الفهرس 
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Abstract
Nephrotic syndrome is a common chronic disorder, characterized by alterations of permeability at the glomerular capillary wall, resulting in its inability to restrict the urinary loss of protein. MCD is by far the most common cause of nephrotic syndrome in children. It accounts for approximately 80-90% of cases. Currently, the gold standard for confirming MCD is kidney biopsy. But this method is invasive and complicated.
CD80 (also called B7-1) is a transmembrane protein expressed on the surfaces of B cells and other antigen-presenting cells. It works as a costimulatory signal and activates T cells by binding to the receptor CD28.It also inhibits T cell activation by binding to CTLA-4. CD80 can be induced to expression on podocytes, causing actin reorganization and proteinuria. Some podocyte antigens are known to be shed, where they can be found in the urine.
According to recent studies, Significantly higher levels of CD80 are detected in the urine samples of subjects with MCD than in those in FSGS patients, MCD patients in remission, and patients with other glomerulopathies. The aim of our study was to investigate the feasibility of using urinary CD80 levels as a non-invasive diagnostic biomarker of MCD.
The current study was conducted in the pediatric Nephrology clinic in Beni Suef University Hospital, it included 40 children with nephrotic syndrome their mean age was (9±3.9 years), 21 males and 19 females. They were divided into three groups according to ranal pathology: group (A) included 21 nephrotic patients with MCD, group (B) included 9 nephrotic patients with FSGS and group (C) included 10 nephrotic patients with other glomerulopathies. These children were also subdivided into two groups according to the disease activity: group (1) included 30 nephrotic patients in remission and group (2) included 10 nephrotic patients in active stage. Ten age, sex- matching healthy children were recruited in this study as control group.
All patients were subjected to the following: Verbal consent of parents, full history taking and thorough physical examination. Laboratory investigations including: Kidney function tests (serum urea, creatinine), serum albumin, serum cholesterol, serum Na-K, urinary protein/creatinine ratio and urinary CD80.
As regards to U.CD80 in this study, we found that U.CD80 showed significantly higher concentration in MCD group as compared with FSGS , other glomerulopathies groups and controls (p= 0.001, 0.001,0.003) respectively. There were no significant differences in urinary CD80 levels between patients in remission stage group and patients in active stage group (p= 0.153). There was a significant positive correlation between U.CD80 and Height (r = 0.3, p= 0.047). There was no significant correlation between urinary CD80 and serum albumin nor urinary protein/creatinine ratio.
In our study, we found that U.CD80 at a concentration of 818.1 ng/l showed the best cutoff value where the sensitivity was 100% and the specificity was 100% calculated by the ROC curve.
Finally, we concluded that, urinary CD80 levels were significantly higher in patients with MCD than in patients with other conditions or in healthy controls.