过敏性紫癜患儿外周血辅助性T细胞、调节性T细胞细胞因子与肾损害的相关性分析

Relationship of cytokines of peripheral blood helper T cells and regulatory T cells with renal damage in children with Henoch-Schönlein purpura

目的:探讨过敏性紫癜患儿外周血辅助性T细胞(Th)、调节性T细胞(Treg)细胞因子与肾损害的相关性。方法:本研究为横断面研究。2021年1月至2022年9月我院收治的315例过敏性紫癜患儿,按照是否有肾损害分为肾损害组(110例)和非肾损害组(205例)。检测并对比外周血Th、Treg的细胞因子:干扰素-γ(IFN-γ)、白介素-4(IL-4)、白介素-17(IL-17)和转化生长因子-β1(TGF-β1)。采用Pearson法分析外周血Th、Treg细胞因子与肾损害的相关性,Logistic回归法分析肾损害的影响因素。结果:血清IL-4、IL-17水平与过敏性紫癜患儿血清N-乙酰-β-氨基葡萄糖苷酶(NAG)、尿微量白蛋白(mAlb)、α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)水平呈正相关(P<0.05)。血清IFN-γ、TGF-β1水平与过敏性紫癜患儿血清的NAG、尿mAlb、α1-MG、β2-MG呈负相关(P<0.05)。肾损害组的血清总IgE、ESR、ASO、IL-4、IL-17水平高于非肾损害组(P<0.05),而IFN-γ和TGF-β1水平则低于非肾损害组(P<0.05)。增高的总IgE、ESR、ASO、血清IL-4和IL-17为肾损害危险因素,而血清IFN-γ和TGF-β1为其保护因素。结论:过敏性紫癜性肾炎患儿血清的IL-4、IL-17水平升高,IFN-γ、TGF-β1水平降低,提示Th和Treg细胞因子可能参与了过敏性紫癜性肾炎的发生发展。

ObjectiveTo explore the relationship of cytokines of peripheral blood helper T (Th) cells and regulatory T (Treg) cells with renal damage in children suffering from Henoch-Schönlein purpura (HSP).MethodsThis was a cross-sectional study. From January 2021 to September 2022, 315 children with HSP admitted to the hospital were divided into a renal damage group (110 cases) and a non-renal damage group (205 cases). Detection and comparison were performed in cytokines of peripheral blood Th and Treg cells, including interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-17 (IL-17), and transforming growth factor-β1 (TGF-β1). Pearson method was used to analyze the correlation between peripheral blood Th and Treg cells cytokines and renal damage, while logistic regression was used to analyze the influencing factors of renal damage.ResultsSerum levels of IL-4 and IL-17 were positively correlated with levels of serum N-acetyl-β-aminoglucosidase (NAG), urinary microalbumin (mAlb), α1-microglobulin (α1-MG), and β2-microglobulin (β2-MG) (P<0.05). Serum levels of IFN-γ and TGF-β1were negatively correlated with levels of serum NAG, urinary mAlb, α1-MG, and β2-MG (P<0.05). The renal damage group showed higher levels of serum total IgE, ESR, ASO, IL-4, and IL-17, but lower levels of IFN-γ and TGF-β1, than the non-renal damage group (P<0.05). Elevated levels of total IgE, ESR, ASO, serum IL-4, and IL-17 were risk factors for renal damage, while serum IFN-γ and TGF-β1 were the protective factors.ConclusionIn the children with HSP, serum levels of IL-4 and IL-17 were increased, while levels of IFN-γ and TGF-β1 were decreased, suggesting that cytokines of Th and Treg cells might be involved in the development of HSP nephritis.