Oz patent for PGI study on steroid toxicity in children

Lucknow: In a first, the government of Australia has awarded an international patent to SGPGI’s nephrology department for innovation in management of common renal disease in children called nephrotic syndrome.

Head of nephrology department at SGPGI, Prof Narayan Prasad said, “As a result of the disease, children lose heavy amount of protein in the urine and swelling appears all over the body. Gradually, it may lead to kidney failure, requiring dialysis and renal transplantation. The treatment for this disease rests on steroid, but while some children are resistant to steroids since the beginning, many develop resistance during treatment”.

At least 8,000 cases of this common renal disease are reported at SGPGI alone each year. About 10-20% of children do not respond to steroid therapy. Nearly one-third of the remaining 80% develop steroid resistance after initial response, while another proportion develop it in the later stages. Prof Prasad said that prolonged resistance to steroid leads to a kind of toxicity in the body, which predisposes them to infections, weakens their immunity, results in to stunted growth, produce bony weakness, many metabolic conditions like diabetes, cataract and moon facies.

“The challenges became the base for research and evolved into an innovation, which earned the Australian patent. Valid for eight years, the patented method recognised new biomarkers — called P-gp and MRP-1 in this case — to identify steroid resistance so that the alternative regimen may be introduced,” said Prof Prasad, adding that other members in the inventors’ team included Prof Vikas Agrawal, Akhilesh Jaiswal, Saurabh Chaturvedi and Harshit Singh.

He said that in case of resistance, the body treats steroid like a foreign substance and triggers release of glycoproteins P-gp and MRP-1. These proteins on the body cell surface work like an efflux pump and bloat to prevent penetration of the medicine inside. As a result, the medicine doesn’t work and the symptoms show up. The puffiness goes up further as the medicine doesn’t act.

Prof Prasad said that exposing children to tests to determine P-gp and MRP-1 levels in blood can help. He said the study establishing the success of the method has been published in high impact medical journal Nature’s publication Pharmacogenomics.


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