BACKGROUND:Systemic lupus erythematosus requires glucocorticoids for management. This study investigates how glucocorticoids influence bone in a SLE mouse model, focusing on bone mineral density (BMD), microstructure, and remodeling markers. METHODS:MRL/lpr and C57BL/6 mice were administered dexamethasone or saline as a control for 4-weeks. Bone assessments included analyses of BMD, bone structure, and serum levels of RANKL and OPG. RESULTS:Dexamethasone decreased BMD and altered cortical and trabecular bone thickness in both MRL/lpr and C57BL/6 mice. In C57BL/6 mice, cortical bone exhibited increased catabolism while trabecular bone showed signs of increased anabolism, whereas MRL/lpr mice did not show significant changes in bone turnover. Both strains experienced weight loss, with a significant decrease in femur length observed only in C57BL/6 mice. Dexamethasone exacerbated BMD reduction in MRL/lpr mice and halted its increase in C57BL/6 mice. C57BL/6 mice exhibited notable changes in cortical and trabecular bone structure, while MRL/lpr mice didn't. After receiving dexamethasone, both strains showed higher serum RANKL levels, especially in C57BL/6 mice. OPG decreased in both strains. CONCLUSION:Both glucocorticoids and SLE contribute to abnormal bone remodeling through RANKL/OPG pathway. IMPACT:Glucocorticoid (GC) treatment in a mouse model of systemic lupus erythematosus (SLE) leads to significant changes in bone parameters, including decreased bone mineral density (BMD) and alterations in bone structure. Those change are associated with the modulation of RANKL and OPG expression. Both GC and inflammation in SLE contribute to BMD reduction, and GC may have a certain protective effect on bone in the early stage of chronic inflammation. GC can upregulate RANKL expression and downregulate OPG expression in vivo. During a state of chronic inflammation, RANKL expression increases. However, OPG may not exert a significant influence on inflammatory stimulation.

While 44-83% of children with steroid-resistant nephrotic syndrome (SRNS) without a proven genetic cause respond to treatment with a calcineurin inhibitor (CNI), current guidelines recommend against the use of immunosuppression in monogenic SRNS. This is despite existing evidence suggesting that remission with CNI treatment is possible and can improve prognosis in some cases of monogenic SRNS. Herein, our retrospective study assessed response frequency, predictors of response and kidney function outcomes among children with monogenic SRNS treated with a CNI for at least three months. Data from 203 cases (age 0-18 years) were collected from 37 pediatric nephrology centers. Variant pathogenicity was reviewed by a geneticist, and 122 patients with a pathogenic and 19 with a possible pathogenic genotype were included in the analysis. After six months of treatment and at last visit, 27.6% and 22.5% of all patients respectively, demonstrated partial or full response. Achievement of at least partial response at six months of treatment conferred a significant reduction in kidney failure risk at last follow-up compared to no response (hazard ratio [95% confidence interval] 0.25, [0.10-0.62]). Moreover, risk of kidney failure was significantly lower when only those with a follow-up longer than two years were considered (hazard ratio 0.35, [0.14-0.91]). Higher serum albumin level at CNI initiation was the only factor related to increased likelihood of significant remission at six months (odds ratio [95% confidence interval] 1.16, [1.08-1.24]). Thus, our findings justify a treatment trial with a CNI also in children with monogenic SRNS.

