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Published in: European Journal of Pediatrics 3/2011

Open Access 01-03-2011 | Short Report

Effect of cyclosporin A on proteinuria in the course of glomerulopathy associated with WT1 mutations

Authors: Anna Maria Wasilewska, Elżbieta Kuroczycka-Saniutycz, Walentyna Zoch-Zwierz

Published in: European Journal of Pediatrics | Issue 3/2011

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Abstract

Denys–Drash syndrome (DDS) is characterized by progressive glomerulopathy caused by diffuse mesangial sclerosis (DMS), genitourinary defects, and a higher risk of developing Wilms’ tumor. It is commonly assumed that the DMS is unresponsive to any medications. In this report, we present a patient with Denys–Drash syndrome, in whom the cyclosporine A (CsA) was found to induce total remission. This observation and observations of other authors confirm that in genetic forms of nephrotic syndrome, the proteinuric effect of CsA may be due to a non-immunologic mechanism. We confirm the beneficial effect of CsA treatment in DDS; however, the potential nephrotoxicity of this drug will probably not allow long-term use.
Literature
1.
go back to reference Aramburu J, Heitman J, Crabtree G (2004) Calcineurin: a central controller of signalling in eukaryotes. EMBO Rep 5:343–348PubMedCrossRef Aramburu J, Heitman J, Crabtree G (2004) Calcineurin: a central controller of signalling in eukaryotes. EMBO Rep 5:343–348PubMedCrossRef
2.
go back to reference Bensman A, Niaudet P (2010) Non-immunologic mechanisms of calcineurin inhibitors explain its antiproteinuric effects in genetic glomerulopathies. Pediatr Nephrol 25:1197–1199PubMedCrossRef Bensman A, Niaudet P (2010) Non-immunologic mechanisms of calcineurin inhibitors explain its antiproteinuric effects in genetic glomerulopathies. Pediatr Nephrol 25:1197–1199PubMedCrossRef
3.
go back to reference Callis L, Vila A, Nieto J, Fortuny G (1992) Effect of cyclosporin A on proteinuria in patients with Alport's syndrome. Pediatr Nephrol 6:140–144PubMedCrossRef Callis L, Vila A, Nieto J, Fortuny G (1992) Effect of cyclosporin A on proteinuria in patients with Alport's syndrome. Pediatr Nephrol 6:140–144PubMedCrossRef
4.
go back to reference Callis L, Vila A, Carrera M, Nieto J (1999) Long-term effects of cyclosporine A in Alport's syndrome. Kidney Int 55:1051–1056PubMedCrossRef Callis L, Vila A, Carrera M, Nieto J (1999) Long-term effects of cyclosporine A in Alport's syndrome. Kidney Int 55:1051–1056PubMedCrossRef
5.
go back to reference Chernin G, Vega-Warner V, Schoeb D, et al. (2010) Genotype/phenotype correlation in nephrotic syndrome caused by WT1 mutations. Clin J Am Soc Nephrol doi:10.2215/CJN.09351209 Chernin G, Vega-Warner V, Schoeb D, et al. (2010) Genotype/phenotype correlation in nephrotic syndrome caused by WT1 mutations. Clin J Am Soc Nephrol doi:10.​2215/​CJN.​09351209
6.
go back to reference Crabtree G, Olson E (2002) NFAT signaling: choreographing the social lives of cells. Cell 109 (Suppl):S67–S79CrossRef Crabtree G, Olson E (2002) NFAT signaling: choreographing the social lives of cells. Cell 109 (Suppl):S67–S79CrossRef
7.
go back to reference Faul C, Donnelly M, Merscher-Gomez S et al (2008) The actin cytoskeleton of kidney podocytes is a direct target of the antiproteinuric effect of cyclosporine A. Nat Med 14:931–938PubMedCrossRef Faul C, Donnelly M, Merscher-Gomez S et al (2008) The actin cytoskeleton of kidney podocytes is a direct target of the antiproteinuric effect of cyclosporine A. Nat Med 14:931–938PubMedCrossRef
8.
go back to reference Gellermann J, Stefanidis C, Mitsioni A, Querfeld U (2010) Successful treatment of steroid-resistant nephrotic syndrome associated with WT1 mutations. Pediatr Nephrol 25:1285–1289PubMedCrossRef Gellermann J, Stefanidis C, Mitsioni A, Querfeld U (2010) Successful treatment of steroid-resistant nephrotic syndrome associated with WT1 mutations. Pediatr Nephrol 25:1285–1289PubMedCrossRef
9.
go back to reference Hinkes B, Wiggins R, Gbadegesin R et al (2006) Positional cloning uncovers mutations in PLCE1 responsible for a nephrotic syndrome variant that may be reversible. Nat Genet 38:1397–1405PubMedCrossRef Hinkes B, Wiggins R, Gbadegesin R et al (2006) Positional cloning uncovers mutations in PLCE1 responsible for a nephrotic syndrome variant that may be reversible. Nat Genet 38:1397–1405PubMedCrossRef
