小儿激素敏感型肾病综合征血清中IL-4、IL-5、TGF-β与IL-10水平变化及意义

Changes of IL-4,IL-5,TGF-β and IL-10 in pediatric steroid-sensitive nephrotic syndrome

目的:探讨小儿激素敏感型肾病综合征(SSNS)治疗前与恢复期Th2细胞相关细胞因子IL-4、IL-5和Treg T细胞相关细胞因子TGF-β、IL-10水平的变化。方法:纳入36例SSNS患儿在治疗前和缓解期以及匹配的18例健康体检儿童,采用ELISA方法检测其血清IL-4、IL-5、TGF-β和IL-10水平,分析其水平变化与各临床指标的相关性。结果:SSNS患儿治疗前血清IL-4、IL-5显著高于缓解期以及健康对照组(P<0.01),肾病治疗前的血清TGF-β显著低于缓解期以及健康对照组(P<0.01),而各组之间的血清IL-10水平差异无统计学意义(P>0.05);SSNS治疗前的血清IL-4水平与血清白蛋白水平负相关(R2=-0.694,P=0.000);与血清胆固醇呈正相关(R2=0.658,P=0.000);血清TGF-β表达水平与血白蛋白呈正相关(R2=0.838,P=0.000),与血清胆固醇呈负相关(R2=-0.722,P=0.000)。结论:肾病综合征患儿血清IL-4、IL-5升高以及TGF-β水平降低与SSNS发病有关。

Objective：To clarify the dynamics of Th2 related cytokines IL-4、IL-5 and the Treg T cell related cytokines TGF-β、IL-10 in children with primary steroid-sensitive nephrotic syndrome （ SSNS） from the nephrotic phase before steroid treatment to the re-mission phase.Methods：All 36 SSNS patients and 18 healthy controls matched for age , gender, body weight and height were enrolled , and their clinical characteristics were evaluated .Serum cytokine level was measured by ELISA assay .The serum levels of interleukin （IL）-4, IL-5, IL-10 and transforming growth factor （TGF）-βwere compared and correlated with serum albumin and cholesterol .Re-sults：Serum IL-4 and IL-5 levels in SSNS of nephrotic phase were higher than serum IL-4 and IL-5 levels of SSNS of remission phase and the healthy control , respectively .The serum TGF-βlevels of the nephrotic phase were significantly lower than those of remission phase or control group , whereas the serum IL-10 levels showed no significant difference between nephrotic phase and remission phase of SSNS or control group.The serum IL-4 levels had a negative correlation with serum albumin （R^2 =-0.694,P=0.000）, and a posi-tive correlation with serum albumin levels （R^2 =0.658,P=0.000）, whereas the serum TGF-βlevels had a positive correlation with serum albumin （R^2 =0.838,P=0.000）, and a negative correlation with serum albumin levels , had （R^2 =-0.722,P=0.000）. Conclusion：This study indicates that IL-4, IL-5 and TGF-βlevel is related to the pathogenesis of pediatric SSNS .