The value of ABCB1 gene expression in children with idiopathic nephrotic syndrome
https://doi.org/10.36485/1561-6274-2021-25-1-83-89
Abstract
Idiopathic nephrotic syndrome is the most common childhood glomerulopathy. Despite modern advances in medicine, idiopathic NS is still a big problem, this is due to the fact that the mechanisms of pathogenesis are not fully understood, and the lack of unified approaches to drug therapy are the main obstacles to improving care for children. Approximately 20% of patients with nephrotic syndrome are resistant to standard glucocorticosteroid therapy, the so-called steroid-resistant nephrotic syndrome. In recent years, the issue of the role of the multidrug resistance gene ABCB1 in the formation of steroid resistance in children with primary nephrotic syndrome has been discussed. This article presents our own data on the study of ABCB1 gene expression in children with idiopathic nephrotic syndrome. A change in ABCB1 gene expression was demonstrated depending on the response to steroid therapy. Thus, ABCB1 gene expression is higher in patients with steroid-resistant nephrotic syndrome than in patients who responded to steroid therapy. At the same time, there are significant differences in ABCB1 expression between SZNS and SNNS. In clinical practice, patients with steroid-dependent nephrotic syndrome have relapses of the disease against the background of withdrawal of prednisolone, which is most likely due to the rapid elimination of prednisolone and further requires a revision of the prednisolone reduction scheme. The data obtained indicate the need for a personal approach to the management of patients with idiopathic nephrotic syndrome, taking into account the molecular genetic characteristics.
Keywords
About the Authors
S. L. MorozovRussian Federation
Sergey L. Morozov - PhD, Veltischev Research and Clinical Institute for Pediatrics, Department of Hereditary and Acquired Kidney Diseases, Senior Researcher; Associate Professor, Department of Hospital Pediatrics, No. 2, Faculty of Pediatrics Pirogov RNRMU
125412, Moscow, Taldomskaya st., 2, Phone: +7(903)1387732
A. S. Voronkova
Russian Federation
Anastasia S. Voronkova - PhD, Research Center of Neurology, Senior Researcher at the Laboratory Neuromorphology.
125367, Moscow, Volokolam-skoye Shosse, 80, Phone: +7(495)4902002
V. V. Dlin
Russian Federation
Veltischev Research and Clinical Institute for Pediatrics, Head of the Department of Hereditary and Acquired Kidney Diseases, Acting Director Veltischev Research and Clinical Institute for Pediatrics
125412, Moscow, Taldomskaya st., 2, Phone: +7(916)6343453
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Review
For citations:
Morozov S.L., Voronkova A.S., Dlin V.V. The value of ABCB1 gene expression in children with idiopathic nephrotic syndrome. Nephrology (Saint-Petersburg). 2021;25(1):83-89. (In Russ.) https://doi.org/10.36485/1561-6274-2021-25-1-83-89