10.
go back to reference Hinkes B, Mucha B, Vlangos C et al (2007) Nephrotic syndrome in the first year of life: two thirds of cases are caused by mutations in 4 genes (NPHS1, NPHS2, WT1, and LAMB2). Pediatrics 119:e907–e919PubMedCrossRef Hinkes B, Mucha B, Vlangos C et al (2007) Nephrotic syndrome in the first year of life: two thirds of cases are caused by mutations in 4 genes (NPHS1, NPHS2, WT1, and LAMB2). Pediatrics 119:e907–e919PubMedCrossRef
11.
go back to reference Ismaili K, Verdure V, Vandenhoute K et al (2008) WT1 gene mutations in three girls with nephrotic syndrome. Eur J Pediatr 167:579–581PubMedCrossRef Ismaili K, Verdure V, Vandenhoute K et al (2008) WT1 gene mutations in three girls with nephrotic syndrome. Eur J Pediatr 167:579–581PubMedCrossRef
12.
go back to reference Malina M, Cinek O, Janda J, Seeman T (2009) Partial remission with cyclosporine A in a patient with nephrotic syndrome due to NPHS2 mutation. Pediatr Nephrol 24:2051–2053PubMedCrossRef Malina M, Cinek O, Janda J, Seeman T (2009) Partial remission with cyclosporine A in a patient with nephrotic syndrome due to NPHS2 mutation. Pediatr Nephrol 24:2051–2053PubMedCrossRef
13.
go back to reference McTaggart S, Algar E, Chow C et al (2001) Clinical spectrum of Denys–Drash and Frasier syndrome. Pediatr Nephrol 16:335–339PubMedCrossRef McTaggart S, Algar E, Chow C et al (2001) Clinical spectrum of Denys–Drash and Frasier syndrome. Pediatr Nephrol 16:335–339PubMedCrossRef
14.
go back to reference Meyrier A (1989) Treatment of glomerular disease with cyclosporin A. Nephrol Dial Transplant 4:923–931PubMed Meyrier A (1989) Treatment of glomerular disease with cyclosporin A. Nephrol Dial Transplant 4:923–931PubMed
15.
go back to reference Meyrier A (2009) Treatment of focal segmental glomerulosclerosis with immunophilin modulation: when did we stop thinking about pathogenesis? Kidney Int 76:487–491PubMedCrossRef Meyrier A (2009) Treatment of focal segmental glomerulosclerosis with immunophilin modulation: when did we stop thinking about pathogenesis? Kidney Int 76:487–491PubMedCrossRef
16.
go back to reference Mucha B, Ozaltin F, Hinkes B et al (2006) Mutations in the Wilms' tumor 1 gene cause isolated steroid resistant nephrotic syndrome and occur in exons 8 and 9. Pediatr Res 59:325–331PubMedCrossRef Mucha B, Ozaltin F, Hinkes B et al (2006) Mutations in the Wilms' tumor 1 gene cause isolated steroid resistant nephrotic syndrome and occur in exons 8 and 9. Pediatr Res 59:325–331PubMedCrossRef
17.
go back to reference Mundel P, Kriz W (1995) Structure and function of podocytes: an update. Anat Embryol (Berl) 192:385–397CrossRef Mundel P, Kriz W (1995) Structure and function of podocytes: an update. Anat Embryol (Berl) 192:385–397CrossRef
18.
go back to reference Mundel P, Reiser J (2010) Proteinuria: an enzymatic disease of the podocyte? Kidney Int 77:571–580PubMedCrossRef Mundel P, Reiser J (2010) Proteinuria: an enzymatic disease of the podocyte? Kidney Int 77:571–580PubMedCrossRef
20.
go back to reference Schumacher V, Scharer K, Wuhl E et al (1998) Spectrum of early onset nephrotic syndrome associated with WT1 missense mutations. Kidney Int 53:1594–1600PubMedCrossRef Schumacher V, Scharer K, Wuhl E et al (1998) Spectrum of early onset nephrotic syndrome associated with WT1 missense mutations. Kidney Int 53:1594–1600PubMedCrossRef
21.
go back to reference Zietse R, Wenting G, Kramer P et al (1992) Effects of cyclosporin A on glomerular barrier function in the nephrotic syndrome. Clin Sci (Lond) 82:641–650 Zietse R, Wenting G, Kramer P et al (1992) Effects of cyclosporin A on glomerular barrier function in the nephrotic syndrome. Clin Sci (Lond) 82:641–650
Metadata
Title
Effect of cyclosporin A on proteinuria in the course of glomerulopathy associated with WT1 mutations
Authors
Anna Maria Wasilewska
Elżbieta Kuroczycka-Saniutycz
Walentyna Zoch-Zwierz
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 3/2011
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-010-1278-4

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