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American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 03 PAGES: 36-43 

SJIF IMPACT FACTOR (2022: 5. 705) (2023: 6.534) (2024: 7.7) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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ABSTRACT 

Glomerular kidney damage - glomerulonephritis (GN) is one of the serious medical and economic problems. Often, GN 

is the main cause of end-stage chronic renal failure, which is incompatible with life and requires renal replacement 

therapy (dialysis, donor kidney transplantation) [2]. According to the course of the disease, there is an acute form of 

GN (the duration of the disease is less than one year) and chronic (the duration of the disease is more than one year). 

In clinical practice, there are often difficulties in timely differentiation of chronic GN and acute GN exacerbation, in 

particular, in the urinary (hidden) form of the disease, due to the lack of clear criteria for their diagnosis. 

KEYWORDS 

Chronic glomerulonephritis, cytokine balance, children. 

INTRODUCTION

Glomerular kidney damage - glomerulonephritis (GN) is 

one of the serious medical and economic problems. 

Often, GN is the main cause of end-stage chronic renal 

failure, which is incompatible with life and requires 

  Research Article 

 

ACUTE AND DISEASE WITH GLOMERULONEPHRITIS CYTOKINE 

BALANCE IN SICK PATIENTS  

 
Submission Date: March 07, 2024, Accepted Date:  March 12, 2024,  

Published Date: March 17, 2024  

Crossref doi: https://doi.org/10.37547/ajbspi/Volume04Issue03-05 

 

 

Ishkabulova Gulchexra Djankurazovna 
Department of Pediatrics, Faculty of Medicine, Candidate of Medical Sciences, Samarkand State Medical 

University, Samarkand, Uzbekistan 

 

Raxmonkulov Shaxzod Islomjon o`g`li 
Student of the Faculty of Pediatrics, Samarkand State Medical University, Samarkand, Uzbekistan 

 

Axtamova Shirin Xayrullaevna 
Student of the Faculty of Medicine, Samarkand State Medical University, Samarkand, Uzbekistan 

Journal Website: 

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Copyright: Original 

content from this work 

may be used under the 

terms of the creative 

commons attributes 

4.0 licence. 

 

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Volume 04 Issue 03-2024 37 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 03 PAGES: 36-43 

SJIF IMPACT FACTOR (2022: 5. 705) (2023: 6.534) (2024: 7.7) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

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renal replacement therapy (dialysis, donor kidney 

transplantation) [2]. According to the course of the 

disease, there is an acute form of GN (the duration of 

the disease is less than one year) and chronic (the 

duration of the disease is more than one year). In 

clinical practice, there are often difficulties in timely 

differentiation of chronic GN and acute GN 

exacerbation, in particular, in the urinary (hidden) form 

of the disease, due to the lack of clear criteria for their 

diagnosis. 

There are works dedicated to the study of biomarkers 

of glomerulonephritis chronicity [1, 3, 7]. At the same 

time, the role of pro- and anti-inflammatory cytokines 

in maintaining the inflammatory process in 

glomerulonephritis of various clinical courses has not 

yet been determined. In relation to the above, the aim 

of this study was to investigate the circulating levels of 

cytokines in patients with acute and chronic GN. 

METHODS 

This study included 55 patients with GN aged 10 to 18 

years who were treated in the nephrology department 

at Children's City Hospital No. 1 in Samarkand. At the 

beginning of the disease, 10 patients (acute GN), with 

exacerbation of chronic GN - 45 patients were studied. 

