Detection And Clinical Significance Of Urinary MCP-1and IL-18in Childrens With PNS

Objective:By detecting the content of Monocyte chemoattractant ptotein-1(MCP-1)and interleukin-18(IL-18) in the urinary of children with primary nephrotic syndrome(PNS) at different time points, the study aims to explore whether there is a correlation with occurrence, development, progression, and prognosis,to find specific and sensitive biological markers and to provide clues for clinical treatment.Methods:65pediatric cases from our hospital were enrolled in this study. they were devided into three groups based on the retrospective the follow-up results, divided them into three groups:35cases of SSNS,15cases of SRNS,15cases of FRNS. Another20healthy children served as normal controls. Peripheral blood samples and urine specimens were collected at three time points:the first time point, the early stages without glucocorticoids (GC); the second time point,treatment after8weeks; the third time point, treatment after16weeks or recurrence. The following data were collected:①the content of MCP-1and IL-18in the urine②blood urea nitrogen, creatinine, and24-hour urinary protein excretion.Results:1.In SSNS group the level of urinary MCP-1was higher than the normal control group.There was no remarkabe difference between control group and SSNS group (before treatment and treated for8weeks)(P>0.05).But after treated for16weeks, the level of urinary MCP-1was markedly decreased compared with that of control group and those before treatment and treated for8weeks (P<0.05); In SRNS group the level of urinary MCP-1before treatment was remarkably higher than that of control group and that of SSNS group before treatment (P <0.05),but there was no difference when it was compared with that treated for8weeks(P>0.05), but the level was markedly decreased after treated with immunosuppressants of CTX for16weeks when compared with those before treatment and treated for8weeks (P<0.05).Compared the level of urinary MCP-1between SSNS group and SRNS group at three time points, SRNS group was remarkably higher than that of SSNS group (P<0.05)2.In FRNS group the level of urinary MCP-1was no remarkabe difference between control group and SSNS group (before treatment and treated for8weeks)(P>0.05),but the level was markedly lower than SRNS group (P<0.05),when repeated,the level of urinary MCP-1significantly increased compared with before treatment and treated for8weeks (P<0.05),and remarkably higher than that of SSNS group after treated for8weeks (P<0.05), but compared with SRNS group was no remarkable difference (P>0.05)3.1n SSNS group the level of urinary IL-18(before treatment and treated for8weeks) was markedly higher than the normal control group (P<0.05); And after treated for16weeks, the level of urinary IL-18was markedly decreased compared with that of before treatment and treated for8weeks (P<0.05). In SRNS group the level of urinary IL-18before treatment was remarkably higher than that of control group and that of SSNS group before treatment (P <0.05),but there was no difference when it was compared with that treated for8weeks(P>0.05), but the level was markedly decreased after treated with immunosuppressants of CTX for16weeks when compared with those before treatment and treated for8weeks (P<0.05).Compared the level of urinary IL-18between SSNS group and SRNS group at three time points, SRNS group was remarkably higher than that of SSNS group (P<0.05)4.1n FRNS group the level of urinary IL-18was markedly higher than the normal control group before treatment and treated for8weeks(P<0.05), but there was no difference when it was compared with SSNS group (P>0.05);but the level was markedly lower than SRNS group (P <0.05).when repeated,the level of urinary IL-18significantly increased compared with before treatment and treated for8weeks(P<0.05),and remarkably higher than that of SSNS group after treated for8weeks (P<0.05), but compared with SRNS group was no remarkable difference (P>0.05)5.There’s no correlation between MCP-1, IL-18and the blood urea nitrogen, creatinine. Positive correlation with the24-hour urinary protein excretion. In addition, there’s a correlation between urinary MCP-1levels and urinary IL-18level.Conclusion:1. For children with PNS, MCP-1and IL-18are higher, especially in the SRNS group. It suggests that in the early detection of urinary MCP-1and IL-18glucocorticoid therapy contributed to the prediction of early children on glucocorticoid sensitivity, thus for clinicians to deveiop a reasonable treatment and provide laboratory support.2. Dynamic MCP-1and IL-18leves is indicator of PNS activity, which provide a theoretical basis for clinicians.3.Combined with clinical symptoms and proteinuria, MCP-1and IL-18levels can be used as an important non-invasive marker to monitor PNS recurrence.