紫癜性肾炎患儿外周血CD4＋CD25＋调节性T细胞的临床意义

Significance of CD4＋CD25＋ Regulation T Cells in Children with Nephritis of Schonlein-Henoch Purpura

目的研究紫癜性肾炎（HSPN）患儿外周血CD4＋CD25＋调节性T细胞数量、相关细胞因子的水平及Foxp3的表达，探讨它们在HSPN发病机制中的作用。方法分别采集40例HSPN患儿及20例健康儿童外周静脉血，通过流式细胞仪分析CD4＋CD25＋调节性T细胞百分率，ELISA测定血浆IL-10和TGF-61水平，荧光定量PCR（Real—timePCR）检测T细胞Foxp3mRNA的表达。结果HSPN患儿外周血CD4＋T，CD25＋T，CD4＋CD25＋T／CD4＋T均低于对照组（P〈0．05）；T细胞Foxp3mRNA的表达明显降低，血浆IL-10水平也明显低于对照组（P〈0．05），血浆TGF-β1水平较对照组明显升高（P〈0．01）；CD4＋CD25＋调节性T细胞百分率随HSPN病理分级加重有降低趋势，二者呈负相关（r=0．966，P〈0．01）。结论HSPN患儿外周血存在细胞免疫功能失调，CD4＋CD25＋调节性T细胞数量减少或功能异常，导致免疫抑制效应不足，参与并促进了儿童HSPN的发生发展，其外周血水平与HSPN病理分级有相关性。

Objective To investigate the amount of CD4＋CD25＋ regulation T cells,the level of related cytokine and the expression of Foxp3 in peripheral blood in children with HSPN ,and explore the correlation of CD4＋CD25＋ regulation T cells with the pathogenesis of HSPN. Methods 40 patients with HSPN and 20 age-matched healthy children were detected. Flow cytometric analysis（FCM） was performed to detect the percentage of CD4＋CD25＋ regulation T cells suhpopulation. Enzyme-linked immunosorbent assay（ELISA） was used to measure the levels of related cytokines （IL-10 and TGF-β） and real-time PCR were used to analyse Foxp3 expression. Results Compared with control group,CD4＋CD25＋ regulation T cells were significantly lower in peripheral blood in HSPN children ,and the expression of Foxp3 mRNA were decreased obviously also （P〈0. 05）. IL-10 level was markedly lower and TGF-β1 level was significantly higher in HSPN children. The percentage of CD4＋CD25＋ regulation T cells correlated negatively with renal pathologic grade in HSPN （r=-0. 966,P〈（ 0. 01）. Conclusion Cellular immunological function disorder is observed in HSPN children. The decrease or afunction of CD4＋CD25＋ regulation T cells will participate in and promote the development of HSPN of children. And its percentage correlate with renal pathologic grade in HSPN.