In vitro sensitivity to methyl‐prednisolone is associated with clinical response in pediatric idiopathic nephrotic syndrome

  title={In vitro sensitivity to methyl‐prednisolone is associated with clinical response in pediatric idiopathic nephrotic syndrome},
  author={Eva Cuzzoni and Sara De Iudicibus and Gabriele Stocco and Diego Favretto and Marco Pelin and Giovanni Messina and Luciana Ghio and Elena Monti and Andrea Pasini and Giovanni Montini and Giuliana Decorti},
  journal={Clinical Pharmacology \& Therapeutics},
The aim of this study was to evaluate the in vitro steroid sensitivity as a predictor of clinical response to glucocorticoids in childhood idiopathic nephrotic syndrome (INS). Seventy‐four patients (median age 4.33, interquartile range [IQR] 2.82–7.23; 63.5% male) were enrolled in a prospective multicenter study: in vitro steroid inhibition of patients' peripheral blood mononuclear cell proliferation was evaluated by [methyl‐3H] thymidine incorporation assay at disease onset (T0) and after 4… Expand
5 Citations
MIF plasma level as a possible tool to predict steroid responsiveness in children with idiopathic nephrotic syndrome
Assessing MIF plasma levels at diagnosis could predict response to glucocorticoids in children with INS, and macrophage migration inhibitory factor (MIF) was a good predictor of steroid response. Expand
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Childhood Idiopathic Nephrotic Syndrome: Does the Initial Steroid Treatment Modify the Outcome? A Multicentre, Prospective Cohort Study
TTR was not found to be a prognostic factor of relapse; because of this, different steroid regimens, adjusted for TTR, did not modify the relapse rate in any relevant measure and younger age and low total serum protein were independent predictors of relapse risk. Expand
Pharmacology and pharmacogenetics of prednisone and prednisolone in patients with nephrotic syndrome
A role for pharmacogenetics to improve individualization of glucocorticoid therapy is suggested and the evidence is limited, but studies in larger cohorts with nephrotic syndrome patients are necessary to draw final conclusions. Expand
Hypomethylation of NLRP3 gene promoter discriminates glucocorticoid‐resistant from glucocorticoid‐sensitive idiopathic nephrotic syndrome patients
A new biological mechanism by which patients with INS may acquire GC resistance, that could be used in future as a novel noninvasive diagnostic tool is uncovered. Expand


Genetic and in vivo determinants of glucocorticoid sensitivity in relation to clinical outcome of childhood nephrotic syndrome.
The GR-9β+TthIII-1 haplotype of the glucocorticoid receptor gene offers new insights into the clinical course of children with nephrotic syndrome and there were no significant differences in therapeutic outcomes between carriers and noncarriers of the BclI haplotype. Expand
Risk factors for steroid dependency in children with idiopathic nephrotic syndrome
By identifying those children with predictive factors of steroid dependency, the clinician will be better able to plan the long-term management of these patients and reduce the morbidity seen with the frequent relapses and steroid treatment, in a disease that is otherwise associated with a favorable prognosis. Expand
Time for initial response to steroids is a major prognostic factor in idiopathic nephrotic syndrome.
The interval from onset of steroid therapy to remission is an accurate early prognostic factor in INS and is found to be associated with relapsing within 3 months after steroid therapy discontinuation. Expand
High incidence of initial and late steroid resistance in childhood nephrotic syndrome.
The results suggest that in the current era, nephrotic syndrome in children may not be as benign as indicated by earlier studies, and a higher incidence of initial and subsequent steroid resistance is shown. Expand
Glucocorticoid receptors, in vitro steroid sensitivity, and cytokine secretion in idiopathic nephrotic syndrome.
Abnormalities of number and affinity of the GC receptor and altered secretion of cytokines may be involved in tissue sensitivity to GC in INS patients. Expand
Association between BclI polymorphism in the NR3C1 gene and in vitro individual variations in lymphocyte responses to methylprednisolone.
The combined evaluation of the in vitro sensitivity to methylprednisolone and BclI polymorphism could represent an aid for physicians to adjust therapy a priori for the optimization of steroid treatment. Expand
Corticosteroid therapy for nephrotic syndrome in children.
Children in their first episode of SSNS should be treated for at least three months with an increase in benefit for up to seven months of treatment, and the benefits and harms of corticosteroid regimens in preventing relapse should be determined. Expand
Influence of age at onset on the outcome of steroid-sensitive nephrotic syndrome
An age of less than 4 years at onset of SSNS is associated with greater likelihood for frequent relapses and a greater time interval to attain long-term remission, according to the Kaplan-Meier method. Expand
Spectrum of adolescent-onset nephrotic syndrome in Indian children
Adolescent-onset NS differs from the childhood variety in having a significantly higher frequency of hematuria, steroid resistance, and evidence of non-MCD, especially MPGN, on histopathology. Expand
Best practice guidelines for idiopathic nephrotic syndrome: recommendations versus reality
This study shows major differences in steroid and symptomatic treatment of nephrotic syndrome by pediatricians and pediatric nephrologists and suggests shared guidelines and their implementation through widespread educational activities are necessary. Expand