MIF plasma level as a possible tool to predict steroid responsiveness in children with idiopathic nephrotic syndrome

Eva Cuzzoni, Raffaella Franca, Sara De Iudicibus, Annalisa Marcuzzi, Marianna Lucafò, Marco Pelin, Diego Favretto, Elena Monti, William Morello, Luciana Ghio, Claudio La Scola, Francesca Mencarelli, Andrea Pasini, Giovanni Montini, Giuliana Decorti, Gabriele Stocco

Research output: Contribution to journalArticle

Abstract

Purpose: Idiopathic nephrotic syndrome (INS) is the most frequent form of childhood nephrotic syndrome. Steroids represent the best therapeutic option; however, inter-individual differences in their efficacy and side effects have been reported. To date, there is no way to predict patients’ resistance and/or dependence. Alterations in the cytokine profile of INS patients might contribute to proteinuria and glomerular damage and affect drug sensitivity. Methods: The cytokine plasma levels were measured in 21 INS children at diagnosis to investigate the association among cytokines pattern and clinical response. Patients were selected on the basis of their clinical response: 7 steroid sensitive (SS), 7 dependent (SD), and 7 resistant (SR). Significant results were then analyzed in 41 additional pediatric INS patients. Results: Within the 48 cytokines analyzed, macrophage migration inhibitory factor (MIF) was a good predictor of steroid response. Indeed, SR patients showed significantly higher MIF plasma levels compared with all others (p = 0.022; OR = 4.3, 95%CI = 1.2–25.4): a cutoff concentration of MIF > 501 pg/ml significantly discriminated SR patients (sensitivity = 85.7%, specificity = 71.4%). On the contrary, SD patients showed lower MIF plasma levels compared with others (p = 0.010; OR = 0.12, 95%CI = 9.2 × 10−3–6.7 × 10−1). Significant results were confirmed in the entire cohort. Conclusions: Our comprehensive cytokine analysis indicates that assessing MIF plasma levels at diagnosis could predict response to glucocorticoids in children with INS.

Original languageEnglish
Pages (from-to)1675-1683
JournalEuropean Journal of Clinical Pharmacology
Volume75
Issue number12
DOIs
Publication statusPublished - 2019

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Steroids
Cytokines
Macrophage Migration-Inhibitory Factors
Nephrotic Syndrome
Congenital Nephrosis
Proteinuria
Individuality
Glucocorticoids
Pediatrics
Sensitivity and Specificity
Pharmaceutical Preparations
Therapeutics

Keywords

  • Cytokines
  • Glucocorticoid response
  • Idiopathic nephrotic syndrome
  • Pediatrics

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

MIF plasma level as a possible tool to predict steroid responsiveness in children with idiopathic nephrotic syndrome. / Cuzzoni, Eva; Franca, Raffaella; De Iudicibus, Sara; Marcuzzi, Annalisa; Lucafò, Marianna; Pelin, Marco; Favretto, Diego; Monti, Elena; Morello, William; Ghio, Luciana; La Scola, Claudio; Mencarelli, Francesca; Pasini, Andrea; Montini, Giovanni; Decorti, Giuliana; Stocco, Gabriele.

In: European Journal of Clinical Pharmacology, Vol. 75, No. 12, 2019, p. 1675-1683.

Research output: Contribution to journalArticle

Cuzzoni, Eva ; Franca, Raffaella ; De Iudicibus, Sara ; Marcuzzi, Annalisa ; Lucafò, Marianna ; Pelin, Marco ; Favretto, Diego ; Monti, Elena ; Morello, William ; Ghio, Luciana ; La Scola, Claudio ; Mencarelli, Francesca ; Pasini, Andrea ; Montini, Giovanni ; Decorti, Giuliana ; Stocco, Gabriele. / MIF plasma level as a possible tool to predict steroid responsiveness in children with idiopathic nephrotic syndrome. In: European Journal of Clinical Pharmacology. 2019 ; Vol. 75, No. 12. pp. 1675-1683.
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title = "MIF plasma level as a possible tool to predict steroid responsiveness in children with idiopathic nephrotic syndrome",
abstract = "Purpose: Idiopathic nephrotic syndrome (INS) is the most frequent form of childhood nephrotic syndrome. Steroids represent the best therapeutic option; however, inter-individual differences in their efficacy and side effects have been reported. To date, there is no way to predict patients’ resistance and/or dependence. Alterations in the cytokine profile of INS patients might contribute to proteinuria and glomerular damage and affect drug sensitivity. Methods: The cytokine plasma levels were measured in 21 INS children at diagnosis to investigate the association among cytokines pattern and clinical response. Patients were selected on the basis of their clinical response: 7 steroid sensitive (SS), 7 dependent (SD), and 7 resistant (SR). Significant results were then analyzed in 41 additional pediatric INS patients. Results: Within the 48 cytokines analyzed, macrophage migration inhibitory factor (MIF) was a good predictor of steroid response. Indeed, SR patients showed significantly higher MIF plasma levels compared with all others (p = 0.022; OR = 4.3, 95{\%}CI = 1.2–25.4): a cutoff concentration of MIF > 501 pg/ml significantly discriminated SR patients (sensitivity = 85.7{\%}, specificity = 71.4{\%}). On the contrary, SD patients showed lower MIF plasma levels compared with others (p = 0.010; OR = 0.12, 95{\%}CI = 9.2 × 10−3–6.7 × 10−1). Significant results were confirmed in the entire cohort. Conclusions: Our comprehensive cytokine analysis indicates that assessing MIF plasma levels at diagnosis could predict response to glucocorticoids in children with INS.",
keywords = "Cytokines, Glucocorticoid response, Idiopathic nephrotic syndrome, Pediatrics",
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T1 - MIF plasma level as a possible tool to predict steroid responsiveness in children with idiopathic nephrotic syndrome

