肾病综合征患儿白细胞介素13的表达与病理形态的关系

THE EXPRESSION OF IL 13 AND ITS RELATIONSHIP WITH PATHOLOGICAL TYPES IN CHILDREN WITH NEPHROTIC SYNDROME

目的 :探讨白细胞介素 13 (IL 13 )在小儿原发性肾病综合征 (NS)中的变化及其与病理形态之间的关系。 方法 :应用逆转录 多聚酶链反应 (RT PCR)及双抗体夹心ELISA法检测了NS患儿外周血单个核细胞IL 13mRNA及蛋白水平的变化 ,并分析其与病理形态改变的关系。 结果 :原发性NS患儿肾病期IL 13mRNA与蛋白水平均显著高于正常对照组 ( 0 4 6± 0 15vs 0 3 6± 0 16,P <0 0 5和 4 8 2 0± 15 90ng/Lvs 3 5 2 2± 4 4 2ng/L ,P <0 0 1) ,缓解期与正常对照组相比差异不显著。IL 13表达与患儿肾脏病理形态改变存在一定的关系 ,以系膜增生性肾小球肾炎和IgA肾病最为明显。 结论 :Th1/Th2细胞免疫功能失衡在原发性NS发病过程中发挥着重要作用 ,IL

OBJECTIVE To examine the changes of IL 13 in children with primary nephrotic syndrome(PNS) and to analyze the correlation between IL 13 and pathological types of childhood PNS. METHODOLOGY 34 children with PNS were included in this study, with 2 cases of MCD,23 cases of MsPGN,5 cases of IgA nephropathy, 2 cases of FSGS and 2 cases of MPGN. Peripheral blood samples were collected in all the patients both in the nephrotic and remission stages.The production of IL 13 protein was determined with ELISA, and the expression of IL 13 mRNA in peripheral blood mononuclear cells (PBMC) was measured with reverse transcription polymerase chain reaction(RT PCR). RESULTS As compared to the controls, the expression of IL 13 mRNA and the production of IL 13 protein were found significantly increased(0 46±0 15 vs 0 36±0 16, P <0 05 and 48 20±15 90 pg/ml vs 35 22±4 42 pg/ml, P <0 01) in nephrotic stage in PNS children. No significant difference in the expression or production of IL 13 was found between patients in remission stage and the controls. The expression of IL 13 in PBMC was found to be rlated to the pathological types of PNS, especially the MsPGN and IgA nephropathy. CONCLUSION The aberration of Th1/Th2 cellular immunity plays an important role in the pathogenesis of PNS. IL 13, a cytokine of Th2 dominant response,may be involved in the pathogenesis of PNS by exerting an anti inflammatory effect.