Diagnostic nephrobiopsy was performed in 34 

patients, mesangioproliferative variant of GN was 

detected in 21 cases, membranoproliferative variant in 

6 cases, membranous in 6 cases, and GN with minimal 

changes in 1 case. There are 24 girls and 31 boys among 

those who passed the examination. Groups of patients 

with acute GN and chronic GN were representative of 

patients with different morphological variants of the 

disease and representative of the functional status of 

the patients' kidneys. In addition to the generally 

accepted studies (general clinical blood and urine 

tests, biochemical studies - creatinine, urea, bilirubin, 

transaminases, hemostasiogram, proteinogram, C-

reactive protein, glomerular filtration rate, tubular 

reabsorption, ultrasound examination of the kidneys), 

concentration. The main cytokines circulating in the 

blood were identified - interleukin-1b (IL-1b), 

interleukin-2 (IL-2), interleukin-10 (IL-10), interferon-y 

(IFN-y) and IL-1b receptor antagonist - Ra -IL-1b. The 

object of the study was venous blood serum. Blood 

tests were performed twice - at admission to inpatient 

treatment (on days 2-3) and at the end of the period of 

inpatient treatment (on days 12-14). The following 

parameters of descriptive statistics were determined: 

arithmetic mean (M), standard deviation (SD). When 

comparing two samples, Student's t-test (p) was used 

to assess the significance of differences. In the case of 

asymmetric distribution of the set of indicator values in 

the groups, the median (Me) was calculated, the limits 

of variation of the study population were from 5% to 

95% (P5 - P95), and the reliability of the differences was 

non-parametric Mann-Whitney tests for independent 

groups. (pm-w) and was evaluated using Wilcoxon 

(pw) for conjugated groups [4]. The reliability of the 

relationship between two series of observations was 

evaluated based on the calculation of the Spearman 

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Volume 04 Issue 03-2024 38 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 03 PAGES: 36-43 

SJIF IMPACT FACTOR (2022: 5. 705) (2023: 6.534) (2024: 7.7) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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rank correlation coefficient (rs), the reliability of the 

coefficients was considered acceptable when 

prs<0.05. The values of the laboratory parameters 

obtained during the study were compared with the 

reference values, which were the results of the 

examination of 25 practically healthy people. Research 

results and discussion. The results of the study show 

that patients with GN, regardless of the nature of the 

clinical course of the disease - acute or chronic, 

produce both pro-inflammatory cytokines (IL-1b, IL-2) 

and anti-inflammatory cytokines. is released. - IL-10 and 

Ra-IL-1b. The object of research was venous blood 

serum. Blood tests were performed twice - at 

admission to inpatient treatment (on 2-3 days) and at 

the end of the inpatient treatment period (on 12-14 

days).     

The statistics of the obtained result were determined 

by the following parameters: arithmetic mean (M), 

standard deviation (SD). When comparing two 

samples, Student's t-test (p) was used to assess the 

significance of differences. In the case of asymmetric 

distribution of the set of indicator values in the groups, 

the median (Me) was calculated, the limits of variation 

of the study population were from 5% to 95% (P5 - P95), 

and the reliability of the differences was non-

parametric Mann-Whitney tests for independent 

groups. (pm-w) and was evaluated using Wilcoxon 

(pw) for conjugated groups [4]. The reliability of the 

relationship between two series of observations was 

evaluated based on the calculation of the Spearman 

rank correlation coefficient (rs), the reliability of the 

coefficients was considered acceptable when 

prs<0.05. The values of the laboratory parameters 

obtained during the study were compared with the 

values of the results of the examination of 25 

practically healthy people. 

RESULTS 

The results of the study show that in patients with GN, 

regardless of the nature of the clinical course of the 

disease - acute or chronic, both pro-inflammatory 

cytokines (IL-1b, IL-2) and anti-inflammatory cytokines 

are produced. Released - IL-10 and Ra-IL-1b. An 

exception is the pro-inflammatory cytokine IFN-γ, 

which has regulatory functions, and their values are at 

the reference level. 

 During GN, the increase in the production of pro-

inflammatory cytokines is explained by the 

development of inflammatory changes in the glomeruli 

as a result of infiltration by lymphocytes, monocytes 

and the increase of resident glomerular cells [5]. An 

increase in the production of anti-inflammatory 

cytokines - IL-10 and Ra-IL-1b, which occurs in parallel 

with an increase in the level of pro-inflammatory 

cytokines, can be considered as an autoregulatory 

reaction aimed at suppressing the increase in 

production, inflammation to suppress the production 

of pro-inflammatory cytokines [6]. 

