Glucocorticoid receptor and vascular endothelial growth factor in nephrotic syndrome

Aim: The aim of the study was to assess plasma and urine concentrations of vascular endothelial growth factor ( VEGF) in nephrotic syndrome children (NS) depending on the total dose of glucocorticoids ( GC) and the percentage of lymphocytes with glucocorticoid receptor expression (CD3/GCR). Methods: We examined 51 children (2 - 15 years), allocated to three groups: group I: 13 children with the first NS onset, group II: 13 children with NS relapse, group C: 25 healthy children. The NS patients were examined: (A) before treatment and ( B) 4 - 5 weeks after prednisone administration at a dose of 60 mg/m(2)/24h. Plasma and urinary VEGF levels were determined using the immunoenzymatic ELISA method. Flow cytometry was applied to assess CD3/GCR expression. Results: Higher plasma and urinary VEGF concentrations were noted in NS children before treatment (A), as compared to control subjects (C). Following prednisone therapy ( B), VEGF level was reduced but it was still higher than in the control group. Positive correlation was observed between VEGF and protein in the urine (group I r = 0.660, P < 0.05, group II r = 0.818, P < 0.01) and a weak positive correlation between VEGF in plasma and urine (group I r = 0.531, P < 0.05, group II - r = 0.581, P < 0.05). CD3/GCR expression was lower in group II. In both groups, the correlation between plasma VEGF and CD3/GCR was positive (P < 0.05). Conclusions: 1. Plasma and urinary VEGF levels increase during nephrotic syndrome onset. 2. Glucocorticoid treatment reduces plasma and urinary VEGF levels in NS children.