PI3K-AKT/mTOR信号通路与原发性肾病综合征患儿Treg/Th17免疫平衡的相关性

Correlation between PI3K⁃AKT/mTOR signaling pathway and Treg/Th17 immune balance in children with primary nephrotic syndrome

目的 研究磷脂酰肌醇3-激酶(PI3K)-蛋白激酶B(AKT)/哺乳动物雷帕霉素靶蛋白(mTOR)信号通路与原发性肾病综合征(PNS)患儿调节性T细胞(Treg)/辅助性T细胞(Th17)免疫平衡的相关性。方法 选取2020年6月至2022年7月贵港市人民医院收治的30例PNS患儿作为肾病组,选取同期本院进行体检的30名健康儿童作为健康组,比较两组外周血CD4+T细胞PI3K、mTOR、Akt信使核糖核酸(mRNA)表达水平及外周血Treg、Th17、Treg/Th17水平,分析PNS患儿外周血CD4+T细胞PI3K、mTOR、Akt mRNA表达水平与外周血Treg、Th17、Treg/Th17水平的相关性。结果肾病组外周血CD4+T细胞PI3K、mTOR、Akt mRNA表达水平及外周血Th17水平高于健康组,差异有统计学意义(t=10.694、3.038、8.915、7.148,P<0.05)。肾病组外周血Treg水平及Treg/Th17低于健康组,差异有统计学意义(t=8.269、15.780,P<0.05)。PNS患儿外周血CD4+T细胞PI3K、mTOR、Akt mRNA表达水平与外周血Treg、Treg/Th17水平呈显著负相关关系(r=-0.637、-0.573、-0.492、-0.559、-0.511、-0.612,P<0.05),与Th17呈显著正相关关系(r=0.479、0.495、0.603,P<0.05)。结论 PNS的发生可引起儿童外周血CD4+T细胞PI3K-AKT/mTOR信号通路指标表达水平异常升高,同时可引起机体Treg/Th17免疫失衡,且PNS患儿外周血CD4+T细胞PI3K-AKT/mTOR信号通路与Treg/Th17免疫平衡之间存在明显的相关性。

Objective To study the correlation between phosphatidylinositol 3-kinase(PI3K)-protein kinase B(AKT)/mammalian target protein of rapamycin(mTOR)and the immune balance of regulato-ry T cells(Treg)/helper T cells(Th17)in children with primary nephrotic syndrome(PNS).Methods 30 children with PNS were admitted to Guigang People's Hospital from June 2020 to July 2022 and were selected as the nephropathy group.Additionally,30 healthy children who underwent physical examinations at the same hospital during the same period were chosen as the healthy group.The expression levels of PI3K,mTOR and Akt messenger ribonucleic acid(mRNA)in CD4+T cells and the levels of Treg,Th17 and Treg/Th17 in periph-eral blood were compared between the two groups,and the correlation between the expression levels of PI3K,mTOR and Akt mRNA in CD4+T cells in children with PNS and the levels of Treg,Th17 and Treg/Th17 in pe-ripheral blood was analyzed.Results The expression levels of PI3K,mTOR,and Akt mRNA in CD4+T cells of the nephropathy group and Th17 in the peripheral blood were higher than those in the healthy group.These differences were statistically significant(t=10.694,3.038,8.915,7.148,P<0.05).The levels of Treg and Treg/Th17 in the peripheral blood of the nephropathy group were lower than those in the healthy group,with a statistically significant difference(t=8.269,15.780,P<0.05).The expression levels of PI3K,mTOR,and Akt mRNA in peripheral blood CD4+T cells of children with PNS were significantly negatively correlated with the levels of Treg and Treg/Th17 in the peripheral blood(r=-0.637,-0.573,-0.492,-0.559,-0.511,-0.612,P<0.05),and significantly positively correlated with Th17(r=0.479,0.495,0.603,P<0.05).Conclusion The occurrence of PNS could lead to abnormal expression levels of the PI3K-AKT/mTOR signaling pathway in children's peripheral blood CD4+T cells.Simultaneously,it could also cause an imbalance between Treg and Th17 immune cells the body.There was a clear correlation between the PI3K-AKT/mTOR signaling pathway in children's peripheral blood CD4+T cells and the Treg/Th17 immune balance.