BACKGROUND:Previously, several studies have indicated that pediatric IgA nephropathy (IgAN) might be different from adult IgAN, and treatment strategies might be also different between pediatric IgAN and adult IgAN. METHODS:We analyzed two prospective cohorts established by pediatric and adult nephrologists, respectively. A comprehensive analysis was performed investigating the difference in clinical and pathological characteristics, treatment, and prognosis between children and adults with IgAN. RESULTS:A total of 1015 children and 1911 adults with IgAN were eligible for analysis. More frequent gross hematuria (88% vs. 20%, p < 0.0001) and higher proteinuria (1.8 vs. 1.3 g/d, p < 0.0001) were seen in children compared to adults. In comparison, the estimated glomerular filtration rate (eGFR) was lower in adults (80.4 vs. 163 ml/min/1.73 m2, p < 0.0001). Hypertension was more prevalent in adult patients. Pathologically, a higher proportion of M1 was revealed (62% vs. 39%, p < 0.0001) in children than in adults. S1 (62% vs. 28%, p < 0.0001) and T1-2 (34% vs. 8%, p < 0.0001) were more frequent in adults. Adjusted by proteinuria, eGFR, and hypertension, children were more likely to be treated with glucocorticoids than adults (87% vs. 45%, p < 0.0001). After propensity score matching, in IgAN with proteinuria > 1 g/d, children treated with steroids were 1.87 (95% CI 1.16-3.02, p = 0.01) times more likely to reach complete remission of proteinuria compared with adults treated with steroids. CONCLUSIONS:Children present significantly differently from adults with IgAN in clinical and pathological manifestations and disease progression. Steroid response might be better in children.

Objective To explore the long-term efficacy and safety of the first single dose of rituximab in children with steroid-dependent minimal-change nephrotic syndrome (SD-MCNS) over a two-year period after infusion.Methods A 2-year retrospective observational study was performed on children with SD-MCNS who received the first single dose of rituximab (375 mg/m2) from October 2011 to December 2018.Results Seventy-seven patients (median age 8.17 years) were included. The efficacy of the first single-dose rituximab in children with SD-MCNS was 90.91% (70/77). An overall relapse rate of 78.33% was achieved. Older age at rituximab treatment onset (>8.46 years), a lower steroid-dependent dosage (<18.76 mg/m2·d) and a higher CD4+ T-cell count before rituximab treatment (>31.22%) were positively related to treatment efficacy (p < 0.05). Male sex, younger age at rituximab treatment onset, a higher IgE level before rituximab treatment, and a higher white blood cell count and CD3+ T-cell count at the time of steroid withdrawal were associated with disease relapse (p < 0.05). A model for predicting relapse after rituximab treatment in SD-MCNS patients was established.Conclusions The first single-dose rituximab treatment for children with SD-MCNS was effective and safe. Greater efficacy was observed in patients who were older at rituximab treatment onset, had a lower steroid-dependent dosage, or had a higher CD4+ T-cell count before rituximab treatment. In contrast, younger male patients with a higher IgE level experienced an increased occurrence of relapse.

BACKGROUND Children with primary nephrotic syndrome (PNS) who relapse after glucocorticoid therapy are shown to have a decreased total proportion of butyrate-producing bacteria in the gut at onset. Glucocorticoid treatment changes the gut microbiota composition. It is unclear whether gut microbiota at remission right after therapy and gut bacteria other than butyrate-producing bacteria are associated with PNS relapse. METHODS PNS relapse of paediatric patients within 1 year after glucocorticoid therapy was recorded. The gut microbiota composition, profiled with 16S rRNA gene V3-V4 region sequencing, was compared between relapsing and non-relapsing PNS children at onset before glucocorticoid treatment (preT group) and in PNS children at remission right after treatment (postT group), respectively. RESULTS The gut microbiota composition of postT children significantly differed from that of preT children by having lower levels of Bacteroides, Lachnoclostridium, Flavonifractor, Ruminococcaceae UBA1819, Oscillibacter, Hungatella and Coprobacillus and higher levels of Ruminococcaceae UCG-013 and Clostridium sensu stricto 1 group. In the preT group, compared with non-relapsing patients, relapsing patients showed decreased Blautia, Dialister and total proportion of butyrate-producing bacteria and increased Oscillibacter, Anaerotruncus and Ruminococcaceae UBA1819. However, relapsing and non-relapsing postT children showed no difference in gut microbiota composition. CONCLUSIONS PNS relapse-associated gut microbiota dysbiosis at onset, which includes alterations of both butyrate-producing and non-butyrate-producing bacteria, disappeared right after glucocorticoid therapy. It is necessary to study the association of the longitudinal changes in the complete profiles of gut microbiota after glucocorticoid treatment with later PNS relapse.

