IgA肾病患者血清Gd-IgA1与Th淋巴细胞亚群变化及临床病理特点的相关性分析

Correlation Analysis Between Serum Gd-IgA1 and Th Lymphocyte Subsets Changesand Clinicopathological Characteristics in Patients with IgA Nephropathy

目的:探讨IgA肾病患者低糖基化IgA1分子与Th淋巴细胞亚群及其细胞因子、临床指标、病理特点的相关性。方法:选取2021年06月—2022年10月北京市昌平区中西医结合医院肾病科门诊及住院的IgA肾病患者30例(IgA肾病组)与健康受试者30例(健康对照组),应用ELISA测定血清中低糖基化IgA1分子、IL-4、IL-6、IL-10水平,应用流式细胞学检测Th淋巴细胞亚群比例,分析比较两组低糖基化IgA1与Th淋巴细胞亚群及其细胞因子、临床指标、病理特点之间相关性。结果:IgA肾病组外周血Gd-IgA1、Th2细胞、Th17细胞、Th17/Treg、IL-4、IL-6、IL-17水平高于对照组(P<0.05),Treg细胞水平低于对照组(P<0.05)。Gd-IgA1与Th2细胞、Th17细胞、Th17/Treg、IL-17呈显著正相关(R=0.463、0.554、0.652、0.531,P<0.05),与Treg细胞、Th1细胞显著负相关(R=-0.690、-0.402,P<0.05)。Gd-IgA1、Th2、Th17/Treg、IL-4、IL-6、IL-17与24 h尿蛋白定量均呈显著正相关,Th17、Th17/Treg与Alb呈显著负相关,Gd-IgA1、Th2、Th17、Th17/Treg与Scr呈显著正相关,Treg与BUN呈显著负相关(P<0.05)。结论:Gd-IgA1、Th淋巴细胞亚群及其细胞因子共同参与IgA肾病多重致病过程,为寻找敏感的血清学指标应用于临床具有参考意义。

Objective:To investigate the correlation between low-glycosylated IgA1 molecules and Th lymphocyte subsets,cytokines,clinical indicators and pathological characteristics in patients with IgA nephropathy.Methods:From June 2021 to October 2022,30 IgA nephropathy patients(IgA nephropathy group)and 30 healthy subjects(healthy control group)who were outpatients and inpatients in the Department of Nephrology,Changping District Hospital of Integrated Traditional Chinese and Western Medicine in Beijing were selected.The levels of low-glycosylated IgA1 molecules,IL-4,IL-6,and IL-10 in serum were measured,and the proportion of Th lymphocyte subsets was detected by flow cytometry.The low-glycosylated IgA1 and Th lymphocyte subsets and the correlation among cytokines,clinical indicators and pathological features were analysised.Results:The levels of peripheral blood Gd-IgA1,Th2 cells,Th17 cells,Th17/Treg,IL-4,IL-6,and IL-17 in the IgA nephropathy group were significantly higher than those in the control group(P<0.05),and the levels of Treg cells were significantly lower than those in the control group group(P<0.05).Gd-IgA1 was significantly positively correlated with Th2 cells,Th17 cells,Th17/Treg,and IL-17(R=0.463,0.554,0.652,0.531,P<0.05),and significantly negatively correlated with Treg cells and Th1 cells(R=-0.690,-0.402,P<0.05).Gd-IgA1,Th2,Th17/Treg,IL-4,IL-6,IL-17 were significantly positively correlated with 24h urine protein quantification,Th17,Th17/Treg were significantly negatively correlated with Alb,Gd-IgA1,Th2,Th17,Th17/Treg were significantly positively correlated with Scr,and Treg was significantly negatively correlated with BUN(P<0.05).Conclusion:Gd-IgA1,Th lymphocyte subsets and their cytokines are involved in the multiple pathogenic processes of IgA nephropathy,which has reference significance for finding sensitive serological indicators for clinical application.