CXCR3 renal expression in glomerulonephritis in children: is there a connection with the course of the disease?

Glomerulonephritis [GN] is a common childhood disease that may represent a significant cause of chronic kidney disease at one point of its course. The role of chemokines in glomerulonephritis, has been long anticipated and studied and the possible link between certain chemokines and different renal pathologies, if proved, can pave the road for future use of such markers for early prognosis and possible therapies for this common disease. Objective: in this study, we aimed at detecting CXCR3 in the renal biopsies done for children with glomerulonephritis and to correlate it to the nature of renal pathology and response to therapy. Methods: The glomerular and interstitial expression of CXCR3 in renal biopsies done for 22 patients with glomerulonephritis was studied using immunohistochemical staining. Pathologies already diagnosed in these biopsies were proliferative GN [mesangioproliferative GN, diffuse proliferative GN, focal proliferative GN, IgA nephropathy and crescentic GN] as well as non-proliferative GN [Minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, diffuse mesangial sclerosis and advanced hypertensive nephrosclerosis]. History, clinical findings and laboratory investigations in the initial presentation and at the time of the study were obtained. Results: The degree of glomerular and interstitial CXCR3 expression did not vary with gender, age of presentation, response to steroids, or cumulative doses of steroids. Percentage of strong glomerular CXCR3 expression was much higher in proliferative GN compared to non-proliferative GN although the difference was not statistically significant, percentage of renal dysfunction was more among strong glomerular and mild/moderate interstitial CXCR3 expression with no statistically significant difference from the counterparts. Conclusion: Our study revealed that enhanced CXCR3 renal expression on glomerular and interstitial levels did not affect the response to steroids along the course of the disease and so can probably act as a therapeutic target rather than a prognostic marker

Renal expression of vascular endothelial growth factor in lupus nephritis the pediatric age groupin

Vascular endothelial growth factor [VEGF] plays a crucial role in preservation of renal functions and may also serve as a useful biomarker in monitoring the progression of lupus nephritis [LN]]. We thought to correlate VEGF expression in the kidney with renal histopathology in lupus nephritis to unveil its possible relation to disease activity and severity. We consecutively enrolled 15 patients with lupus nephritis and ten renal biopsy specimens from patients with cystic renal diseases as controls. The study measurements included SLEDAI, SLICC/ ACR damage index and BILAG renal score. Paraffin sections from renal biopsies were subjected to routine haematoxylin and eosin staining and Immunohistochemical staining for VEGF. Results: Among SLE patients, 7 [46.7%] showed mild expression of VEGF, 5 [33.3%] showed moderate while 3 [20%] had strong expression of the marker. On the contrary, the control samples [100%] revealed strong marker expression. All subjects with class IV and V lupus nephritis had mild renal expression of VEGF. Renal expression of VEGF had a significant positive correlation with serum creatinine and complement C3 levels. The 24 hours' excretion of urinary proteins had a significant negative correlation with the renal expression of the marker. On the other hand, the activity indices and therapeutic modalities did not correlate with VEGF expression. Conclusion: This pilot study among pediatric cases of SLE revealed mild to moderate VEGF expression in most cases of proliferative LN. Further longitudinal studies are needed to investigate the consequences of this finding on the prognosis of the disease

Effects of ovariectomy and thyroidectomy on course and outcome of Trichinella spiralis infection in rat

Physiological hormones modulate immune responses and implicate in associated susceptibilities to infections. To clarify these endocrinological effects, the influence of estrogen and thyroid deficiency, due to ovariectomy and thyroidectomy, respectively, on course and outcome of Trichinella spiralis infection in rats was studied. While in ovariectomized rats there was significant increase in both adult and muscle larval counts as compared to intact infected rats, in thyroidectomized rats there was a significant increase in larval but not in adult count. Combined ovariectomy and thyroidectomy resulted in significant increase in both adult and larval counts. Serum CPK and blood glucose were significantly elevated in ovariectomized and/or thyroidectomized rats as compared to intact infected one. The deficiency of female sex hormones, and/or thyroid hormones in T. spiralis infected rats affected the host resistance to infection by increasing parasite burden influencing the course and outcome of parasitic infection