摘要
目的了解外周血辅助性T细胞(helper T cell,Th)17/调节性T细胞(regulatory T cells,Treg)和相关细胞因子在狼疮性肾炎(lupus nephritis,LN)治疗前后的变化和意义,并评估Th17/Treg在预测LN治疗反应中的价值。方法选取2016年2月至2018年10月于复旦大学附属中山医院肾内科就诊的活动性LN患者31例为研究对象,并选取与LN患者性别、年龄相匹配的健康志愿者20例为健康对照组。流式细胞术检测外周血Th17和Treg细胞所占比例,计算Th17/Treg比值,酶联免疫吸附试验法(enzyme linked immunosorbent assay,ELISA)检测血清中相关细胞因子的表达。患者在开始治疗后对其进行随访,每月一次,共两个月。结果与健康对照组相比,活动性LN患者红细胞计数、血红蛋白水平、血小板计数、C4、CH50、白蛋白和估算肾小球滤过率值(estimated glomerular filtration rate,eGFR)显著较低(P<0.05),血清肌酐(serum creatinin,SCr)显著较高(P<0.05)。治疗前,活动性LN患者外周血Treg细胞比例、白细胞介素(interleukin,IL)-10和转化生长因子(transforming growth factor,TGF)-β1水平显著低于健康对照组,差异具有统计学意义[(4.90±2.05)%比(6.70±1.69)%,(12.99±1.77)pg/mL比(14.93±0.47)pg/mL,(3408.37±711.94)pg/mL比(4695.99±545.01)pg/mL,t值分别为4.19,9.85,4.67,P值均<0.05];Th17细胞比例,Th17/Treg比值、IL-17和IL-23水平显著高于健康对照组,差异具有统计学意义[(5.94±3.01)%比(1.90±0.77)%,(1.30±0.37)比(0.29±0.13),(6.68±0.99)pg/mL比(5.33±0.39)pg/mL,(199.89±56.98)pg/mL比(111.58±44.77)pg/mL,t值分别为3.57,6.19,4.14和7.35,P值均<0.05)]。相关分析显示,LN患者外周血Treg细胞比例与血清IL-10、TGF-β1水平呈正相关(r值分别为0.45和0.32,P值均<0.05);LN患者外周血Th17细胞比例与血清IL-17、IL-23水平呈正相关(r值分别为0.70和0.28,P值均<0.05)。与入组时相比,经糖皮质激素联合免疫抑制剂或单独治疗两个月后,活动性LN患者系统性红斑狼疮疾
Objective To explore the changes and significance of helper T cell(Th)17/regulatory T cells(Treg)and some related cytokines in lupus nephritis(LN)before and after treatment,and to evaluate the value of Th17/Treg in predicting the therapy on LN.Methods Thirty-one patients with active LN treated in the Department of Nephrology in Zhongshan Hospital,Fudan University,from February 2016 to October 2018 were enrolled.Twenty healthy volunteers matched with the gender and age of LN patients were selected as the healthy control group.The proportion of Th17 and Treg in peripheral blood was tested by flow cytometry and the Th17/Treg ratio was calculated.The expression of related cytokines in serum was detected by enzyme-linked immunosorbent assay(ELISA).The patients were followed every month after the beginning of the therapy for two months.Results Compared with the healthy control group,the erythrocyte count,hemoglobin level,platelet count,C4,CH50,albumin and estimated glomerular filtration rate(eGFR)in patients with active LN were significantly lower(P<0.05),and the serum creatinine(SCr)was significantly higher(P<0.05).Before treatment,the proportion of Treg cells,the level of interleukin(IL)-10 and transforming growth factor(TGF)-β1 in peripheral blood of patients with active LN was significantly lower than that of healthy control group[(4.90±2.05)%vs(6.70±1.69)%,(12.99±1.77)pg/mL vs(14.93±0.47)pg/mL,(3408.37±711.94)pg/mL vs(4695.99±545.01)pg/mL,t values were 4.19,9.85 and 4.67 respectively,all P values<0.05].The proportion of Th17 cells,Th17/Treg ratio,expression level of IL-17 and IL-23 in patients with active LN were significantly higher than those in the healthy control group[(5.94±3.01)%vs(1.90±0.77)%,(1.30±0.37)vs(0.29±0.13),(6.68±0.99)pg/mL vs(5.33±0.39)pg/mL,(199.89±56.98)pg/mL vs(111.58±44.77)pg/mL,t values were 3.57,6.19,4.14 and 7.35 respectively,all P values<0.05].Correlation analysis showed that the proportion of Treg cells in peripheral blood of patients with LN was positively correlated with
作者
许嵘
钟一红
朱加明
Xu Rong;Zhong Yihong;Zhu Jiaming(Department of Nephrology,the Traditional Chinese Medicine Hospital of Jiangsu Province,the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China;Department of Nephrology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《国际免疫学杂志》
CAS
2022年第1期27-34,共8页
International Journal of Immunology
