中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
17期
1309-1312
,共4页
贺丽蓉%邵晓珊%李宇红%蒋新辉%徐海霞%应蓓%邱杰%郑莎莎%林俊
賀麗蓉%邵曉珊%李宇紅%蔣新輝%徐海霞%應蓓%邱傑%鄭莎莎%林俊
하려용%소효산%리우홍%장신휘%서해하%응배%구걸%정사사%림준
原发性肾小球疾病%Th17细胞%CD4+ CD25+调节性T淋巴细胞%白细胞介素-17
原髮性腎小毬疾病%Th17細胞%CD4+ CD25+調節性T淋巴細胞%白細胞介素-17
원발성신소구질병%Th17세포%CD4+ CD25+조절성T림파세포%백세포개소-17
Primary glomerular diseases%Th17 cells%CD4 + CD25 + regulatory T lymphocytes%Interleukin-17
目的 探讨Th17细胞、CD4+ CD25+调节性T淋巴细胞(Treg)及其效应因子在儿童原发性肾小球疾病中的作用.方法 外周血:选择贵阳市儿童医院肾脏免疫科2013年12月至2014年12月住院确诊为原发性肾小球疾病的患儿30例为观察组,男20例,女10例;发病年龄1.6 ～14.0岁[(8.2±3.8)岁].同时收集贵阳市儿童医院同期健康体检儿童10例为健康对照组,男8例,女2例;年龄(5.9±3.3)岁.肾组织:收集贵阳市儿童医院同期经肾活检确诊为原发性肾小球疾病患儿25例为病例组,男17例,女8例;发病年龄2～14岁[(7.7±3.5)岁].其中微小病变型肾病(MCNS) 10例,系膜增生性肾小球肾炎(MsPGN)9例,局灶节段性肾小球硬化(FSGS)6例.同时收集贵阳市儿童医院儿外科5例行肾积水等手术患儿的正常肾组织(距病变组织5 cm以上)为对照组.流式细胞仪检测观察组及健康对照组儿童外周血中Th17、Treg细胞的比例;通过荧光定量PCR检测白细胞介素-17 (IL-17) mRNA在肾小球疾病患儿及健康儿童外周血中的表达;并用免疫组织化学SP法分析25例原发性肾小球疾病患儿不同病理类型肾组织中IL-17表达水平.结果 1.观察组儿童外周血Th17细胞的比例显著高于健康对照组(t=7.635,P＜0.05),而观察组外周血Treg细胞比例显著低于健康对照组(t=19.920,P＜0.05).2.观察组和健康对照组IL-17 mRNA相对表达水平分别为4.427±2.870和1.095±0.212,观察组IL-17 mRNA相对表达水平高于健康对照组(t=3.636,P＜0.05).3.病例组患儿肾组织病理检测阳性,IL-17可表达在肾小球及肾小管细胞的胞质,对照组肾组织内IL-17基本无表达.对照组、MCNS组、MsPGN组和FSGS组IL-17水平分别为0.134±0.007、0.210±0.016、0.237 ±0.006和0.284±0.024,组间比较差异有统计学意义(F=99.09,P＜0.05).结论 Th17/Treg细胞失衡在肾脏疾病发病机制中起着重要作用,使Th17/Treg细胞恢复平衡可能是肾脏疾病的一个新的治疗靶点.
目的 探討Th17細胞、CD4+ CD25+調節性T淋巴細胞(Treg)及其效應因子在兒童原髮性腎小毬疾病中的作用.方法 外週血:選擇貴暘市兒童醫院腎髒免疫科2013年12月至2014年12月住院確診為原髮性腎小毬疾病的患兒30例為觀察組,男20例,女10例;髮病年齡1.6 ～14.0歲[(8.2±3.8)歲].同時收集貴暘市兒童醫院同期健康體檢兒童10例為健康對照組,男8例,女2例;年齡(5.9±3.3)歲.腎組織:收集貴暘市兒童醫院同期經腎活檢確診為原髮性腎小毬疾病患兒25例為病例組,男17例,女8例;髮病年齡2～14歲[(7.7±3.5)歲].其中微小病變型腎病(MCNS) 10例,繫膜增生性腎小毬腎炎(MsPGN)9例,跼竈節段性腎小毬硬化(FSGS)6例.同時收集貴暘市兒童醫院兒外科5例行腎積水等手術患兒的正常腎組織(距病變組織5 cm以上)為對照組.流式細胞儀檢測觀察組及健康對照組兒童外週血中Th17、Treg細胞的比例;通過熒光定量PCR檢測白細胞介素-17 (IL-17) mRNA在腎小毬疾病患兒及健康兒童外週血中的錶達;併用免疫組織化學SP法分析25例原髮性腎小毬疾病患兒不同病理類型腎組織中IL-17錶達水平.結果 1.觀察組兒童外週血Th17細胞的比例顯著高于健康對照組(t=7.635,P＜0.05),而觀察組外週血Treg細胞比例顯著低于健康對照組(t=19.920,P＜0.05).2.觀察組和健康對照組IL-17 mRNA相對錶達水平分彆為4.427±2.870和1.095±0.212,觀察組IL-17 mRNA相對錶達水平高于健康對照組(t=3.636,P＜0.05).3.病例組患兒腎組織病理檢測暘性,IL-17可錶達在腎小毬及腎小管細胞的胞質,對照組腎組織內IL-17基本無錶達.對照組、MCNS組、MsPGN組和FSGS組IL-17水平分彆為0.134±0.007、0.210±0.016、0.237 ±0.006和0.284±0.024,組間比較差異有統計學意義(F=99.09,P＜0.05).結論 Th17/Treg細胞失衡在腎髒疾病髮病機製中起著重要作用,使Th17/Treg細胞恢複平衡可能是腎髒疾病的一箇新的治療靶點.
