原发性肾病综合征患儿的免疫细胞对肾小球固有细胞生物活性的直接影响

目的 探讨原发性肾病综合征（简称肾病）患儿的免疫细胞对肾小球固有细胞的直接作用。方法 肾病患儿２８例，健康体检儿１５例，分为未治组、激素组、阴转组及正常对照组。制备外周血单个核细胞条件液（ＰＢＭＣ－ＣＭ），运用肾小球细胞体外培养技术、同位素掺入技术、放射免疫竞争性抑制法，检测ＰＢＭＣ－ＣＭ刺激后的大鼠肾小球上皮细胞合成层粘连蛋白（ＬＮ）、总胶原、Ⅲ型前胶原、Ⅳ型胶原等基质成分的含量；ＰＢＭＣ－ＣＭ对大鼠的肾小球系膜细胞＾３Ｈ－ＴｄＲ掺入指数的影响。结果 ４组的ＬＮ抑制指数分别为０．９５，１．０２，１．０１，１．０３；＾３Ｈ－羟脯氨酸的掺入指数为０．９３，１．２４，１．２３，１．１１；Ⅲ型前胶原的抑制指数为０．９６，１．００，０．９９，１．０１；Ⅳ型胶原抑制指数为１．０４，１．０５，１．０４，１．０８。未治组患儿

The direct effect of circulating immune cell from idiopathic nephrotic children on glomerular intrinsic cells

Objective To investigate the direct effect of circulating immune cell from idiopathic nephrolic children on glomerular epithelial cell and mesangial cell. Methods Twenty eight children with idiopathic nephropathy and 15 healthy children were randomly selected and divided into four groups. Group 1: the nephrotic children with no steroid treatment; Group 2: nephrotic children received prednison - treatment for at least 2 weeks; Group 3: prednison - treated children with no proteinuria; Group 4: healthy children. The peripheral blood mononuclear cell were collected from the children and their conditional medium (PBMC - CM) were prepared. Glomerular epithelial and mesangial cells culture, 3H - prolin and 3H - TdR incorporation, and competivitive combined radioimmunoassay were used to investigate:①The synthesis of laminin (LN), total collagen, collagen Ⅲ and collagen Ⅳ by cultured rat glomerular epithelial cell (GEC) after treatment with PBMC - CM of the children in 4 groups; ②The proliferation of glomerular mesangial cell (GMC). Results ①The inhibition coefficient of LN in these 4 groups were 0.95, 1.02, 1.01 and 1.03 respectively; the 3H - prolin incorporation coefficient of 4 groups were 0.93, 1.24, 1.23 and 1.11; the inhibition coefficient of collagen Ⅲ were 0.96, 1.00, 0.99 and 1.01. There were significant differences in the three coefficiencies of Group 1 compared with each of other groups (P<0.05), while the inhibition coefficient of collagen 1Ⅳ shown no significant difference among the 4 groups 1.04, 1.05, 1.04 and 1.08 respectively (P>0.05); ②The 3H- TdR incorporation coefficients of the GMC of 4 groups were 1.21, 1.53, 1.50 and 1.10 respectively, and shown no significant difference among the 4 groups ( P > 0.05). Conclusion Circulating immune cells from idiopatic nephrotic children have direct effect on the LN, collagen and collagen Ⅲ synthesis of rat GEC. The bioactivity can be neutrolized by prednison treatment, but the circulating immune cell has no effect on GMC proliferation.