The role of thalidomide on laboratory finding of nephrotic syndrome in the model of adriamycine induced nephrosis

Aim: The current hypothesis for the pathogenesis of childhood idiopathic nephrotic syndrome favors the involvement of a T cell-mediated immune response. Adriamycin induced nephritic syndrome is a widely used model for idiopathic nephrotic syndrome. Thalidomide is an immunmodulatory agent that down regulates the inflammatory tumor necrosis factor- ? , interleukin-6, and as well as angiogenesis, and apopitosis. The aim of this study was to investigated the role of thalidomide on proteinuria, tumor necrosis factor- ? and interleukin-6 in the model of adriamycine-induced nephrosis.Method: Sixty rats divided equally into four groups: Group 1 was healthy control group except the first group, experimental nephrotic syndrome was induced by intraperitoneal adriamycine (10 mg/kg). Group 2 consist of 15 rats which were not performed any treatment and accepted as nephritic control group. Both Group 3 and 4 received thalidomide, but thalidomide started at the first day in Group 3 and at the 11th day in Group 4 for 20 days. On 21st day, rats were sacrificed after obtaining material for biochemical analysis. Effects of thalidomide on renal function, biochemical parameters, and expression of serum and urine tumor necrosis factor- ? and interleukin-6 were determined.Result: Urinary protein excretion and urinary protein/creatinine ratio were significantly highest in Group 2, and lowest in Group 1, and found significantly lower in Group 3 than in Group 2. No difference was found between Group 1 and 3. The levels of serum total protein and albumin levels were significantly higher in Group 3 than in Groups 2 and 4 (p<0,001). No statistically significant difference was found in Group 3 when compared with Group 1.Total cholesterol and triglyceride levels were significantly lower in Group 3 than in Group 2. But no difference was found in cholesterol and triglyceride levels between Group 3 and 4. Mean serum interleukin-6 level was significantly lower in the Group 1 than all of the groups (p< 0,001). Urinary interleukin-6 level was not statistically different between the groups. Urinary tumor necrosis factor- ? level was found significantly higher in the Group 1 than in the Group 3 (p<0,001). Serum tumor necrosis factor- ? level was lowest in the Group 1 but no statistically significant difference was found between groups.Conclusion: Thalidomide is an effective anti-proteinuric and immunmodulatory agent that capable of suppressing adriamycine-induced nephrosis with early treatment.