Immunogenetic features of steroid-sensitive nephrotic syndrome and focal segmental glomeru losclerosis in Brazilian patients of the northeast region of the state of São Paulo

Abstract

Steroid-sensitive nephrotic syndrome (SSNS) and focal segmental glomerulosclerosis (FSGC) share immunologic and pathogenetic features. We studied 93 Brazilian patients (46 with SSNS and 47 with FSGC) and 104 control subjects with the objective of characterizing the immunogenetic profile of these varieties of idiopathic nephrotic syndrome. HLA-A, -B, and -DR antigens were typed using a complement-dependent microlymphocytotoxicity assay. No significanty association was observed with HLA-A or -B antigens in either group; however, HLA-B7 and -B12 antigens were increased in SSNS patients. HLA-DR7, -DR1 and the combination of HLA-DR1/DR7 antigens were significantly increased in the total group of patients with SSNS compared to controls or to FGSC patients. The study of only Caucasoid individuals revealed that HLA-DR7 antigen remained significantly increased in SSNS patients. The HLA-B7/DR7 haplotype was siginificantly increased in both SSNS and FSGC patients. Although the Brazilian population is highly miscigenated, the same antigen (HLA-DR7) which confers susceptibility to SSNS in other Caucasian population is still prevalent in this series.