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Elevated serum fucose levels in idiopathic nephrotic syndrome
1Department of Pediatrics, School of Medicine, Niigata University, Japan.
Insights
Serum fucose levels are elevated in children with idiopathic nephrotic syndrome (INS) across all disease states. This elevation, linked to glycoproteins, may indicate immune system involvement in INS.
Area of Science:
- Pediatric Nephrology
- Biochemistry
- Immunology
Background:
- Idiopathic nephrotic syndrome (INS) is a complex kidney disorder in children.
- Elevated serum fucose has been observed in various inflammatory and immune conditions.
Purpose of the Study:
- To investigate serum fucose concentrations in children with INS.
- To compare fucose levels in INS patients with those in children with chance proteinuria/hematuria (CPH) and healthy controls.
- To explore the potential association of serum fucose with immune function in INS.
Main Methods:
- Serum fucose levels were measured in 34 children with INS, 23 with CPH, and 20 healthy controls.
- Patients with INS were assessed at onset, relapse, and remission.
- Gel-chromatography was used to analyze the molecular fraction of serum fucose.
Main Results:
- Serum fucose was significantly elevated in INS patients compared to CPH patients and controls.
- Elevated fucose levels were observed at onset, relapse, and remission in INS.
- In remission, fucose levels were higher within one week of remission compared to 1-6 months post-remission, with the latter group's levels similar to controls.
- Gel-chromatography indicated fucose is bound to high molecular weight glycoproteins in INS serum.
Conclusions:
- Serum fucose concentrations are consistently elevated in children with idiopathic nephrotic syndrome.
- The high molecular weight suggests fucose is bound to glycoproteins, potentially impacting immune responses.
- Serum fucose may play a role in the immunodepression observed in INS patients.
Abstract:
We measured serum fucose concentrations in 34 children with idiopathic nephrotic syndrome (INS), 23 with chance proteinuria and/or hematuria (CPH), and 20 healthy children as controls. The serum fucose levels in the patients with INS were significantly elevated at onset (14.0 +/- 3.7 mg/dl, n = 4, p < 0.02), in relapses (19.1 +/- 3.7 mg/dl, n = 10, p < 0.001), and in remission (13.9 +/- 7.0 mg/dl, n = 30, p < 0.01) as compared with CPH patients (10.6 +/- 3.2 mg/dl, n = 23) and controls (9.1 +/- 3.1 mg/dl, n = 20). Those in remission were further divided into 2 groups and the mean fucose concentrations were significantly different in the two remission groups: 20.1 +/- 4.6 mg/dl in 14 patients whose blood samples were taken within one week of remission and 9.0 +/- 2.9 mg/dl in the other 16 patients whose samples were taken at 1 to 6 months of remission. The mean value in the latter remission group was significantly lower in comparison with the former group, but not different from the controls. Gel-chromatography of serum samples from patients with INS revealed a single peak of fucose in the high molecular fraction, and this was also found in the same fractions of serum inhibitor of lymphocyte blastogenesis in INS. We concluded that serum fucose concentrations are elevated in INS patients and that, because of the large molecular weight, the fucose is probably in a form bounded to some glycoproteins in the serum. Considering various reports on fucose, serum fucose may be associated with immunodepression in INS patients.