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Published on: May 10, 2017
Circulating plasmablasts in children with steroid-sensitive nephrotic syndrome.
Federica Zotta1, Marina Vivarelli1, Rita Carsetti2
1Division of Nephrology, Department of Pediatric Subspecialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
In pediatric steroid-sensitive nephrotic syndrome (SSNS), circulating plasmablasts are not elevated. However, their levels decrease during remission and are reduced by certain treatments, suggesting a distinct B cell role compared to adults.
Area of Science:
- Pediatric Nephrology
- Immunology
- B cell biology
Background:
- B cells are implicated in steroid-sensitive nephrotic syndrome (SSNS).
- Adults with minimal change disease (MCD) show increased plasmablasts during active disease.
- Plasmablasts have not been studied in pediatric SSNS.
Purpose of the Study:
- To investigate circulating plasmablast levels in pediatric SSNS patients.
- To compare these levels with healthy donors and correlate with disease status.
- To assess the impact of different treatments on plasmablast levels.
Main Methods:
- Retrospective flow cytometry analysis of circulating plasmablasts in 107 pediatric SSNS patients (onset, relapse, remission).
- Comparison with age- and sex-matched healthy donors (HD).
- Correlation analysis with proteinuria and serum proteins; assessment of treatment effects.
Main Results:
- Plasmablast levels were normal in all pediatric SSNS subgroups compared to HD.
- Patients in remission had significantly lower plasmablasts than those at disease onset.
- Prednisone/mycophenolate mofetil reduced plasmablasts; prednisone/calcineurin inhibitors did not.
Conclusions:
- Pediatric SSNS B cell phenotype differs from adult MCD.
- This difference may explain varying therapeutic responses.
- Plasmablasts may play a role in pediatric SSNS, but differently than in adults.
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