All issues > Volume 45(2); 2002

Original Article

J Korean Pediatr Soc. 2002;45(2):240-246. Published online February 15, 2002.

Clinical Study of the Correlation of Tumor Necrosis Factor Alpha and the Proteinuria of Henoch-Schönlein Nephritis and Idiopathic Nephrotic Syndrome

Dong-Ho DH Jeong¹, Jeong-Hyun JH Park¹, Hye-Cheon HC Jeong¹, Hyun-Hoe HH Koo¹, Jun-Ho JH Lee², Tae-Sun TS Ha¹

¹Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
²Department of Pediatrics, College of Medicine, Pochon Cha Uuniversity, Bundang, Korea

Correspondence Tae-Sun TS Ha ,Email: tsha@med.chungbuk.ac.kr

Abstract

Purpose
: It is not clear that the development of glomerular injury and aggravation by tumor necrosis factor alpha(TNF-α) is related to intrarenal or serum concentration of TNF-α. So, we studied the relationship between the concentration of TNF-α and aggravation of glomerular damage in the Henoch-Schönlein nephritis(HSN) and idiopathic nephrotic syndrome(INS).
Methods
: We collected the sera and urines of 21 patients with Henoch-Sch nlein purpura(HSP) and 22 patients with INS visited Chungbuk National University hospital from March 1998 to March 2001. The concentration of TNF-α in the sera and urines were measured by sandwich ELISA.
Results
: Serum TNF-α levels in the HSP patients with renal involvement were significantly higher than those without renal involvement(P=0.009). But urine TNF-α levels have no correlation with renal involvement(P=0.088). In the HSN patients, proteinuria have a significant correlation with serum TNF-α levels(P=0.004) but less correlation with urine TNF-α levels(P=0.053). Otherwise, proteinuria have no correlation with serum TNF-α levels(P=0.763) but have a significant correlation with urine TNF-α levels(P=0.007) in INS.
Conclusion
: These result suggest that the serum concentration of TNF-α would be important to glomerular involvement in HSP. And, it is interesting that proteinuria shows a significant relation with serum TNF-α levels in the HSN, but with urine TNF-α levels in the INS. This means the major production of TNF-α may be originated by extrarenal inflammation in the HSN and by intrarenal tubulo-interstitial damage due to proteinuria in the INS.

Keywords :Tumor necrosis factor-α, Proteinuria, Henoch-Schönlein nephritis, Idiopathic nephrotic syndrome