Blood concentration of aminothiols in children with relapse of nephrotic syndrome
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Blood concentration of aminothiols in children with relapse of nephrotic syndrome Marcin Tkaczyk, Monika Miklaszewska, Jolanta Lukamowicz, Wojciech Fendler Łódź, Poland
Methods: This cross-sectional study was conducted in 125 children aged 2-18 years. The children were divided into 4 groups: group A, early relapse (n=37); group B, early remission for 4-6 weeks from the onset (n=37); group C, late steroid-free remission (n=31); and group D, long-term remission for 2-5 years (n=20). Control group (E) consisted of 30 age- and gender-matched healthy children. The study protocol comprised an analysis of plasma concentrations of glutathione, homocysteine, cysteine and cysteinylglycine by high-performance liquid chromatography. Fractions of protein-bound and free aminothiols were measured. Endothelial injury was assessed by thrombomodulin, PAI-1 concentration, and von Willebrand factor activity. Results: The children with INS had unbalanced aminothiol metabolism only in relapse and early remission, that shifted towards increased oxidative processes. Administration of cyclosporine A caused a significant increase in homocysteine and cysteine concentration. Changes in aminothiol metabolism were significantly related to endothelial injury.
Author Affiliations: Division of Nephrology, Polish Mother's Memorial Hospital Research Institute of Łódź, 281/289 Rzgowska st. 93-338 Łódź, Poland (Tkaczyk M); Department of Pediatric Nephrology, Collegium Medicum of Jagiellonian University, Wielicka 265 30-663 Kraków, Poland (Miklaszewska M); Center of Medical Diagnostics, Polish Mother's Memorial Hospital Research Institute of Łódź, Poland, 281/289 Rzgowska st. 93-338 Łódź, Poland (Lukamowicz J); Medical University of Łódź, al. Kościuszki 4, Łódź, Poland (Tkaczyk M, Fendler W) Corresponding Author: Marcin Tkaczyk, MD, PhD, Division of Nephrology, Polish Mother's Memorial Hospital Research Institute, 281/289 Rzgowska St. 93-338 Łódź, Poland (Tel: ++48 42 2711391; Fax: ++48 42 2711390; Email: [email protected]) doi: 10.1007/s12519-016-0028-8
©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2016. All rights reserved.
World J Pediatr, Vol 12 No 3 . August 15, 2016 . www.wjpch.com
Conclusion: The findings of this study may be helpful in elucidating the pathogenesis of premature atherosclerosis in patients with INS refractory to the treatment or in the case of frequent relapse. World J Pediatr 2016;12(3):353-359 Key words: aminothiols; children; cyclosporine A; homocysteine; nephrotic syndrome
Introduction
I
diopathic nephrotic syndrome (INS) is associated with the presence of several classical risk factors of cardiovascular disease such as obesity, hypercholesterolemia, increased thrombinogenesis, impaired fibrinolysis, enhanced platelet activation, oxidative stress, insulin resistance, immunological disregulation and subclinical inflammation.[1,2] Among them, oxidative stress in humans is described as an excessive production of reactive oxygen species (ROS) or a diminished f
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