Efficacy of Tacrolimus in Treating Nephrotic Syndrome Children.

Nephrotic Syndrome (NS) is primarily a pediatric disorder, common in pre-schooler and school aged children. Immunosuppresive drugs like prednisolone, cyclophosphamide, cyclosporine A (CsA) has been the main treatment regimen in the management of Nephrotic syndrome. This has remain still the same therapy which is not satisfactory in the management of nephrotic syndrome children. The management of children with idiopathic Steroid-Resistant Nephrotic Syndrome (SRNS) and Steroid-Dependent Nephrotic Syndrome (SDNS) are difficult to treat but there is no consensus on the most appropriate treatment therapy. Pneumonia and urinary tract infection are also a challenge in the management of NS. The main goal of treatment is complete or partial remission of proteinuria, which is the most important marker of long term outcome. Calcineurin inhibitors (CNIs) are used to avoid steroid toxicity in children with NS. There are limited data on the relative efficacy and safety of calcineurin inhibitors and alkylating agents for NS in children. There are different immunosuppressant drugs but tacrolimus can be used in the treatment of childhood NS which is less expensive, have less cosmetic side effects and easy to administered. In this review we discuss the safety and efficacy of tacrolimus, a new drug which can be administered orally as a twice daily dose in the management of childhood NS. Some study suggests that application of tacrolimus can be a new turning point for the treatment of nephrotic syndrome.

HBV X Gene Transfection Upregulates IL-1β and IL-6 Gene Expression and Induces Rat Glomerular Mesangial Cell Proliferation / 华中科技大学学报（医学）（英德文版）

The X gene of HBV encodes a 17-KD protein, termed HBx, which has been shown to function as a transcriptional trans-activator of a variety of viral and cellular promoter/enhancer elements. The aim of this study was to investigate the effect of HBx on gene expression of interleukin (IL)-1β and IL-6, and proliferation of rat mesangial cells in vitro. The X gene of HBV was amplified by PCR assay, and inserted into the eukaryotic expression vector pCI-neo. The structure of recombinant pCI-neo-X plasmid was proved by restrict endonuclease digestion and sequencing analysis. pCI-neo-X was transfected into cultured rat mesangial cell line in vitro via liposome. HBx expression in transfected mesangial cells was detected by Western blot. The IL-1β and IL-6 mRNA expression in those cells was assayed by semiquantitative RT-PCR. Mesangial cell proliferation was tested by MTT. The results showed that HBx was obviously expressed in cultured mesangial cell line at 36th and 48th h after transfection. The expression of IL-1β and IL-6 mRNA was simultaneously increased. The cell proliferation was also obvious at the same time. It was concluded that HBx gene transfection could induce IL-1β and IL-6 gene expression and mesangial cell proliferation. HBx may play a critical role in mesangial cell proliferation through upregulation of the IL-1β and IL-6 gene expression.