{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:20:33Z","timestamp":1766035233778,"version":"3.48.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>The pathogenesis of idiopathic nephrotic syndrome (INS) in most pediatric cases involves immune cell dysfunction, mediated, among other factors, by biologically active polyunsaturated fatty acids -dependent compounds in the blood and cell membranes. The immunosuppressive drug mycophenolate mofetil (MMF) is commonly used to maintain remission in patients with steroid-dependent nephrotic syndrome. The aim of this pilot study was to investigate the effect of trough blood mycophenolic acid (MPA) levels on the endoleukocyte fatty acid omega-3 and omega-6 series. Eighteen pediatric subjects with INS were enrolled, including 12 steroid-sensitive and 6 steroid-resistant children. Fatty acid (FA) profile was analyzed by gas-chromatography, and MPA blood level was evaluated by immunometric assay. Among steroid-sensitive patients, a positive correlation was observed between endoleukocyte omega-3 FA (n-3) and trough blood MPA levels, and a negative correlation was found between endoleukocyte omega-6 FA (n-6) and trough blood MPA levels. In addition, a positive correlation was found between endoleukocyte anti-inflammatory DHA and trough blood MPA levels. In contrast, in steroid-resistant subjects no correlation between endoleukocyte n-6\/n-3 ratio and trough blood MPA levels was observed. In conclusion, adequate trough MPA drug levels may have contributed to switch the FA pathway to a more favorable endoleukocyte n-6\/n-3 ratio and DHA levels, possibly supporting the natural anti-inflammatory activities of n-3 FA. In steroid-resistant NS, despite adequate MPA levels, no promotion of the anti-inflammatory activity of the n-3 series was found.<\/jats:p>","DOI":"10.3389\/fphar.2025.1672304","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:16:03Z","timestamp":1766034963000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic trough mycophenolic acid levels positively correlate with omega-3 fatty acids in leukocytes of children with idiopathic nephrotic syndrome. a pilot study"],"prefix":"10.3389","volume":"16","author":[{"given":"Stefano","family":"Turolo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Edefonti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Louise","family":"Syren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita S.","family":"Bellotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Morello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Collino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Agostoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Montini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"719","DOI":"10.24953\/turkjpediatr.2024.4575","article-title":"Heat shock protein 70 levels in children with nephrotic syndrome","volume":"66","author":"Aksu","year":"2024","journal-title":"Turk J. 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