Clinical Research On The Change Of α-Isoform Of Glucocorticoid Receptor In The Children With Frequently Recurrent Nephrotic Syndrome And The Effect Of Traditional Chinese Medicines

Objective: To investigate the alternation of a -isoform of glucocorticoid receptor(GR a ) in peripheral blood mononuclear cells (PBMC) in patients of Qi and Yin deficiency syndrome (QY) with frequently recurrent nephrotic syndrome (simple type) (simple type FRNS). To analyze the pharmacological mechanism of ShenKangLing(SKL) through the study on its effect on GR a of PBMC of the patients.Methods: 60 patients of QY with simple type FRNS were divided into therapy group (30 cases) and control group (30 cases). 30 healthy children were taken as normal group. Therapy group was treated by SKL and prednisone. Control group was treated by prednisone. The heparinized elbow venouse blood (10-15ml) was collected from healthy children and patients at 8 o'clock in the morning. The blood of patients was collected before treatment and when the urinary protein had disappeared for two weeks. PBMC were isolated by Ficoll-Hypaque gradient centrifugation. 3H-dexamethansone binding assay was used to measure the number of GR a . Radioimmunoassay was used to investigate the level of blood plasma cortisol. Statistical analysis was performed on SPSS8.0 system software.Results: Before treatment, the level of blood plasma cortisol in therapy group and control group was much lower than that in healthy children(P<0.01), but no significant difference was foundbetween two disease groups(P>0.05). After treatment , the level of blood plasma cortisol in therapy group and control group was significantly lower than that before treatment (P<0.01). However, the difference in the level of blood plasma cortisol between two disease groups was not found after treatment(P>0.05).The number of GR a in therapy group and control group was lower than that in normal group before treatment(P<0.01), but the number of GR a between therapy group and control group was not remarkably different (P>0.05). After treatment, there was no significant change in the number of GR a in therapy group(P>0.05), but the number of GR a in control group was markedly lower than that before treatment(P<0.01), and the number of GR a in therapy group was significantly higher than that in control group (P<0.01).Conclusions: 1. The number of GR a might be low in simple type FRNS patients. The decrease of GR a number may be one of factors regulating to simple type FRNS. 2. SKL might have antagonistic effect when the number of GR a is reduced by large dose hormone.