Sj?gren′s syndrome(SS) is a chronic inflammatory autoimmune disease, including primary SS (pSS) and secondary SS (sSS). Pediatric sSS has the similar clinical characters with pSS, which can be classified based on the same classification criteria.Compared with those of adult SS, pediatric SS is rare, insidious and lacks the typical manifestations of dry eyes and dry mouth.Therefore, the classification criteria for adult SS is not suitable for pediatric SS.So far, there are no classification criteria for pediatric SS that have been widely applied and validated, which needs to be further explored.The present review described the clinical characteristics and progress of classification criteria for pediatric SS, and compared pSS and sSS in affected children.

Background The effect of recombinant human GH (rhGH) in Chinese children with chronic kidney disease (CKD) is unclear. Methods This was a 52-week, multicenter, randomized, open-label, negative-controlled phase 3 study. Prepubertal subjects were randomized 1:1 to either daily subcutaneous injections of rhGH 0.05 mg/kg/day or no treatment for 52 weeks. Results A total of 68 subjects with a mean age of 7.8 ± 3.27 years were enrolled. At week 52, the height standard deviation score (HT-SDS) in the treated group increased by 0.75 ± 0.58, which was significantly higher compared with 0.17 ± 0.47 in the untreated group (least squares mean 0.58, 95% confidence interval, 0.32–0.84; P < 0.001). At week 52, significant improvements were observed in other growth parameters (height velocity [ P < 0.001]), insulin-like growth factor 1 (IGF-1) SDS [ P < 0.001], IFG-1/insulin-like growth factor binding protein-3 molar ratio [ P < 0.001], and height [ P < 0.001]) compared with the untreated control. Seven patients reported treatment-related adverse events (TRAEs) and most TRAEs were mild in severity. Most subjects recovered without further intervention. Conclusions Daily rhGH for 52 weeks in children with CKD-induced growth retardation significantly improved HT-SDS and other growth parameters without compromising safety. Impact The efficacy and safety of growth hormone (GH) therapy in Chinese children with chronic kidney disease (CKD) are unclear. This study found that giving short stature Chinese children with CKD daily recombinant human growth hormone (rhGH) for 52 weeks improved growth parameters without compromising safety. This study’s information can give physicians the confidence to treat these patients in their clinical practice.

肾小管疾病是由各种原发和/或继发因素导致肾小管结构、功能及细胞代谢异常的一类疾病.目前尚无公认的肾小管疾病归类方法,作者根据疾病的病程、病因、累及部位、物质转运障碍类型以及人类基因组组织的统一命名进行初步分类.统一规范的分类有助于肾小管疾病的临床诊治.由于儿童肾小管疾病临床表现多样化,缺乏特异性症状,疾病呈现缓慢进展状态,实验室检测手段有限,迄今对该类疾病认识不足,在临床上易误诊误治,因此早期识别至关重要.肾小管疾病早期诊断依赖于病史的详细询问、临床症状与体征的细致观察、实验室和影像学及基因的精准检查等.多学科合作诊治有利于改善肾小管疾病的预后.

原发性肾病综合征主要表现为水肿、大量蛋白尿、低蛋白血症以及高脂血症.受脂质代谢紊乱、血液黏稠度增加、血容量减少等因素的影响,机体的凝血系统、抗纤溶系统失衡,血液处于高凝状态,容易并发血液栓塞性疾病,如不及时处理后果往往非常严重.本研究报道1例5岁原发性肾病综合征患儿,患儿因肺部感染入院,确诊为肺隔离症后行胸腔镜下肺叶切除术,术后50 h经血管B超诊断为髂外动脉多发血栓,后经积极溶栓治疗痊愈出院.本文总结本例治疗经验并复习相关文献,为肾病综合征患儿行胸腔镜手术的围手术期处理提供参考.

