Abstract
Fibronectin (Fn) is a high-molecular-weight glycoprotein, and exists on the cell surface and in the cytoplasma of fibroblasts or other cells, in the plasma, and in the cerebrospinal fluid. The role of plasma Fn is related to coagulation of blood, restoration process of wounds and removal of foreign substances by reticuloendothelial system, but it's precise roles are not yet determined. We measured plasma Fn by laser nephelometer and some interesting results were obtained. Seventy-six patients were studied: 36 cases of chronic renal diseases (age range 7-15 years), 19 bronchial asthma (7-17 years), and 21 progressive muscular dystrophy and it's related diseases (7-20 years). Plasma Fn levels in these patients were shown as percentage of Fn level of normal adult pooled plasma.
Results: 1) Chronic renal diseases: In patients with steroid sensitive nephrotic syn- drome (SSNS) the plasma Fn level was 11.5&21.9% (n=16) (in active stage 130.3&19.2%) and it was significantly high (p<0.001). The plasma Fn level was 104.0&18.4% (n=8) in patients with membrane-proliferative glomerulonephritis, and was 127.5&22.1% (n=3) in patients with other nephritic nephrosis. It's level was 113.9&10.3% (n=10) in patients with persistent glomerulonephritis, was low in patients with nephritis associated with liver cirrhosis (3 cases) and was within normal limits in patients with purpura nephritis (2 cases). Some patients with SSNS showed normalized Fn level as their nephrotic state improved. 2) Bronchial asthma: The plasma Fn level (104.3&20.8% (n=19)) was within normal limits in patients with bronchial asthma. In patients with atopic type asthma it was 105.1&23.0% (n=15), in infections type asthma it was 95.8&5.0% (n=2) and in mixed type asthma it was 107.8&4.4% (n=2). Most cases who had been free from asthma attack over one year had the Fn level above 100%. 3) Muscular dystrophy: In patients with Duchenne type muscular dystrophy the plasma Fn level was 107.4&10.0% (n=15), in congenital musclar dystrophy it was 97.0&7.596 (n=3) and in the other related diseases it was 108.9&11.596 (n=3).
Discussion: In chronic diseases in childhood (especially in SSNS of chronic renal diseases), plasma Fn level varied with change in disease condition, so it was suggested that it would be useful to serially measure plasma Fn for the understanding of the disease condition
