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 journalArticlepeer-review


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
Number of pages9
JournalEuropean Journal of Clinical Pharmacology
Issue number12
Publication statusPublished - Dec 2019


  • Cytokines
  • Glucocorticoid response
  • Idiopathic nephrotic syndrome
  • Pediatrics


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