Cytokines in chronic kidney disease: potential link of MCP-1 and dyslipidemia in glomerular diseases.

BACKGROUND: Many studies have indicated a role for cytokines in chronic kidney disease (CKD). The aim of this study was to evaluate plasma and urinary levels of monocyte chemoattractant protein-1 (MCP-1/CCL2), transforming growth factor-beta1 (TGF-ß1), and interleukin-8 (IL-8/CXCL8) in pediatric patients with CKD stages 2-4. METHODS: Cytokines were measured in 37 healthy controls and in 42 CKD patients by enzyme-linked immunoassay. Patients were divided into groups according to CKD etiology: glomerular disease (group 1, n = 11) and congenital anomalies of the kidney and urinary tract (group 2, n = 31). Urinary cytokine measurements were standardized for creatinine. RESULTS: Plasma and urinary levels of MCP-1/CCL2 were significantly higher in both CKD groups compared to the control group. Between the two CKD groups, only urinary MCP-1/CCL2 levels were significantly different, with MCP-1/CCL2 levels higher in group 1 patients. Plasma and urinary levels of IL-8/CXCL8 and TGF-ß1 were undetectable in the control group but comparable between the two CKD groups. In group 1 patients, urinary MCP-1/CCL2 levels were negatively correlated to serum albumin levels and positively correlated to the levels of total cholesterol and triglycerides. In group 2 patients, urinary levels of IL-8/CXCL8 were negatively correlated with the estimated glomerular filtration rate and positively correlated with body mass index. CONCLUSIONS: Differences in cytokine profiles may be related to CKD etiology and other disease-associated alterations.

Síndrome do anticorpo antifosfolípide: relato de caso e revisão da literatura / Antiphospholipid antibody syndrome: case report and review of the literature

A síndrome do Anticorpo Antifosfolípide (SAF) é doença autoimune de manifestações clínicas abrangentes e exuberantes, frequentemente associadas ao lúpus eritematoso sistêmico (LES). Associa-se com a presença de anticorpos antifosfolípides e acomete mais as mulheres. Seu diagnóstico é definido pela presença de pelo menos um critério clínico e um laboratorial. Este consiste na detecção dos anticorpos antifosfolípides (APL), que são o anticoagulante lúpico (AL), o anticorpo anticardiolipina (ACL) e anticorpos dirigidos a várias proteínas, principalmente beta 2-glicoproteína I (ß2GPI). Esses anticorpos são fatores de risco independentes para trombose e complicações gestacionais. A doença pode ocorrer em sua forma primária ou pode associar-se com outras condições clínicas, especialmente a autoimune, neoplásica ou infecciosa. Outra forma possível é a catastrófica, na qual se observa oclusão vascular aguda em múltiplos órgãos e sistemas, como púrpura trombótica trombocitopênica. O paciente com SAF deve ser tratado quando apresentar as repercussões clínicas da doença.

The Antiphospholipid Antibody Syndrome (APS) is an autoimmune disease with clinical manifestations ranging varying levels of activity, and it is often associated with Systematic Lupus Erythematosus (SLE). APS is associated with the presence of antiphospholipid antibodies (APL) and is more common amongst women. The diagnosis requires both one clinical criterion and one laboratorial confirmation. These are the detection of antiphospholipid antibodies (APL), which are the lupus anticoagulant (LA), anticardiolipin antibodies (ACL), and antibodies against various proteins, especially beta 2-glycoprotein I (ß2GPI). These antibodies are independent risk factors for thrombosis and pregnancy complications. The disease can occur in its primary form or in association with other medical conditions, particularly with other autoimmune, neoplastic or infectious disease. Another possible form is the catastrophic form of the disease in which patients develop a clinical condition characterized by acute vascular occlusion in multiple organs and systems, such as thrombotic thrombocytopenic purpura. Patients with APS diagnosis must be treated when presenting clinical manifestations of the disease.