| Original Article : Differences in Pathologic Findings and Gene Expressions of Renal Tissue according to Steroid Responsiveness in Adult-Onset Minimal Change Disease |
| Sun Young Park, M.D., Seung Hyeok Han, M.D., Hyung Jung Oh, M.D., Seung Jun Kim, M.D. Dong Eun Yoo, M.D., Han Sung Lee, M.D., Tae Hee Lee, M.D., Sung Jin Moon, M.D.Hoon Young Choi, M.D., Dae Suk Han, M.D. and Shin Wook Kang M.D. |
| Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea |
| 임상연구 : 성인 미세변화 질환 환자에서 치료 반응에 따른 병리학적 소견 및 신조직 내 유전자 발현의 차이 |
| 박선영 |
| 연세대학교 의과대학 내과학교실 |
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| Abstract |
Purpose
Compared to children, adult MCD patients tend to have a slower response to steroids, however, little is known about the relationships between pathologic findings or the expression of certain gene and the response to steroid treatment in adult-onset MCD. This study was undertaken to investigate the differences in pathologic findings and the mRNA expression of nephrin and glucocorticoid receptor (GCR) in renal tissue according to steroid responsiveness in adult-onset MCD.
Methods
Twenty-eight adult patients who presented with idiopathic nephrotic syndrome at our institution and fulfilled the criteria for MCD clinically and pathologically were chosen for this study. Based on the response to steroid treatment, patients were divided into two groups: early responders (ER) in whom CR was achieved within 4 weeks of steroid treatment; late responders (LR) in whom CR was achieved after 4 weeks of steroid treatment.
Results
Of the 28 patients, ER consisted of 20 patients. Time to CR was significantly shorter in ER compared to LR (16.5±0.9 vs. 52.0±4.9 days, p<0.01). The proportion of patients with minimal IgM deposition on immunofluorescence was significantly higher in LR compared to ER (75.0% vs. 30.0%,p<0.01). On the other hands, the mRNA expression of GCR, assessed by real time-PCR, was significantly lower in LR than that in ER (p<0.005), whereas nephrin mRNA expression was not different between the two groups.
Conclusion
The presence of glomerular IgM deposition and the amount of GCR in renal tissue may be useful predictors of steroid responsiveness in adult MCD patients.
Key Words : Nephrotic syndrome, Gene expression, Steroid |
| Key Words:
Nephrotic syndrome, Gene expression, Steroid, 신증후군, 유전자 발현, 스테로이드 |
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