原发性肾病综合征患儿外周血单个核细胞中Toll样受体-2、-4、-6表达与血清IgG、IgM相关性分析

Expressions of Toll like receptor-2,-4 ,-6 in peripheral blood mononuclear cells and the association of serum IgG and IgM levels in children with idiopathic nephrotic syndrome

目的探讨原发性肾病综合征(INS)患儿活动期和缓解期外周血单个核细胞(PBMC)中Toll样受体(TLR)-2、TLR-4和TLR-6的表达及与血清中IgG、IgM的水平相关性.方法选取2017年6月至2018年10月新乡医学院第一附属医院收治的42例INS患儿(男32例,女10例)作为试验组,门诊健康体检29例健康儿童(男19例,女10例)作为健康对照组,2组性别(x2=0.966,P=0.326)及年龄(t=-0.139,P=0.89)比较差异均无统计学意义,具有可比性.采用实时荧光定量聚合酶链反应(qPCR)测定INS患儿在活动期和缓解期及健康儿童PBMC中TLR-2 mRNA、TLR4 mRNA和TLR-6 mRNA的表达水平,同时采用免疫比浊法检测INS患儿在活动期及健康儿童血清IgG、IgM的水平,采用Spearman相关性分析TLR-2 mRNA、TLR-4 mRNA、TLR-6mRNA表达水平与血清IgG、IgM水平的相关性.结果INS患儿活动期、缓解期和健康对照组TLR-2 mRNA表达水平分别为1.85±0.30、1.00±0.23和0.85±0.12,TLR-4 mRNA表达水平分别为1.24±0.27、0.80±0.23和0.68±0.09,TLR-6 mRNA表达水平分别为1.35±0.23、0.92±0.19和0.79±0.15,差异均有统计学意义(F=198.453、67.013、82.405,均P<0.01).INS患儿活动期血清IgG水平(2.90±0.89)g/L低于健康对照组(9.21±1.88)g/L,而活动期血清IgM水平(2.87±0.96)g/L高于健康对照组(1.48±0.30)g/L,差异均有统计学意义(t=-16.810、8.701,均P<0.05).INS患儿活动期PBMC中TLR-2 mRNA、TLR-4 mRNA、TLR-6mRNA的表达水平与血清IgG、IgM水平均无明显相关性(均P>0.05).结论TLR-2、TLR4、TLR-6和IgG、IgM可能通过不同途径参与儿童INS的发病机制.

Objective To investigate expressions of Toll-like receptor(TLR)-2,TLR-4 and TLR-6 in peripheral blood mononuclear cells(PBMC)and serum immunoglobulin G(IgG)and IgM levels in pediatric idiopathic nephrotic syndrome(INS).The correlation between Toll-like receptors(TLR-2,TLR-4 and TLR-6)and serum immunoglobulin levels(IgG and IgM)will be proven in the pathogenesis of childhood INS in active stage(AS)and remission stage(RS).Methods Forty-two INS patients(experimental group,32 boys,10 girls)and 29 healthy individuals(healthy control group,19 boys,10 girls)were enrolled in the present study from June,2017 to October,2018 in the First Affiliated Hospital of Xinxiang Medical University.There were no significant differences in gender(x2=0.966,P=0.326)and age(t=-0.139,P=0.89)between 2 groups.TLR-2 mRNA,TLR-4 mRNA and TLR-6 mRNA expressions of PBMC were evaluated by using real-time PCR in both INS children with AS and RS and healthy children.The blood samples were drawn to detect by way of immunoturbidimetry serum immunoglobulin(IgG and IgM)levels in both INS children with AS and healthy children.The correlation between Toll-like receptors(TLR-2 mRNA,TLR-4 mRNA,TLR-6 mRNA)and serum immunoglobulin(IgG,IgM)levels were analyzed by using spearman correlation analysis.Results The expression levels of TLR-2 mRNA in INS children with AS,RS and healthy children were 1.85±0.30,1.00±0.23 and 0.85±0.12,respectively,and the expression levels of TLR-4 mRNA were 1.24±0.27,0.80±0.23 and 0.68±0.09,respectively,while the expression levels of TLR-6 mRNA were 1.35±0.23,0.92±0.19 and 0.79±0.15,respectively,so the differences were statistically significant(F=198.453,67.013,82.405,all P<0.01).The serum IgG level(2.90±0.89)g/L was lower in INS children with AS compared with the controls(9.21±1.88)g/L.However,the serum IgM level(2.87±0.96)g/L was higher in INS children with AS when compared with the controls(1.48±0.30),and the differences were statistically significant(t=-16.810,8.701,all P<0.05).No significant correlation was noted between Toll-like receptors(TLR-2 mRNA,TLR-4 mRNA,TLR-6 mRNA)and serum immunoglobulin levels(IgG,IgM)(all P>0.05).Conclusions The results indicate that Toll-like receptors(TLR-2,TLR-4 and TLR-6)and immunoglobulin(IgG,IgM)might play a role in the pathogenesis of pediatric INS via distinct pathway.