狼疮肠系膜血管炎(LMV)作为儿童系统性红斑狼疮(SLE)首发起病的情况非常罕见,临床表现为腹痛、呕吐、腹泻等非特异性症状,极易误诊.患儿,男,13岁,因腹痛伴呕吐2天就诊.入院体检示全腹肌紧张,肠鸣音减弱.辅助检查血小板30×109/L,抗核抗体1:320阳性,抗心磷脂抗体IgM阳性,C 3和C 4降低,Coomb's试验弱阳性,24小时尿蛋白1.18 g;腹部CT示小肠肠壁明显增厚、水肿(靶征).明确诊断为SLE、LMV,予甲基泼尼松龙60 mg及羟氯喹治疗,腹痛好转,但血小板进行性下降,先后予环孢素、甲基泼尼松龙冲击治疗血小板仍下降,予利妥昔单抗治疗后血小板逐渐升高,后续予贝利尤单抗治疗,病情平稳后出院.LMV可为SLE首发表现,腹部CT对LMV确诊有重要价值.糖皮质激素可有效减轻病情,但LMV易复发,环磷酰胺冲击及利妥昔单抗治疗可能对复发患者效果好.

Indroduction: SLE is an autoimmune multisystem disease. Glucocorticoid is an irreplaceable medication for SLE. Glucocorticoid and inflammation impact bone remodeling by OPG/RANKL/RANK signal system, which could lead to osteoporosis. Our aim is to clarify the expression of RANKL/OPG in children with SLE, and to preliminarily explore the changes of bone metabolism related indexes in children with SLE. Methods: Serum RANKL and OPG of 40 children with SLE and healthy children were detected by ELISA, while 25(OH)VitD 3 was detected routinely. Clinical data of children with SLE were recorded, including gender, age, height, weight, BMI, duration of the disease, accumulated dose of glucocorticoid, and correlation analysis was conducted with RANKL, OPG and 25(OH)VitD 3 . Results: Serum RANKL concentration in SLE group was significantly higher than health group (9.82±7.20 vs. 6.80±4.35 pg/ml, P<0.05), and the concentrations of OPG and 25(OH)VitD 3 in serum were significantly lower than health group (156.34±57.33 vs. 189.16±68.70 pg/ml and 43.66±31.27 vs. 59.04±21.56 mmol/L, P<0.05). Serum RANKL in children with SLE was positively correlated with the duration of SLE, accumulated dose of GC(r=0.593, 0.727, P<0.05). And it was negatively correlated with serum OPG and 25(OH)VitD 3 (r=-0.601, -0.469, P<0.05). In addition, serum OPG and 25(OH)VitD 3 concentrations were inversely correlated with accumulated dose of GC (r=-0.66, -0.508, P<0.05). Conclusion: Low levels of vitamin D3 and bone metabolic abnormalities were found in children with SLE under the condition of disease remission, while serum RANKL expression was elevated, OPG expression was reduced. These changes associated with the duration of SLE, accumulated dose of GC. In the case of exclusion of disease activity, GC and other factors may be involved in the occurrence and development of abnormal bone metabolism through RANKL/OPG.

OBJECTIVE:The main purpose of this research was to investigate the influence of the novel COL4A5 missense mutation on collagen type IV.METHODS:Clinical data and detailed family history were collected. Targeted next-generation sequencing (NGS) was applied to examine potential pathogenic variants in COL4A3, COL4A4, COL4A5 genes in the proband, and then the variants were analyzed using bioinformatics tools and pedigree analysis. The CRISPR/Cas9 gene editing was used to knock in potential pathogenic variants in human podocytes, and then western blot analyses and immunofluorescence assays were used to measure COL4A5 protein expression.RESULTS:Three patients (I: 2, II: 1 and II: 2) presented with microscopic hematuria and proteinuria, and the patient II: 1 progressed to abnormal renal function by age 14. A novel missense variant, c.2641G>A (p. Gly881Arg), located in exon 31 of COL4A5 gene, was chosen as a possible pathogenic variant. The variant significantly decreased collagen IV α5 chain expression in CRISPR/Cas9 gene edited podocytes.CONCLUSION:By conducting NGS and CRISPR/Cas9 gene-editing of podocytes, a novel COL4A5 missense variant, c.2641G>A (p. Gly881Arg), was confirmed to be the genetic defect of X-linked Alport syndrome in the Chinese family. Our findings extend the genetic spectrum of X-linked Alport syndrome with COL4A5 mutations and provide a method for evaluating the functional significance of novel COL4A5 missense variants in vitro.

Prednisone (PRED) is a synthetic glucocorticoid (GC) widely used in immunemediated diseases for its immunosuppressive and anti-inflammatory properties. The effects of GC are achieved by genomic and nongenomic mechanisms. However, the nongenomic effects are largely unknown. Thus, we aimed to investigate how long-term prednisone therapy changes the composition of the gut microbiota and fecal metabolites in rats. Male Sprague-Dawley rats were randomly assigned to a control (CON) group and a PRED group, which received prednisone treatment daily for 6 weeks by gavage. The V3 to V4 regions of bacterial 16S rRNA genes were amplified and sequenced after the total bacterial DNA was extracted from fecal samples. The alpha and beta diversities were calculated. The compositional alteration of the gut microbiota at different taxonomic levels was analyzed using the Metastats method. Meanwhile, the fecal metabolites were quantitated in an ultra-performance liquid chromatography system. Similar microbial richness and diversity between the CON and PRED groups were indicated by the alpha diversity results. The gut microbial communities differed significantly between two groups. The relative abundances of the genera Eisenbergiella, Alistipes, and Clostridium XIVb decreased, whereas that of Anaerobacterium increased significantly in rats after the 6-week prednisone treatment. In total, 11 downregulated and 10 upregulated fecal metabolites were identified. Differential fecal metabolites were enriched in the pathways, including phenylalanine metabolism, butanoate metabolism, and propanoate metabolism. The lowered production of short-chain fatty acids was associated with the decreased relative abundance of the genera Alistipes and Clostridium XIVb and increased abundance of the genus Anaerobacterium. The composition of the gut microbiota and fecal metabolites was changed after long-term prednisone treatment. This may help us to understand the pharmacology of prednisone. IMPORTANCE Prednisone is widely used in chronic glomerular diseases, immunological disorders, and rheumatic diseases for its anti-inflammatory and immunosuppressive properties. It is a synthetic glucocorticoid (GC) that shows therapeutic effects after conversion to prednisolone by the liver. Prolonged GC therapy causes anti-inflammatory effects; it also results in a variety of adverse events, including obesity, hypertension, psychiatric symptoms, and dyslipidemia. The therapeutic effects and adverse events of GCs may be associated with changes in the gut microbiota, as the host might be affected by the metabolites generated by the altered gut microbes. Thus, we investigated how long-term prednisone therapy changed the composition of the gut microbiota and fecal metabolites in rats. This study may shed new light on the pharmacology of prednisone.

