Glucocorticoid Receptors and the Pattern of Steroid Response in Idiopathic Nephrotic Syndrome

Introduction: Little is known about the relationships between the T lymphocytes (CD3+) expression of glucocorticoid receptors (GCR) and the response to glucocorticoid treatment in children with idiopathic nephrotic syndrome (NS). The aim of the current study is to determine whether steroid responsiveness is dependent on the amount of T lymphocytes GCR expression Methods: We studied 60 children with idiopathic NS in the age group from 2-10 years. According to the response to steroids we classified our patients into early responders (ER; n=46) and late responders (LR; n=14). Sixty age and gender matched healthy children represented the control group. The clinical and laboratory findings at baseline and GCR expression by T lymphocytes (CD3+) as determined by flow cytometry were compared between the three groups. Results: The T lymphocytes (CD3+) expression of GCR was significantly lower in the LR than that in the control group (P<0.01), whereas it was similar in the ER and control groups. GCR expression was also decreased in the LR group compared to the ER group (P<0.01). Furthermore, the T lymphocytes (CD3+) expression of GCR correlated inversely with the time to complete remission (CR) (r = -0.54, P<0.05), but not with urinary protein excretion at baseline. Conclusion: The levels of T lymphocytes (CD3+) expression of GCR may be a useful predictor of steroid responsiveness in children presenting with idiopathic NS.