INS, B Cells and Microbiota

Nantes University Hospital30 enrolled

Overview

Idiopathic nephrotic syndrome (NIS) is a clinical entity defined by the association of selective albuminuria, hypoalbuminemia, and nonspecific glomerular lesions (lesions minimal glomerular (LGM) or segmental and focal hyalinosis (HSF). The complication of this kidney disease is the progression towards chronic renal failure and in case of kidney transplantation, its immediate recurrence on the graft . The origin of this syndrome is unknown but a number of clinical observations tend to show an involvement of immune system. A link has been highlighted between atopy, diet and nephrotic flare-ups. The speed of recurrence of this initial disease on the graft and the observation of remissions obtained after treatment by plasma exchange or immunoadsorptions support the presence of a pathogenic plasma factor. Anti-CD20 treatments depleting B lymphocytes has made it possible to favorably treat a number of patients. Dysfunction of regulatory T cells has also been shown in SNI patients. This modification seems linked to allergies and could be due to an aberrant microbiota. The hypothesis of causality between dysbiosis, alteration lymphocyte and triggering of an SNI was mentioned recently. Two studies have shown intestinal dysbiosis in pediatric SNI/LGM, with reduction of T circulating regulators

Study Type

OBSERVATIONAL

Enrollment

Conditions

Microbiota B-lymphocytes Glomerulosclerosis T-lymphocytes

Eligibility

Sex: ALLMin age: 12 Years

Medical Language ↔ Plain English

Inclusion Criteria : * Patient treated in participating centers * In nephrotic attack, defined biologically by: Proteinuria \> 3g 24h or A proteinuria/creatinuria ratio \> 3 or Defined at the discretion of the clinician Non inclusion Criteria : * Patient with a history of NIS flare-ups resistant to corticosteroid therapy * Patient treated with immunosuppressant * Patient treated with corticosteroids \> 10 mg/d * Weight \<50 kg * Pregnant woman * Patient under guardianship / curatorship

Outcomes

Primary Outcomes

Sequencing and analysis of blood peripheral immune populations and intestinal and urinary microbiota

For the analysis of peripheral populations, blood cells will be collected by density gradient (Ficoll) and frozen in 20% DMSO. They will then be marked and identified by flow cytometry.

Time frame: 3 months

Sequencing and analysis of intestinal microbiota

The microbiota will be analyzed using DNA extracted from fecal samples.

Time frame: 3 months

Sequencing and analysis of urinary microbiota

The microbiota will be analyzed using DNA extracted from urine samples.

Time frame: 3 months

Secondary Outcomes

Compare blood peripheral immune populations in patients with SNI to that of type SN patients.

We will collect clinical and biological variables from each patient with a syndrome nephrotic type GEM or IgA as well as the results of the analysis of populations peripheral immune systems.

Time frame: 3 months

Compare intestinal microbiota in patients with SNI to that of type SN patients.

We will collect clinical and biological variables from each patient with a syndrome nephrotic type GEM or IgA as well as the results of the analysis of the microbiota

Time frame: 3 months

Compare urine microbiota in patients with SNI to that of type SN patients.

We will collect clinical and biological variables from each patient with a syndrome nephrotic type GEM or IgA as well as the results of the analysis of the microbiota

Time frame: 3 months

INS, B Cells and Microbiota

Overview

Conditions

Interventions

Eligibility

Locations (2)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts