Plasma zonulin levels in childhood nephrotic syndrome

NEPTUNE Cohort Study

Research output: Contribution to journalArticle

Abstract

Objective: We conducted this study to test the hypothesis that plasma zonulin levels are elevated in pediatric patients with nephrotic syndrome compared to healthy controls. Study Design: Plasma zonulin levels were measured by ELISA in 114 children enrolled in the NEPTUNE study. Clinical and laboratory data were retrieved from the NEPTUNE database. Results: The median age of the patients was 10 (IQR = 5 to 14) years, 59 were male, 64 had minimal change disease, 47 focal segmental glomerulosclerosis, median eGFR was 96 (IQR = 80 to 114) ml/min/1.73 m2, and median urine protein:creatinine ratio was 0.5 (IQR = 0.1 to 3.4) (g:g). The plasma zonulin level was 14.2 ± 5.0 vs. 10.2 ± 2.5 ng/ml in healthy adults in a report using the same assay kit, P = 0.0025. These findings were confirmed in an independent cohort of children with nephrotic syndrome compared to healthy age-matched controls, P = 0.01. Zonulin concentrations did not differ in children with minimal change disease vs. focal segmental glomerulosclerosis, frequently relapsing vs. steroid-dependent vs. steroid-resistant clinical course, and were not influenced by the immunosuppressive treatment regimen. There was no relationship between plasma zonulin levels and the absolute or percentage change in proteinuria from enrollment until the time of the zonulin assay. Conclusion: Plasma zonulin levels are elevated in childhood nephrotic syndrome regardless of level of proteinuria or specific treatment. The cause of the high plasma zonulin levels and whether zonulin contributes to glomerular injury requires further study.

Original languageEnglish (US)
Article number197
JournalFrontiers in Pediatrics
Volume7
Issue numberMAY
DOIs
StatePublished - Jan 1 2019

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Nephrotic Syndrome
Lipoid Nephrosis
Focal Segmental Glomerulosclerosis
Proteinuria
Steroids
zonulin
Immunosuppressive Agents
Creatinine
Enzyme-Linked Immunosorbent Assay
Urine
Databases
Pediatrics
Wounds and Injuries
Therapeutics

Keywords

  • Focal segmental glomerulosclerosis
  • Minimal change disease
  • Nephrotic syndrome
  • PAR-2
  • Zonulin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Plasma zonulin levels in childhood nephrotic syndrome. / NEPTUNE Cohort Study.

In: Frontiers in Pediatrics, Vol. 7, No. MAY, 197, 01.01.2019.

Research output: Contribution to journalArticle

NEPTUNE Cohort Study. / Plasma zonulin levels in childhood nephrotic syndrome. In: Frontiers in Pediatrics. 2019 ; Vol. 7, No. MAY.
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abstract = "Objective: We conducted this study to test the hypothesis that plasma zonulin levels are elevated in pediatric patients with nephrotic syndrome compared to healthy controls. Study Design: Plasma zonulin levels were measured by ELISA in 114 children enrolled in the NEPTUNE study. Clinical and laboratory data were retrieved from the NEPTUNE database. Results: The median age of the patients was 10 (IQR = 5 to 14) years, 59 were male, 64 had minimal change disease, 47 focal segmental glomerulosclerosis, median eGFR was 96 (IQR = 80 to 114) ml/min/1.73 m2, and median urine protein:creatinine ratio was 0.5 (IQR = 0.1 to 3.4) (g:g). The plasma zonulin level was 14.2 ± 5.0 vs. 10.2 ± 2.5 ng/ml in healthy adults in a report using the same assay kit, P = 0.0025. These findings were confirmed in an independent cohort of children with nephrotic syndrome compared to healthy age-matched controls, P = 0.01. Zonulin concentrations did not differ in children with minimal change disease vs. focal segmental glomerulosclerosis, frequently relapsing vs. steroid-dependent vs. steroid-resistant clinical course, and were not influenced by the immunosuppressive treatment regimen. There was no relationship between plasma zonulin levels and the absolute or percentage change in proteinuria from enrollment until the time of the zonulin assay. Conclusion: Plasma zonulin levels are elevated in childhood nephrotic syndrome regardless of level of proteinuria or specific treatment. The cause of the high plasma zonulin levels and whether zonulin contributes to glomerular injury requires further study.",
keywords = "Focal segmental glomerulosclerosis, Minimal change disease, Nephrotic syndrome, PAR-2, Zonulin",
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AU - Trachtman, Howard

AU - Gipson, Debbie S.

AU - Lemley, Kevin V.

AU - Troost, Jonathan P.

