激素敏感型单纯性肾病综合征单个核细胞病毒基因表达的研究

Gene expression of viruses in peripheral blood mononuclear cells from the patients with steroid responsive and simple nephrotic syndrome

目的 探讨外周血单个核细胞 (PBMC)呼吸道病毒感染与激素敏感型单纯性肾病综合征 (SRSNS)发病的相关性。方法 采用逆转录 聚合酶链反应 (RT PCR)、APAAP法和ELISA法 ,分别对42例SRSNS患儿 (活动期 2 4例、缓解期 1 8例 )、2 0例肾炎性肾病、2 5例毛细支气管炎和 1 9例健康对照儿童单个核细胞 (PBMC)呼吸道病毒基因、病毒抗原及血清病毒抗体进行检测。结果 (1 )SRSNS患儿活动期组PBMC中呼吸道病毒基因、病毒抗原及血清病毒抗体检出率均高于RSNS患儿缓解期组、肾炎性肾病组及正常对照组 ,差异有显著意义 (P <0 0 5)。 (2 )SRSNS患儿活动期组PBMC中呼吸道合胞病毒检出率最高 ,其次为流感病毒。 (3)SRSNS患儿病毒基因、抗原的表达检出率与激素应用无关 ,血清病毒抗体的检出率降低与激素应用有关。 (4)病毒基因与病毒抗原检查结果有较好一致性(χ2 =5 71 4 ,P <0 0 5)。

Objective The clinical observation had suggested that respiratory virus infections were related to the onset or relapse of steroid responsive and simple nephrotic syndrome (SRSNS),and authors′ recent study indicated that the positive rate of viruses in respiratory tract epithelial cells from children with SRSNS at the active stage was higher than that at the remission stage However, so far whether respiratory viruses exist in peripheral blood mononuclear cells (PBMC) remains unknown The purpose of this study was to evaluate the correlation between the respiratory tract viruses infection in PBMC and the episode of SRSNS Methods Forty two children with SRSNS were selected, including the active stage group ( n =24) and the remission stage group ( n =18) The PBMC and serum from 20 nephritic nephrosis, 25 bronchiolitis and 19 healthy children were served as the control By using the methods of reverse transcriptase PCR (RT PCR),alkaline phosphoesterase anti alkaline phosphoesterase enzyme linked assay (APAAP) and enzyme linked immunosorbent assay (ELISA), viral genes and antigens in PBMC and viral antibodies in the serum were assayed, respectively Results (1)Eighteen out of 24 SRSNS children at the active stage showed positive results revealed by RT PCR with a positive rate of 75%, which included 10 respiratory syncytial virus, 6 influenza virus and 2 parainfluenza virus Eight out of 20 SRSNS children at the active stage showed positive by APAAP with a positive rate of 40%, which included 5 respiratory syncytial virus, 2 influenza virus and 1 parainfluenza virus Fifteen out of 24 SRSNS children at the active stage were also positive results revealed by ELISA with a positive rate of 62 5%, which included 9 respiratory syncytial virus, 4 influenza virus and 2 parainfluenza virus No positive result was found in children with SRSNS at the remission stage group and in normal controls The positive rate of detecting viruses in the active stage group of SRSNS children was higher than that in the remission group, nephritic nephrosis children and normal controls ( P <0 05) (2) The respiratory syncytial virus was the most common virus in PBMC from SRSNS at the active stage, and the influenza virus the second (3) The application of prednisone showed no effect on the positive rate of viruses gene and antigens While the decrease of the positive rate of viruses antibody in serum related to prednisone (4)The result of gene detection was in accordance with that of antigen detection (χ 2=5 714, P <0 05) Conclusion Respiratory tract viruses existed in the PBMC from SRSNS children