微小変化型ネフローゼ症候群における血清interferon-γ濃度と末梢血単核球interferon-γ産生能

Abstract

The present study was designed to clarify the ability of peripheral blood mononuclear cells (PBMC) from patients with minimal change nephrotic syndrome (MCNS) to produce interferon-γ (IFN-γ) in vitro. Subjects were 35 patients with MCNS, 25 with membranous nephropathy (MN), 42 with IgA nephropathy (IgA-GN), and 23 healthy volunteers as controls. Upon stimulation with phytohemagglutinin and tetradecanoyl phorbol-13-acetate, PBMC of patients with MCNS produced significantly lower amounts of IFN-γ compared to normal healthy volunteers. The reduction of IFN-γ production by PBMC was prominent in the nephrotic stage of MCNS. Decreased production of IFN-γ by PBMC from patients with MCNS returned to normal levels when PBMC were cultured in the presence of autologous serum, suggesting that there may be enhancing factor(s) for IFN-γ production in patient sera. In addition, we have measured the levels of IFN-γ in serum from MCNS. The samples from MCNS in the nephrotic stage had significantly higher levels of IFN-γ than normal healthy volunteers, although the samples from MCNS in incomplete remission and complete remission had normal levels of IFN-γ. Finally, 3 patients of MCNS in the nephrotic stage were found to show a remarkable reduction in their IFN-γ production and an elevation of serum IFN-γ levels. But IFN-γ production and serum IFN-γ levels returned to normal range when the disease was in remission. These findings indicate that disturbance of IFN-γ formation by PBMC and elevation of serum IFN-γ levels may be related to immunological abnormalities in MCNS.