Expression of glucocorticoid receptors in nephrotic children depending on total prednisone dose.

OBJECTIVE: To evaluate the expression of glucocorticoid receptors (GCR) in lymphocytes (CD3/ GCR) and monocytes (CD14/GCR) in children with nephrotic syndrome (NS).

PATIENTS: The patients were divided into two groups: group I: 17 children with the first NS attack, and group II: 17 children with a subsequent NS event. In both groups, examinations were carried out before treatment (A) and after albuminuria disappearance during prednisone treatment (B). The control group (C) consisted of 23 healthy children, never treated with glucocorticosteroids.

METHODS: Flow cytometry was employed twice to determine the number of CD3+ lymphocytes and CD14+ monocytes and the percentage of CD3/GCR+ and CD14/GCR+ cells.

RESULTS: In group I, the expression of CD3/GCR before treatment (A) decreased during prednisone therapy (B) (p < 0.01), but CD14/GCR did not change. In group II, before treatment (A), both CD3/GCR and CD14/GCR were markedly lower compared to the controls and group I. In examination B, both CD3/GCR and CD14/GCR had decreased.

CONCLUSION: A low number of GCR might confer a worse response to glucocorticoid therapy. Longitudinal studies should be performed on larger groups of children with their first and subsequent nephrotic syndome attacks.