Injury to E‐ and
VE
‐Cadherin in Paediatric Idiopathic Steroid‐Sensitive Nephrotic Syndrome: Potential Markers of the Disease Status
Takahiro Kanai, Jun Aoyagi, Masanori Kurosaki, Tomomi Maru, Marika Ishii, Toshihiro Tajima ABSTRACT
Aim
The pathophysiology of idiopathic steroid‐sensitive nephrotic syndrome (ISSNS) remains unclear. This study aimed to explore the pathophysiology by examining E‐cadherin injury, observed in atopic dermatitis, and VE‐cadherin injury, associated with systemic edema formation.
Methods
Twenty‐one paediatric patients with ISSNS were enrolled. Serum E‐ and VE‐cadherin levels were measured using ELISA and compared between the nephrotic and remission phases. Correlations between each serum E‐ and VE‐cadherin level and urinary protein/creatinine (UP/UCr) ratios and serum albumin (Alb) levels were analysed. Additionally, a correlation between changes in serum VE‐cadherin levels and in body weight between phases was analysed.
Results
Both serum E‐ and VE‐cadherin levels were elevated in the nephrotic phase compared to the remission phase ( p < 0.01 for both). Remission‐phase E‐cadherin levels remained higher than those in healthy children, while remission‐phase VE‐cadherin levels were similar to those in healthy children. Serum E‐cadherin levels showed a significant correlation with UP/UCr ratios ( p = 0.04), but not with serum Alb levels. Serum VE‐cadherin levels did not correlate with either UP/UCr ratios or serum Alb levels. However, changes in VE‐cadherin levels between the phases were significantly correlated with changes in body weight ( p = 0.04).
Conclusion
Elevated E‐ and VE‐cadherin levels during the nephrotic phase suggest that injury to these adhesion molecules may be correlated with the disease status and could serve as biomarkers for paediatric ISSNS. Injury to E‐cadherin may contribute to proteinuria while injury to VE‐cadherin may lead to systemic edema. These findings provide new insights into paediatric ISSNS pathophysiology.