To evaluate the balance status of interleukin 18 （IL-18） and interleukin 18 binding protein （IL-18BP） in circulation in patients with lupus nephritis （LN） and primary nephrotic syndrome （PNS）, plasma levels as...To evaluate the balance status of interleukin 18 （IL-18） and interleukin 18 binding protein （IL-18BP） in circulation in patients with lupus nephritis （LN） and primary nephrotic syndrome （PNS）, plasma levels as well as mRNA expression in peripheral blood mononuclear cells （PBMCs） of IL-18 and IL-18BP were measured by ELISA and RT-PCR respectively. The ratio of IL-18/IL-18BP was also calculated. Both plasma IL-18 and IL-18BP increased significantly in LN patients while only IL-18BP increased in PNS, which resulted in an elevated ratio of IL-18/IL-18BP in LN but not in PNS patients when compared with normal controls. In contrast, increased level of IL-18 mRNA was only detected in LN but not in PNS group, although IL-18BP mRNA expressions in PBMCs in both groups were higher than that in control. The imbalance of IL-18 and IL-18BP might be involved in the pathogenesis of LN, based on which a therapeutic approach is valuable to be developed for LN.展开更多
文摘目的：观察中医益气养阴清热法配合激素对原发性肾病综合征（PNS）患儿的临床疗效及血清、尿液IL-18、IL-1β的影响。方法：将60例PNS患儿随机分为治疗组和对照组各30例,两组均给予足量泼尼松2 mg/（kg·d）治疗,4～8周后开始减量;治疗组在上述基础上加用益气养阴清热功效的中药煎剂,研究观察周期为12周;同时设正常组30例。分别在治疗前后测定患儿24 h尿蛋白定量、血白蛋白水平,并检测血清和尿液中IL-18、IL-1β含量,正常组仅检测IL-18、IL-1β。结果：治疗组的临床疗效总有效率和中医证候疗效总有效率均显著优于对照组（P〈0.05）;两组的24 h Upro较治疗前有显著降低,ALB显著升高（P〈0.05）,且治疗组的改善作用较对照组相比更为显著（P〈0.05）。PNS患儿的血清和尿液中IL-18、IL-1β均较正常组有显著升高（P〈0.05）;治疗后两组的血清和尿液中IL-18、IL-1β均较治疗前有显著降低（P〈0.05）,且治疗组的降低程度较对照组相比更为显著（P〈0.05）。结论：益气养阴清热中药配合激素疗法不仅可以改善患儿的临床症状,而且能显著降低患儿尿蛋白水平、升高血浆白蛋白,从而更加有效缓解PNS病情;其可能机制为降低机体IL-18、IL-1β水平,抑制机体炎症反应,改善免疫功能紊乱。
基金supported by a grant from Guangdong Natural Science Foundation(5011589)a PhD scholarship of Guangdong Medical College(200301).
文摘To evaluate the balance status of interleukin 18 （IL-18） and interleukin 18 binding protein （IL-18BP） in circulation in patients with lupus nephritis （LN） and primary nephrotic syndrome （PNS）, plasma levels as well as mRNA expression in peripheral blood mononuclear cells （PBMCs） of IL-18 and IL-18BP were measured by ELISA and RT-PCR respectively. The ratio of IL-18/IL-18BP was also calculated. Both plasma IL-18 and IL-18BP increased significantly in LN patients while only IL-18BP increased in PNS, which resulted in an elevated ratio of IL-18/IL-18BP in LN but not in PNS patients when compared with normal controls. In contrast, increased level of IL-18 mRNA was only detected in LN but not in PNS group, although IL-18BP mRNA expressions in PBMCs in both groups were higher than that in control. The imbalance of IL-18 and IL-18BP might be involved in the pathogenesis of LN, based on which a therapeutic approach is valuable to be developed for LN.
