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Urinary excretion of sphingomyelinase phosphodiesterase acid‐like 3b in children with intractable nephrotic syndrome
Author(s) -
Watanabe Shojiro,
Tsugawa Koji,
Tsuruga Kazushi,
Imaizumi Tadaatsu,
Tanaka Hiroshi
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13355
Subject(s) - medicine , excretion , nephrotic syndrome , urinary system , focal segmental glomerulosclerosis , urology , urine , endocrinology , proteinuria , gastroenterology , renal biopsy , glomerulosclerosis , biopsy , kidney
Rituximab ( RTX ), a specific antibody to human CD 20, has been successfully used to treat intractable nephrotic syndrome ( NS ). Recent studies have suggested a direct effect of RTX on podocytes by targeting sphingomyelinase phosphodiesterase acid‐like 3b ( SMPDL ‐3b). Thus, we examined the urinary excretion of SMPDL ‐3b as well as its immunoreactivity in biopsy specimens from children with intractable NS . Urine samples from six patients (five with minimal‐change NS and one with focal segmental glomerulosclerosis) and from four healthy adults were examined. Glomerular immunoreactivity and urinary excretion of SMPDL 3b in proteinuric NS patients decreased compared with controls. Interestingly, urine samples obtained from the same patients at the remission stage after RTX treatment showed an increase in urinary SMPDL ‐3b excretion compared with the proteinuric stage. Urinary excretion level of SMPDL ‐3b could thus be used to predict the clinical efficacy of RTX treatment in NS patients.