Lymphocyte subpopulations in children with steroid responsive nephrotic syndrome

Abstract

To study the mechanism of steroid action on the pathogenesis of nephrotic syndrome, the author examined lymphocyte subsets using monoclonal antibodies in 52 children with steroid responsive nephrotic syndrome in the nephrotic, responsive and remission stages. single-color staining showed a relatively high OKT4/OKT8 ratio in the nephrotic stage as compared with the normal level. However, as proteinuria disappeared with steroid therapy, the OKT4/OKT8 ratio was lowered mainly because of a decreased number of OKT4 cells. The ratio became normal in the remission stage. HLA_DR⁺ CD8⁺ cells, suppressor-inducer T cells and suppressor T cells were examined by two-color staining to assess the kinetics of functional lymphocyte subsets. In children who responded to steroids, suppressor-inducer T cells were found to increase in the nephrotic stage, while suppressor T cells decreased. Treatment with steroid therapy resulted in a decrease in the number of suppressor-inducer T cells and an increase in the number of suppressor T cells and HLA_DR⁺ CD8⁺ cells. The above results indicate that the lymphoyte subset abnormalities in nephrotic syndrome mainly occur in suppressor inducer T cells and suppressor T cells, suggesting their possible relation with the etiology of the disease. The mechanism of action of steroids was considered to involve an increase in the number of suppressor T cells and a decrease in the number of suppressor inducer T cells.