Cytokine profile of patients with GN revealed some 

features depending on the clinical course of the 

disease. Thus, the average amount of Ra-IL-1b in 

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Volume 04 Issue 03-2024 39 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 03 PAGES: 36-43 

SJIF IMPACT FACTOR (2022: 5. 705) (2023: 6.534) (2024: 7.7) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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patients with exacerbation of chronic GN is 2.6 times 

lower than the corresponding value in patients with 

acute GN, and IFN-γ in the last stage of inpatient 

treatment with acute GN was 1.6 times higher than that 

of the group of sick patients. Despite the fact that the 

average amount of IL-1β in patients with chronic GN 

was 4.7 times lower than the corresponding value in 

patients with acute GN, the difference between the 

level of production of this cytokine in the compared 

groups of patients was statistically not important. 

        Comparison of cytokine levels before and after 

treatment using the Wilcoxon test revealed certain 

dynamics of cytokine production levels during 

treatment in patients with acute GN, with a decrease in 

the initial high levels of IL-1β, Rα-IL-1β and IL-2 

appeared. The level of IFNγ was also significantly 

decreased (pw<0.05), its baseline level was not 

different from the corresponding reference values. No 

significant dynamics in the production of cytokines 

were observed during treatment in patients with 

chronic GN. 

In connection with the known situation about the 

mutual dependence of the production of individual 

cytokines, we investigated the correlation relationship 

between the levels of the studied cytokines. In healthy 

people, only one correlation was established between 

the indicators of cytokine status - a negative 

correlation of the levels of anti-inflammatory cytokines 

- IL-10 and Ra-IL-1b (rs = -0.76; prs = 0.030). Being With 

the development of glomerular kidney damage, the 

total number of connections increased significantly. 

Cytokine profile of patients with chronic GN including 

pro-inflammatory cytokine IL-1β and its receptor 

antagonist, pro-inflammatory cytokines IL-2 and IFNγ, 

pro-inflammatory cytokine IFNγ and pro-inflammatory 

cytokine IL-10 baseline characterized by the existence 

of a direct relationship between internal levels. 

Relationships established at the end of treatment were 

also observed. In addition, by the end of treatment, a 

new correlation was found between IL-2 and IL-10 

levels. The correlations found in patients with chronic 

GN suggest the interaction of pro-inflammatory and 

anti-inflammatory cytokine production. 

This, the results of the correlation analysis show that 

there is a correlation between only pro-inflammatory 

cytokines in healthy individuals. The relationships 

identified in the acute form of GN reflect the 

interdependence of the production of pro-

inflammatory cytokines. A close relationship between 

the levels of pro-inflammatory and anti-inflammatory 

cytokine production during the period of exacerbation 

of chronic GN is revealed. In addition, by the end of 

chronic GN exacerbation relief, the number of such 

connections increases, in patients with acute GN, by 

the end of inpatient treatment, no correlation is found 

in the level of studied cytokines. 

In connection with the differences in the levels of Rα-

IL-1β and IFNγ detected in patients with acute and 

chronic GN, it is noteworthy that these cytokines 

correlate with the indicators of a set of standard 

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Volume 04 Issue 03-2024 40 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 03 PAGES: 36-43 

SJIF IMPACT FACTOR (2022: 5. 705) (2023: 6.534) (2024: 7.7) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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laboratory tests for GN (4 -table). Baseline values of Rα-

IL-1β were positively correlated with peripheral blood 

neutrophil leukocyte levels and negatively correlated 

with urine specific gravity. At the end of hospital 

treatment, IFNγ levels were positively related to serum 

creatinine levels. 

Cytokines  Laboratory 

indicators 

Rs Prs 

IL-1b (1) Serum urea (2) 0,35 0,016 

 Specific gravity of 

urine (1) 

-0,33 0,027 

Ra-IL-1b (1)  neutrophils% (1) 0,45 0,009 

 neutrophils abs (1) 0,37 0,037 

 neutrophils abs (2) 0,43 0,015 

IFNy Serum creatinine(2) 0,35 0,047 

    

 

Table 1. Statistically significant correlation between 

indicators of cytokine status and standard laboratory 

tests in patients with GNNote: (1) - indicator values on 

days 2-3 and (2) - on days 12-14 of hospital treatment; 

abs. – absolute value (in 1 l). 