Introduction: Few studies have addressed the genetic spectrum of NPHS1 variants in Chinese children with nephrotic syndrome. In this multicenter study, the clinical manifestations and features of NPHS1 variants in Chinese children with nephrotic syndrome were researched.Method: Genotypical and phenotypical data from 30 children affected by NPHS1 variants were collected from a multicenter registration system in China and analyzed retrospectively.Results: The patients were divided into two groups: congenital nephrotic syndrome (CNS [n = 24]) and non-CNS (early onset nephrotic syndrome [n = 6]). Renal biopsy was performed on four patients in the non-CNS group, revealing minimal change disease in three and focal segmental glomerulosclerosis in one. A total of 61 NPHS1 variants were detected, involving 25 novel variants. The "recurrent variants" included c.928G>A(p.Asp310Asn) in eight patients with CNS, followed by c.616C>A(p.Pro206Thr) in four, and c.2207T>C (p.Val736Ala) in three. Steroid treatment was applied in 29.2% (7/24)of the patients in the CNS group and 50% (3/6) of the patients in the non-CNS group. One patient in each group experienced complete remission but relapsed subsequently. Immunosuppressants were administered to three patients in the non-CNS group, eliciting an effective response. In the CNS group, three patients underwent renal transplantation and six died mainly from infection.Conclusion: Variants of NPHS1 cause CNS and early childhood-onset nephrotic syndrome. NPHS1 variants in Chinese individuals with nephrotic syndrome (NS) were mainly compound heterozygous variants, and c.928G>A(p.Asp310Asn) in exon 8 may act as a recurrent variant in the Chinese population, followed by c.616C>A(p.Pro206Thr) in exon 6. Steroids and immunosuppressants may be effective in selected patients.

BACKGROUND:X-linked Alport syndrome (XLAS) is the most common form of Alport syndrome (AS), involves mutations in the COL4A5 gene encoding the type IV collagen a5 chain. In this research, we will report the analysis of the COL4A5 gene in a Chinese family with XLAS, and investigate the effect of the missense mutation of this family on type IV collagen.METHODS:Targeted sequencing using next-generation sequencing (NGS) was conducted for genes (COL4A3/4/5). Normal and mutation COL4A5 plasmids were constructed and then transfected into human podocytes, none plasmid and empty plasmid transfection as control. And then real-time PCR, western blot and indirect immunofluorescence were used to detect the COL4A1/3/5 mRNA, protein, and immunofluorescence expression of each group.RESULTS:In this study, we found an Alport family, and the whole exon sequencing found a new missense mutation c.1844G>C in exon 25. The results of real-time PCR, western blot and immunofluorescence showed that in the mutation group, both the mRNA and protein levels of COL4A5 were significantly reduced.CONCLUSIONS:c.1844G>C is a functional variation of COL4A5, which might play a very important role in the occurrence and development of AS.

Chloroquine (CQ) is an antimalarial drug widely used in rheumatic, immunological and infectious diseases. CQ is also a well-known autophagy inhibitor. It slows the progression of renal injury in patients with rheumatology diseases. Long-term CQ treatment could also damage podocytes which are highly differentiated cells wrapping the glomerular capillary to maintain renal filtration. However, the related underlying mechanism remains unclear. The effects of CQ treatment on podocytes need to be elucidated. Our results showed that CQ diminished cell motility and disrupted actin cytoskeleton in human podocytes in vitro. Totally 210 up-regulated and 67 down-regulated differentially expressed proteins (DEPs) were identified after CQ treatment in podocytes by using tandem mass tag (TMT)-labeled quantitative proteomics analysis. Gene Ontology (GO) analysis revealed that proteins mainly functioned in cell motility, cell adhesion, localization of cells and response to external stimulus. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment showed that DEPs were predominantly associated with lysosome, cell adhesion molecules (CAMs) and cytokine-cytokine receptor interaction. Protein-protein interaction (PPI) analysis revealed that syndecan-4 was the core protein in regulating podocyte adhesion among differentially expressed CAMs. Moreover, activated RhoA, Cdc42 and Rac1 decreased after CQ treatment. Taken together, our findings suggested that CQ could alter the stability of podocyte cytoskeleton. Proteomic analysis revealed important molecules for understanding the effects of CQ on human podocytes.

