SGPGIMS gets Australian patent for study on steroid toxicity

Lucknow, Nov 10 The Australian government has awarded an international patent to the nephrology department of Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) for innovation in management of common renal disease in children called nephrotic syndrome.

According to Prof Narain Prasad, head of nephrology department at SGPGI: "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 and about 10-20 per cent of children do not respond to steroid therapy. Nearly one-third of the remaining 80 per cent develop steroid resistance after initial response, while another proportion develop it in the later stages.

Prasad said that prolonged resistance to steroid leads to a kind of toxicity in the body, which pre-disposes them to infections, weakens their immunity, results in stunted growth, produces bone weakness, many metabolic conditions like diabetes and cataract.

"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 Prasad.

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 does not work and the symptoms show up. The puffiness goes up further as the medicine does not act.

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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