The ultrastructural organization of the cytoskeleton of normal podocytes and glomerular endothelial cells was studied in man (adults and children) and in adult Sprague-Dawley rats. In podocytes of both species, cytoplasmic microtubules (MT) were observed in the cell body close to the Golgi apparatus and along the main axis of the major processes where they formed bundles. A network of intermediate filaments (IF) was observed in the cell body and in the major processes where they sometimes formed bundles parallel to MT, especially in man. Numerous clustered microfilaments (MF) were noticed in the foot processes close to the plasma membrane. In glomerular endothelial cells from both species, networks of MT and IF were observed in the cell body, whereas MF surrounded the endothelial fenestrations. The high degree of organization of the cytoskeleton suggests that it may play an important role in several functions of both cell types.
The effect of methyl prednisolone therapy (PM) was studied in 18 children with severe idiopathic nephrotic syndrome (NS). Eight patients were defined as "corticosteroid-resistant" because there was no response to treatment after a minimum of 4 weeks of 2 mg/kg/day of prednisone; 10 patients had a corticosteroid-dependent NS with frequent relapses which occurred under a high threshold dose of prednisone (1 mg/kg/day). Each patient received 4-6 pulses of 1 g/1.73 m2 methylprednisolone. Tolerance was generally good. PM therapy permitted a more rapid remission than oral prednisone (average 9 +/- 4 days vs. 22 +/- 9 days). Remission occurred in 5 of the 8 corticosteroid-resistant patients three of these 5 patients developed corticosteroid-dependent NS. For the children with a corticosteroid-dependent nephrotic syndrome, PM therapy did not affect the threshold dose of prednisone.
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