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Serum Levels of B-Cell Activating Factor and A Proliferation-Inducing Ligand in Children with Steroid-Sensitive Nephrotic Syndrome

Abstract Introduction: The therapeutic efficacy of B-cell-depleting anti-CD20 treatments is well established for children with steroid-sensitive nephrotic syndrome (SSNS), thus suggesting that B cells may play an important role in… Click to show full abstract

Abstract Introduction: The therapeutic efficacy of B-cell-depleting anti-CD20 treatments is well established for children with steroid-sensitive nephrotic syndrome (SSNS), thus suggesting that B cells may play an important role in the occurrence of this disease. However, the role of B-cell survival factors and cytokines in SSNS has yet to be fully elucidated. Methods: We used commercially available ELISA kits to determine the serum levels of B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in 84 children with SSNS and 25 healthy controls. Then, we performed correlation analysis between these two serum factors and clinical parameters in children with SSNS. Results: The serum level of BAFF in the relapse group was 1,295.2 ± 584.2 pg/mL, significantly higher than other groups (p < 0.001). The serum level of APRIL in the relapse group was 2,830.5 ± 945.8 pg/mL, significantly higher than the other groups (p < 0.001). The proportion (%) of memory B cells was positively correlated with the levels of BAFF and APRIL in children with SSNS (Pearson’s correlation coefficient: r = 0.351, p = 0.001; Pearson’s r = 0.234, p = 0.032). The proportion (%) of transitional B cells was negatively correlated with the levels of BAFF (Pearson’s r = −0.237, p = 0.030) while the serum levels of IgG were negatively correlated with those of APRIL (Pearson’s r = −0.274, p = 0.012). Conclusions: Our data indicate that BAFF appears to play a role in the recurrence of SSNS while APRIL appears to play a role in the pathogenesis of this condition, thus indicating that these molecules represent potential therapeutic targets for SSNS.

Keywords: children steroid; serum; nephrotic syndrome; sensitive nephrotic; serum levels; steroid sensitive

Journal Title: Nephron
Year Published: 2025

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