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Nephrotic syndrome (NS) can be primary or secondary and they are both characterized by glomerular damages.
Under physiological condition, the glomerular capillary wall can effectively prevent macromolecular materials in the blood such as protein and red blood cells from entering the renal capsules. While under pathological condition, the filtration barrier is damaged and there will be glomerular proteinuria.
The pathogenic factors of NS include immune system, environment, heredity, etc among which the immune factor is the main inducing factor including humoral immune, cellular immune and immune mechanism in which the renal intrinsic cells are involved.
Before the invention of antibiotics, infection is one major cause of death of NS. The risks of the disease and death have been greatly lowered with the understanding of NS and its complications.
Cyclosporin has dual functions on treating Nephrotic syndrome.
1. The immune mechanism. Cyclosporin can inhibit the activation of IL-2 and T lymphocyte selectively and reversibly (the T cell-mediated immune reaction is on of the pathogenesis of NS).
2. Non-immune mechanism. It can help reduce proteinuria through influencing the glomerular permeability including aperture selectivity, charge selectivity and glomerular filtration rate (GFR).
The structure and function of the podocyte is very crucial for maintaining the normal function of glomerular filtration barrier. Synaptopodin is one of the main skeleton proteins of podocyte. Cyclosporin can help reduce its degradation and maintain the stability of podocyte and reduce its damages.
It has been proved tha Cycloporin is effective on alleviating proteinuria and inflammations and it is a very necessary immunosuppressant for severe illness conditions, but long term intake of cycloporin will cause a lot of side effects such as moon face, hairiness, susceptibility to infections, osteoporosis, femoral head necrosis, etc. Therefore patients especially children should not rely on cycloporin only.
