression and cumulative doses of steroids.
And in a trial to find a correlation between CXCR3 renal expression and s.TG in our GN patients. The finding suggested that there is positive correlation between int. CXCR3 renal expression and s.TG.
In conclusion, glom. CXCR3 renal expression rather than int.CXCR3 seems to have a pathogenic effect in PGN. Also, it seems to have a deleterious effect on consequences of GN assessed by degree of proteinuria in terms of urine prot./cr. ratio,24 hours urinary protein and renal impairment in terms of renal function tests. Both glom. and int. CXCR3 affect serum lipids. Our study revealed that enhanced CXCR3 renal expression might need more anti-inflammatory treatment. Further studies on a wider scale are recommended to assess the exact role of CXCR3 renal expression in the severity of GN and response to treatment