雷公藤多苷对IgA肾病CD_4～+CD_(25)～(high)调节性T细胞及Th1、Th2影响

The Effect of Tripterygium Wilfordii glycoside on the Expression of CD_4+CD_(25)^(high) Regulatory T cells,Th1 and Th2 with IgA Nephropathy

目的:探讨CD4+CD25high调节性T细胞(Treg)及辅助性T细胞亚群(Th1、Th2)比例失衡在IgA肾病(IgAN)免疫发病机制中的作用,以及使用雷公藤多苷(tripterygium wilfordii glycoside,TW)治疗后对IgAN的Treg、Th1、Th2及Th1/Th2的比例影响。方法:用流式细胞分析仪检测30例IgAN患者,使用雷公藤多苷治疗前后的外周血Treg、Th1、Th2及Th1/Th2的比例。并与健康对照组进行比较,两组间比较采用t检验。结果:IgA N患者外周血Treg的比例明显高于健康人(P<0.01);IgAN患者外周血中,Th2细胞比例显著高于健康对照组(P<0.01);IgAN患者Th1/Th2比值显著低于健康对照组(P<0.01)。使用TW(1 mg·kg-1·d-1)治疗IgAN 3个月后,可显著降低IgAN患者外周血Treg(P<0.01),但治疗后Treg仍高于健康对照组(P<0.05);显著降低Th2细胞比例(P<0.05),显著升高Th1/Th2比值(P<0.01);且治疗后IgAN的尿蛋白明显降低(P<0.01),血清白蛋白升高(P<0.05)。结论:TW可改善IgAN患者体内存在T细胞亚群表达紊乱,对IgAN治疗具有一定作用。

Objective： To investigate the effects of CD4 ＋ CD25 high regulatory T cells （Treg） and imbalance of helper T lym- phocyte subsets （Thl/rl＇h2）on the immunological mechanism of IgA Nephropathy （IgAN）patients. and to Observe the effect of triptery- gium wilfordii glycoside（TW） on Treg,Thl ,Th2 and Thl/Th2 in 30 patients with IgAN. Methods： Before and after therapy of TW , the percentage of Treg and helper T cells subpopulation （Th1/h2） in the peripheral blood of 30 IgAN~ patients and 30 healthy con- trois are examined by flow cytometry. With both groups compared with T test. Results： the percentage of Treg and Th2 cells are signifi- cantly higher in the peripheral blood of 30 IgAN patients compared to that of 30 healthy controls（ P 〈 0.01 ）. Th1/Th2 ratio is signifi- cantly reduced in the IgAN patients（P 〈 0.01 ）. After 3 month treatment of TW （ 1 mg · kg^- 1·d^-1 ） in 30 IgAN patients, the per- centage of Treg and Th2 cells are significantly lower but Thl/Th2 ratio is still higher in the peripheral blood of 30 IgAN patients com- pared to that before treatment of TW （P 〈0.01, 〈0.05 and 〈0.01 ）. After The Therapy of TW,the proteinuria in IgAN patients de- creases significantly （ （P 〈 0.01 ） and serum albumin increases significantly （ P 〈 0.05 ）. Conclusion： There is disorder of T lympho- cyte population in the the peripheral blood of IgAN patients. Therapy of TW may help treat this disorder.