AU - Cuzzoni, Eva

AU - Franca, Raffaella

AU - De Iudicibus, Sara

AU - Marcuzzi, Annalisa

AU - Lucafò, Marianna

AU - Pelin, Marco

AU - Favretto, Diego

AU - Monti, Elena

AU - Morello, William

AU - Ghio, Luciana

AU - La Scola, Claudio

AU - Mencarelli, Francesca

AU - Pasini, Andrea

AU - Montini, Giovanni

AU - Decorti, Giuliana

AU - Stocco, Gabriele

PY - 2019

Y1 - 2019

N2 - Purpose: Idiopathic nephrotic syndrome (INS) is the most frequent form of childhood nephrotic syndrome. Steroids represent the best therapeutic option; however, inter-individual differences in their efficacy and side effects have been reported. To date, there is no way to predict patients’ resistance and/or dependence. Alterations in the cytokine profile of INS patients might contribute to proteinuria and glomerular damage and affect drug sensitivity. Methods: The cytokine plasma levels were measured in 21 INS children at diagnosis to investigate the association among cytokines pattern and clinical response. Patients were selected on the basis of their clinical response: 7 steroid sensitive (SS), 7 dependent (SD), and 7 resistant (SR). Significant results were then analyzed in 41 additional pediatric INS patients. Results: Within the 48 cytokines analyzed, macrophage migration inhibitory factor (MIF) was a good predictor of steroid response. Indeed, SR patients showed significantly higher MIF plasma levels compared with all others (p = 0.022; OR = 4.3, 95%CI = 1.2–25.4): a cutoff concentration of MIF > 501 pg/ml significantly discriminated SR patients (sensitivity = 85.7%, specificity = 71.4%). On the contrary, SD patients showed lower MIF plasma levels compared with others (p = 0.010; OR = 0.12, 95%CI = 9.2 × 10−3–6.7 × 10−1). Significant results were confirmed in the entire cohort. Conclusions: Our comprehensive cytokine analysis indicates that assessing MIF plasma levels at diagnosis could predict response to glucocorticoids in children with INS.

AB - Purpose: Idiopathic nephrotic syndrome (INS) is the most frequent form of childhood nephrotic syndrome. Steroids represent the best therapeutic option; however, inter-individual differences in their efficacy and side effects have been reported. To date, there is no way to predict patients’ resistance and/or dependence. Alterations in the cytokine profile of INS patients might contribute to proteinuria and glomerular damage and affect drug sensitivity. Methods: The cytokine plasma levels were measured in 21 INS children at diagnosis to investigate the association among cytokines pattern and clinical response. Patients were selected on the basis of their clinical response: 7 steroid sensitive (SS), 7 dependent (SD), and 7 resistant (SR). Significant results were then analyzed in 41 additional pediatric INS patients. Results: Within the 48 cytokines analyzed, macrophage migration inhibitory factor (MIF) was a good predictor of steroid response. Indeed, SR patients showed significantly higher MIF plasma levels compared with all others (p = 0.022; OR = 4.3, 95%CI = 1.2–25.4): a cutoff concentration of MIF > 501 pg/ml significantly discriminated SR patients (sensitivity = 85.7%, specificity = 71.4%). On the contrary, SD patients showed lower MIF plasma levels compared with others (p = 0.010; OR = 0.12, 95%CI = 9.2 × 10−3–6.7 × 10−1). Significant results were confirmed in the entire cohort. Conclusions: Our comprehensive cytokine analysis indicates that assessing MIF plasma levels at diagnosis could predict response to glucocorticoids in children with INS.

KW - Cytokines

KW - Glucocorticoid response

KW - Idiopathic nephrotic syndrome

KW - Pediatrics

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