Serum levels of BAFF and APRIL in children with steroid-sensitive nephrotic syndrome.

Abstract

Introduction: The therapeutic efficacy of B cell-depleting anti-CD20 treatments is well established for children with steroid-sensitive nephrotic syndrome (SSNS), thus suggesting that B cells may play an important role in the occurrence of this disease. However, the role of B-cell survival factors and cytokines in SSNS has yet to be fully elucidated.

Methods: We used commercially available ELISA kits to determine the serum levels of B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in 84 children with SSNS and 25 healthy controls. Then, we performed correlation analysis between these two serum factors and clinical parameters in children with SSNS.

Results: The serum level of BAFF in the relapse group was 1295.2 ± 584.2pg/ml, significantly higher than other groups (p<0.001). The serum level of APRIL in the relapse group was 2830.5 ± 945.8 pg/ml, significantly higher than the other groups (p<0.001). The proportion (%) of memory B cells was positively correlated with the levels of BAFF and APRIL in children with SSNS (Pearson's correlation coefficient: r=0.351, P=0.001; Pearson's r=0.234, P=0.032). The proportion (%) of transitional B cells was negatively correlated with the levels of BAFF (Pearson's r=-0.237, P=0.030) while the serum levels of IgG were negatively correlated with those of APRIL (Pearson's r=-0.274, P=0.012).

Conclusions: Our data indicate that BAFF appears to play a role in the recurrence of SSNS while APRIL appears to play a role in the pathogenesis of this condition, thus indicating that these molecules represent potential therapeutic targets for SSNS.