Fas-Ligand and Granzyme-b Levels in Children with Nephrotic Syndrome

There is an urgent need to develop alternative to kidney biopsy in children to diagnose nephrotic syndrome. Increased apoptosis plays a central role in the development of nephrotic syndrome. The aim of this study was to evaluate the blood levels of two markers of apoptosis, Fas-ligand (Fas-l) and granzyme-b in children with nephrotic syndrome. Thirty children with biopsy-proven nephrotic syndrome as well as twenty four healthy controls were evaluated in this study. Clinical and laboratory data of included cases and controls were collected. Serum Fas-ligand and granzyme-b levels were measured using specific enzyme-linked immunosorbent assay (ELISA). The results of the current study showed that children with nephrotic syndrome had significantly higher serum levels of Fas-ligand (183.29±43.34pg/ml) and granzyme-b (151.68±30.47pg/ml) than healthy control subjects (Fas-1=99.28±7.20pg/ml, and granzyme-b=86.10±5.68pg/ml) (P=0.000). A significant increase in Fas-ligand levels in Focal segmental glomerulosclerosis cases than that of minimal changes nephrotic syndrome cases (p=0.004) was found. Granzyme-b levels were not significantly differing between the two groups of nephrotic syndrome cases. In conclusion, markers of the extrinsic pathway of kidney apoptosis as Fas-ligand and granzyme-b are potential novel biomarkers in children with nephrotic syndrome that could be used as non invasive alternative to kidney biopsy in assessment of those children.