X-linked Alport syndrome (XLAS) is a rare form of hereditary nephritis caused by mutations in the COL4A5 gene encoding the type IV collagen α5 chain. A skin biopsy was performed on one female patient with XLAS who carried a heterozygous p.G409S (c. 1225 G > A) mutation in the COL4A5 gene. A human-induced pluripotent stem cell (iPSC) line was generated from dermal fibroblasts using the integrating free Sendai virus technique. The generated iPSC line SHCDNRi001-A offers an efficient resource to research pathogenic mechanisms in XLAS, as well as a cell-based disease model for drug testing or other treatments.

This study aimed to investigate the exact function of RGC-32 in kidney diseases and explore the potential mechanism of RGC-32 in regulating cell cycle. RGC-32 knockout (RGC-32-/-) mice were generated from C57BL/6 embryonic stem cells. Differentially expressed proteins in the kidney were investigated with the isobaric tags for relative and absolute quantification (iTRAQ) technique. Gene ontology analyses (GO), Kyoto encyclopedia of genes and genomes (KEGG) pathway mapping analysis and functional network analysis were also performed. The expressions of Smc3, Smad 2-3, DNA-PK were further confirmed by qPCR. Results showed that 4690 proteins were quantified on the basis of 25165 unique peptides. Comparative proteomic analysis revealed 361 differentially expressed proteins in RGC-32-/- mice (knockout/wild ratio >+/- 1.2 and P<0.05). GO and KEGG pathway mapping analyses showed differentially expressed proteins were involved in spliceosome, fluid shear stress and atherosclerosis protein processing in endoplasmic reticulum, pathways in cancer, viral carcinogenesis, epithelial cell signaling in Helicobacter pylori infection, HTLV-I infection, PI3K-Akt signaling pathway, ubiquitin mediated proteolysis, Parkinson's disease, MAPK signaling pathway, carbon metabolism, Alzheimer's disease, NOD-like receptor signaling pathway, tight junction, Proteoglycans in cancer, phagosome, ribosome, mTOR signaling pathway, and AMPK signaling pathway. Differentially expressed proteins Smc3 (0.821), DNA-PK (0.761), Smad 2-3 (0.631) were involved in cell cycle regulation. mRNA expression of Smad2-3, DNA-PK, and Smc3 was consistent with that from iTRAQ. It is concluded that RGC-32 may affect the expression of many proteins (76 up-regulated and 285 down-regulated) in the kidney, and may regulate the expression of Smc3, DNA-PK and Smad 2-3 to affect the cell cycle.

Neuroblastoma is the second most common extracranial malignant solid tumor that occurs in childhood, and metastasis is one of the major causes of death in neuroblastoma patients. The epithelial-mesenchymal transition (EMT) is an important mechanism for both the initiation of tumor invasion and subsequent metastasis. Therefore, this study investigated the mechanism by which transforming growth factor (TGF)-β1 induces EMT in human neuroblastoma cells. Using quantitative RT-qPCR and western blot analyses, we found that the mRNA and protein expression levels of E-cadherin were significantly decreased, whereas that of α-SMA was significantly increased after neuroblastoma cells were treated with different concentrations of TGF-β1. A scratch test and Transwell migration assay revealed that cell migration significantly and directly correlated with the concentration of TGF-β1 indicating that TGF-β1 induced EMT in neuroblastoma cells and led to their migration. Inhibiting Smad2/3 expression did not affect the expression of the key molecules involved in EMT. Further investigation found that the expression of the glioblastoma transcription factor (Gli) significantly increased in TGF-β1-stimulated neuroblastoma cells undergoing EMT, accordingly, interfering with Gli1/2 expression inhibited TGF-β1-induced EMT in neuroblastoma cells. GANT61, which is a targeted inhibitor of Gli1 and Gli2, decreased cell viability and promoted cell apoptosis. Thus, TGF-β1 induced EMT in neuroblastoma cells to increase their migration. Specifically, EMT induced by TGF-β1 in neuroblastoma cells did not depend on the Smad signaling pathway, and the transcription factor Gli participated in TGF-β1-induced EMT independent of Smad signaling.