AU - Faul, Christian

AU - Morrison, Debra J.

AU - Vento, Suzanne M.

AU - Ahn, Dong Hyun

AU - Goldberg, Judith D.

AU - Sedor, J.

AU - Dell, K.

AU - Schachere, M.

AU - Lemley, K.

AU - Whitted, L.

AU - Srivastava, T.

AU - Haney, C.

AU - Sethna, C.

AU - Grammatikopoulos, K.

AU - Appel, G.

AU - Toledo, M.

AU - Greenbaum, L.

AU - Wang, C.

AU - Lee, B.

AU - Adler, S.

AU - Nast, C.

AU - La Page, J.

AU - Athavale, A.

AU - Itteera, M.

AU - Neu, A.

AU - Boynton, S.

AU - Fervenza, F.

AU - Hogan, M.

AU - Lieske, J.

AU - Chernitskiy, V.

AU - Kaskel, F.

AU - Kumar, N.

AU - Flynn, P.

AU - Kopp, J.

AU - Castro-Rubio, E.

AU - Brede, E.

AU - Trachtman, H.

AU - Zhdanova, O.

AU - Modersitzki, F.

AU - Vento, S.

AU - Lafayette, R.

AU - Mehta, K.

AU - Gadegbeku, C.

AU - Johnstone, D.

AU - Pfeffer, Z.

AU - Cattran, D.

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N2 - Objective: We conducted this study to test the hypothesis that plasma zonulin levels are elevated in pediatric patients with nephrotic syndrome compared to healthy controls. Study Design: Plasma zonulin levels were measured by ELISA in 114 children enrolled in the NEPTUNE study. Clinical and laboratory data were retrieved from the NEPTUNE database. Results: The median age of the patients was 10 (IQR = 5 to 14) years, 59 were male, 64 had minimal change disease, 47 focal segmental glomerulosclerosis, median eGFR was 96 (IQR = 80 to 114) ml/min/1.73 m2, and median urine protein:creatinine ratio was 0.5 (IQR = 0.1 to 3.4) (g:g). The plasma zonulin level was 14.2 ± 5.0 vs. 10.2 ± 2.5 ng/ml in healthy adults in a report using the same assay kit, P = 0.0025. These findings were confirmed in an independent cohort of children with nephrotic syndrome compared to healthy age-matched controls, P = 0.01. Zonulin concentrations did not differ in children with minimal change disease vs. focal segmental glomerulosclerosis, frequently relapsing vs. steroid-dependent vs. steroid-resistant clinical course, and were not influenced by the immunosuppressive treatment regimen. There was no relationship between plasma zonulin levels and the absolute or percentage change in proteinuria from enrollment until the time of the zonulin assay. Conclusion: Plasma zonulin levels are elevated in childhood nephrotic syndrome regardless of level of proteinuria or specific treatment. The cause of the high plasma zonulin levels and whether zonulin contributes to glomerular injury requires further study.

AB - Objective: We conducted this study to test the hypothesis that plasma zonulin levels are elevated in pediatric patients with nephrotic syndrome compared to healthy controls. Study Design: Plasma zonulin levels were measured by ELISA in 114 children enrolled in the NEPTUNE study. Clinical and laboratory data were retrieved from the NEPTUNE database. Results: The median age of the patients was 10 (IQR = 5 to 14) years, 59 were male, 64 had minimal change disease, 47 focal segmental glomerulosclerosis, median eGFR was 96 (IQR = 80 to 114) ml/min/1.73 m2, and median urine protein:creatinine ratio was 0.5 (IQR = 0.1 to 3.4) (g:g). The plasma zonulin level was 14.2 ± 5.0 vs. 10.2 ± 2.5 ng/ml in healthy adults in a report using the same assay kit, P = 0.0025. These findings were confirmed in an independent cohort of children with nephrotic syndrome compared to healthy age-matched controls, P = 0.01. Zonulin concentrations did not differ in children with minimal change disease vs. focal segmental glomerulosclerosis, frequently relapsing vs. steroid-dependent vs. steroid-resistant clinical course, and were not influenced by the immunosuppressive treatment regimen. There was no relationship between plasma zonulin levels and the absolute or percentage change in proteinuria from enrollment until the time of the zonulin assay. Conclusion: Plasma zonulin levels are elevated in childhood nephrotic syndrome regardless of level of proteinuria or specific treatment. The cause of the high plasma zonulin levels and whether zonulin contributes to glomerular injury requires further study.

KW - Focal segmental glomerulosclerosis

KW - Minimal change disease

KW - Nephrotic syndrome

KW - PAR-2

KW - Zonulin

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