A pilot prospective cohort study: Changes in circulating T-lymphocyte subsets during steroid therapy in patients with nephrotic syndrome.

ObjectiveGlucocorticoids are used to treat nephrotic syndrome; however, some patients develop resistance. T-lymphocyte subsets are involved in immune regulation and may be associated with disease progression and treatment response. The current prospective pilot cohort study explored T-cell immune phenotypes associated with steroid responsiveness in patients with nephrotic syndrome.MethodsEleven patients newly diagnosed with nephrotic syndrome between 2023 and 2024, classified as steroid-sensitive or steroid-resistant based on treatment outcomes, and 14 healthy volunteers were enrolled. Peripheral blood samples were collected at diagnosis (baseline), at weeks 4 and 8 after hormone therapy, and during monthly follow-up visits. T-cell subsets and T-cell immunoglobulin and mucin domain-containing protein 3 (TIM-3) expression were analyzed using flow cytometry. Differences were identified by performing variance analysis, and correlations were assessed by performing linear regression.ResultsCD3+ CD8+ T cells differed between steroid-resistant patients and both steroid-responsive patients and controls (p < 0.05). The proportion of CD3+ TIM-3+ T cells differed between controls and steroid-sensitive patients (p < 0.001). Steroid treatment was associated with an increase in CD3+ TIM-3+ T cells and a potential negative correlation with albumin levels in steroid-sensitive patients.ConclusionsT-cell immune phenotypes, particularly TIM-3-expressing T cells, may be associated with steroid responsiveness in nephrotic syndrome. The current findings provide preliminary evidence for potential laboratory markers related to immune regulation.