목적 탐토Th17세포、CD4+ CD25+조절성T림파세포(Treg)급기효응인자재인동원발성신소구질병중적작용.방법 외주혈:선택귀양시인동의원신장면역과2013년12월지2014년12월주원학진위원발성신소구질병적환인30례위관찰조,남20례,녀10례;발병년령1.6 ～14.0세[(8.2±3.8)세].동시수집귀양시인동의원동기건강체검인동10례위건강대조조,남8례,녀2례;년령(5.9±3.3)세.신조직:수집귀양시인동의원동기경신활검학진위원발성신소구질병환인25례위병례조,남17례,녀8례;발병년령2～14세[(7.7±3.5)세].기중미소병변형신병(MCNS) 10례,계막증생성신소구신염(MsPGN)9례,국조절단성신소구경화(FSGS)6례.동시수집귀양시인동의원인외과5례행신적수등수술환인적정상신조직(거병변조직5 cm이상)위대조조.류식세포의검측관찰조급건강대조조인동외주혈중Th17、Treg세포적비례;통과형광정량PCR검측백세포개소-17 (IL-17) mRNA재신소구질병환인급건강인동외주혈중적표체;병용면역조직화학SP법분석25례원발성신소구질병환인불동병리류형신조직중IL-17표체수평.결과 1.관찰조인동외주혈Th17세포적비례현저고우건강대조조(t=7.635,P＜0.05),이관찰조외주혈Treg세포비례현저저우건강대조조(t=19.920,P＜0.05).2.관찰조화건강대조조IL-17 mRNA상대표체수평분별위4.427±2.870화1.095±0.212,관찰조IL-17 mRNA상대표체수평고우건강대조조(t=3.636,P＜0.05).3.병례조환인신조직병리검측양성,IL-17가표체재신소구급신소관세포적포질,대조조신조직내IL-17기본무표체.대조조、MCNS조、MsPGN조화FSGS조IL-17수평분별위0.134±0.007、0.210±0.016、0.237 ±0.006화0.284±0.024,조간비교차이유통계학의의(F=99.09,P＜0.05).결론 Th17/Treg세포실형재신장질병발병궤제중기착중요작용,사Th17/Treg세포회복평형가능시신장질병적일개신적치료파점.
Objective To investigate the role of Th17/CD4 + CD25 + regulatory T lymphocytes(Treg) and its effector in children with primary glomerular diseases.Methods Peripheral blood:30 patients with primary glomerular diseases from December 2013 to December 2014 in Department of Nephrology at Guiyang Children's Hospital were enrolled as experimental group,20 male, 10 female;age: 1.6-14.0 years old [(8.2 ± 3.8) years old].Meanwhile, 10 healthy age-matched children after physical examination in Guiyang Children's Hospital were collected as health control group, 8 male and 2 female, with mean age (5.9 ± 3.3) years old.Renal tissue :25 patients with primary glomerular diseases diagnosed through renal biopsy in Guiyang Children's Hospital were collected as case group, 17 male,8 female;age :2-14 years old [(7.7 ± 3.5) years old].Among them, 10 patients with minimal change nephrotic syndrome (MCNS) ,9 patients with mesangial proliferative glomerulonephritis (MsPGN) ,6 patients with focal segmental glomerulosclerosis (FSGS).In addition,5 age-matched children of hydronephrosis with normal kidney tissue (more than 5 cm from the lesion) in Department of Surgery in Guiyang Children's Hospital were recruited as control group.The circulating frequencies of Thl7 cells and Treg cells in peripheral blood in experimental group and healthy control group were measured by means of flow cytometry.The mRNA expressions of interleukin-17 (IL-17) in peripheral blood of the patients and the healthy children were analyzed using real-time polymerase chain reaction(PCR).The expressions of IL-17 in renal tissue of different pathological types were tested with immunohistochemical techniques.Results (1) Circulating frequency of Th17 cells in experimental group was higher than those in health control group (t =7.635, P ＜ 0.05).But the circulating frequency of Treg cells in experimental group were lower than those in the health control group (t =19.920 ,P ＜ 0.05).(2) The mRNA level of IL-17 in the experimental group were higher than that in the health control group (4.427 ± 2.870 vs 1.095 ± 0.212, t =3.636, P ＜ 0.05).(3) Pathological test of renal tissues in case group was positive, IL-17 expression in glomerular and renal tubular cell cytoplasm was found, but IL-17 had no expression in renal tissue in the control group.The expressions of IL-17 in control group, MCNS group, MsPGN group and FSGS group were 0.134 ± 0.007,0.210 ± 0.016,0.237 ± 0.006 and 0.284 + 0.024, and there were significant differences among the groups (F =99.09, P ＜ 0.05).Conclusions The imbalance of Th17/Treg cell plays an important role in the pathogenesis of renal disease.To recover the balance of Th17/Treg cells may be a new target in the treatment of kidney disease.
