Beneficial effects of tonsillectomy plus steroid pulse therapy on inflammatory and tubular markers in patients with IgA nephropathy

Shuntaro Maruyama; Tomohito Gohda; Yusuke Suzuki; Hitoshi Suzuki; Yuji Sonoda; Saki Ichikawa; Zi Li; Maki Murakoshi; Satoshi Horikoshi; Yasuhiko Tomino

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자료유형: 학술저널

저자정보: Shuntaro Maruyama (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Tomohito Gohda (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Yusuke Suzuki (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Hitoshi Suzuki (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Yuji Sonoda (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Saki Ichikawa (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Zi Li (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Maki Murakoshi (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Satoshi Horikoshi (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To) Yasuhiko Tomino (Division of Nephrology Department of Internal Medicine Juntendo University Faculty of Medicine To)

저널정보: 대한신장학회 Kidney Research and Clinical Practice Kidney Research and Clinical Practice Vol.35 No.4

발행연도: 2016.1

수록면: 233 - 236 (4page)

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Background: IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. Tonsillectomy plus steroid pulse therapy has been able to induce clinical remission in early-stage IgAN. However, its possible effect on systemic and local cytokines and tubular markers has not been fully investigated. Methods: We obtained serum and urine samples from 38 patients just before renal biopsy and third steroid pulse therapy. Markers of tubular damage such as N-acetylb- D-glucosaminidase, and kidney injury molecule-1 and inflammation such as interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, intercellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule (VCAM)-1 were measured by immunoassay. Results: Before renal biopsy, only urinary inflammatory markers, except MCP-1, were associated with glomerular (proteinuria) and/or tubular damage markers. Proteinuria, hematuria, and estimated glomerular filtration rate dramatically improved after therapy. In addition, levels of serum IL-6 and ICAM-1 and all urinary markers declined significantly; however, serum MCP-1 and VCAM-1 levels did not. None of the urinary markers correlated with the serum inflammatory markers. Conclusion: Tonsillectomy plus steroid pulse therapy for patients with IgAN might be useful for improving not only glomerular damage marker but also tubular damage markers through the improvement of local renal inflammation.

참고문헌 (11)

참고문헌 신청

Tomino Y / 1994 / Expression of intercellular adhesion molecule-1 and infiltration of lymphocytes in glomeruli of patients with IgA nephropathy / Nephron 67:302~307

Tomino Y / 1991 / Urinary levels of interleukin-6 and disease activity in patients with IgA nephropathy / Am J Nephrol 11:459~464

Saitoh A / 1998 / Urinary levels of monocyte chemoattractant protein(MCP)-1 and disease activity in patients with IgA nephropathy / J Clin Lab Anal 12:1~5

Kawamura T / 2014 / A multicenter randomized controlled trial of tonsillectomy combined with steroid pulse therapy in patients with immunoglobulin A nephropathy / Nephrol Dial Transplant 29:1546~1553

Matsuo S / 2009 / Revised equations for estimated GFR from serum creatinine in Japan / Am J Kidney Dis 53:982~992

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