Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025
[Effect of rituximab combined with short-course glucocorticoid therapy on cellular immunity and cytokines in children with new-onset nephrotic syndrome].
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Yuan Ting-Ting, Zhu Bing-Bing, Li Yan, Zhang Rui-Feng, Qiu Shan, Lyu Juan, Zhou Su-Qin
Аннотация
OBJECTIVES: To explore the effect of rituximab on cellular immunity and cytokines in children with new-onset steroid-sensitive nephrotic syndrome (SSNS).
METHODS: Clinical data of 60 children with new-onset SSNS treated at Xuzhou Children's Hospital from December 2021 to March 2023 were retrospectively analyzed. Children were allocated according to rituximab use into a control group (no rituximab) and an observation group (rituximab). The relapse rate, T-lymphocyte subsets and cytokines before and after treatment, and the incidence of adverse reactions were compared between groups.
RESULTS: The relapse rate was lower in the observation group than in the control group (27% vs 73%, P<0.05). After treatment, CD3+ and CD4+ T-lymphocyte counts, the CD4+/CD8+ ratio, and serum interleukin-2 increased in the observation group and were higher than in the control group (P<0.05). Interleukin-6 and tumor necrosis factor-α levels decreased after treatment in the observation group and were lower than in the control group (P<0.05). After treatment, CD8+ T-lymphocyte counts decreased, interferon-γ increased, and interleukin-10 decreased in both groups, with no significant differences between the two groups (P>0.05). The incidence of adverse reactions did not differ significantly between the two groups (P>0.05).
CONCLUSIONS: Rituximab can reduce the relapse rate in children with new-onset nephrotic syndrome and shows good safety. Its therapeutic effect is achieved by regulating the number and function of T cells and by modulating the anti-inflammatory effects of cytokines.
METHODS: Clinical data of 60 children with new-onset SSNS treated at Xuzhou Children's Hospital from December 2021 to March 2023 were retrospectively analyzed. Children were allocated according to rituximab use into a control group (no rituximab) and an observation group (rituximab). The relapse rate, T-lymphocyte subsets and cytokines before and after treatment, and the incidence of adverse reactions were compared between groups.
RESULTS: The relapse rate was lower in the observation group than in the control group (27% vs 73%, P<0.05). After treatment, CD3+ and CD4+ T-lymphocyte counts, the CD4+/CD8+ ratio, and serum interleukin-2 increased in the observation group and were higher than in the control group (P<0.05). Interleukin-6 and tumor necrosis factor-α levels decreased after treatment in the observation group and were lower than in the control group (P<0.05). After treatment, CD8+ T-lymphocyte counts decreased, interferon-γ increased, and interleukin-10 decreased in both groups, with no significant differences between the two groups (P>0.05). The incidence of adverse reactions did not differ significantly between the two groups (P>0.05).
CONCLUSIONS: Rituximab can reduce the relapse rate in children with new-onset nephrotic syndrome and shows good safety. Its therapeutic effect is achieved by regulating the number and function of T cells and by modulating the anti-inflammatory effects of cytokines.