In view of the established correlation of the cytokine 

system, some features of laboratory results of GN can 

be explained by different types of clinical course. 

In patients with chronic GN, the content of neutrophil 

cells is lower than in patients with acute GN. This fact 

may be related to the low initial level of Rα-IL-1β in the 

chronic course of GN, which is positively related to the 

amount of neutrophils in the blood. 

Table 2. Statistically significant differences in 

laboratory parameters in patients with different 

clinical course of GN 

Note: (1) - indicator values on days 2-3 and (2) - on days 

12-14 of hospital treatment; abs. – absolute value (in 1 

l). 

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Volume 04 Issue 03-2024 41 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 03 PAGES: 36-43 

SJIF IMPACT FACTOR (2022: 5. 705) (2023: 6.534) (2024: 7.7) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Previously, we tried to find immuno-hematological 

markers that distinguish the exacerbation of chronic 

GN from the onset of the disease [1]. We found that the 

absolute number of neutrophils and the relative 

number of eosinophils determined before treatment 

of a patient with GN can be used to distinguish the 

nature of the clinical course of GN. Contrary to 

expectations, immunological indicators were not 

suitable for use as diagnostic criteria to determine the 

nature of the clinical course of GN: we could not find 

differences in innate and adaptive immune response 

indicators in groups of patients with acute and chronic 

diseases 

In patients with GN, a different situation occurs 

according to the results of the study of the cytokine 

profile: the exacerbation of chronic GN is distinguished 

from the onset of GN by a smaller increase in the level 

of anti-inflammatory cytokine - Ра-IL-1b, the 

characteristics of which are 5- 95 percentile interval 

from 111 to 3915 pg/ml (in patients with acute GN - from 

395 to 2942 pg/ml) and high levels of pro-inflammatory 

cytokine - IFNγ are distributed, at the end of treatment 

from 26.7 With changes up to 412.4 pg / ml (in patients 

with acute GN - from 24.1 to 45 pg / ml). Therefore, 

determination of the levels of Rα-IL-1β and IFN-γ can be 

used to distinguish between acute and chronic GN: a 

baseline Rα-IL-1β level below 395 pg/ml in a patient 

with GN is concentration increases the probability of 

diagnosis in favor of chronic GN with the presence of 

other symptoms of chronic GN. In this case, if the level 

of IFN-γ is higher than 45 pg / ml, the diagnosis of 

chronic GN can be confirmed by the 14th day of 

hospital treatment. 

CONCLUSION 

1. Differences in the cytokine profile in patients with GN 

were determined depending on the clinical course of 

the disease. 

2. In the acute period of GN, a direct correlation was 

found in the levels of production of pro-inflammatory 

cytokines, which disappear until the end of hospital 

treatment. The chronic course of GN is characterized 

by the presence of interdependence in the production 

of pro-inflammatory and anti-inflammatory cytokines. 

3. Cytokine profile of patients with exacerbation of 

chronic GN is characterized by low initial level of 

circulating Ра-IL-1b and high level of IFN-γ by the end of 

the inpatient treatment course. 

4. The initial concentration of Ra-IL-1b at 

hospitalization of a patient with GN below 395 pg / ml 

increases the probability of diagnosis in favor of 

chronic GN. 

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Volume 04 Issue 03-2024 42 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 03 PAGES: 36-43 

SJIF IMPACT FACTOR (2022: 5. 705) (2023: 6.534) (2024: 7.7) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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ISHKABULOVA G.J.1, KHAIDAROVA K.R.1, 

KUDRATOVA G.N.1, KHOLMURADOVA Z.E.1 

Department of Pediatrics, Faculty of Therapeutics, 

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Volume 04 Issue 03-2024 43 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 03 PAGES: 36-43 

SJIF IMPACT FACTOR (2022: 5. 705) (2023: 6.534) (2024: 7.7) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

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