儿童激素敏感性肾病综合征CD30~+细胞及TH2类细胞因子研究

目的　了解糖皮质激素敏感性肾病综合征 (SSNS)患儿CD30阳性细胞及分泌白细胞介素 4(IL 4) ,5 ,6的TH2细胞活化状态 ,进一步证实SSNS免疫异常模式。方法　流式细胞仪 (FACS)检测SSNS与健康儿童CD30阳性细胞百分率、ELISA检测外周血单个核细胞 (PBMC)培养上清中IL 4,5 ,6及血清IgE浓度 ;用SSNS患儿CD30细胞百分率与PBMC培养上清中IL 4,5 ,6及血清IgE作直线相关分析。 结果　SSNS患儿CD30阳性细胞率、IL 4及血IgE( 11.96 %lg 2 .11pg/ml,2 99IU/ml)显著高于健康儿童 ( 2 .81%lg 1.37pg/ml,110IU/ml) (P均 <0 .0 1) ,但IL 5 ,6水平与健康儿童比较则未见显著性差异 (P >0 .0 5 ) ;SSNS患儿CD30阳性细胞百分率与IL 4及血IgE水平相关有显著性 (r =0 .94,P <0 .0 1,r=0 .74,P <0 .0 1) ;与IL 5、IL 6水平无显著性相关 (P <0 .0 5 )。结论　SSNS患儿CD30阳性细胞增加并不意味着存在TH2类细胞全面活化 ,SSNS患儿既有某些TH2类细胞因子 (IL 4)升高 ,又有一些TH2细胞因子的降低 (IL 5 )或无变化 (IL 6 ) ,本文资料不能证明SSNS发病与TH1/TH2失衡有直接关联

State of CD30~+ Cells and TH2 Cytokines in Children with the Steroid Sensitive Nephrotic Syndrome

Objective To study the TH2 state as represented by the percentage of CD30 + cells, levels of IL 4, IL 5, and IL 6 in PBMC, and serum IgE levels in children with the steroid sensitive nephrotic syndrome (SSNS). Methods CD30 + cells were assayed using FACS. IL 4, 5, 6 and serum IgE were determined using ELISA. Results There was a higher percentage of CD30 + cells (11.96%) and higher levels of IL 4 (lg 2.11 pg/ml) and serum IgE (299 IU/ml) in children with SSNS compared to the healthy control group (2.81%, lg 1.37 pg/ml, 110 IU/ml, respectively) (P< 0.01 ). No significant difference was found in the levels of IL 5 and IL 6 in the two groups. There was a significant correlation between the percentage of CD30 + cells and IL 4 (r= 0.94 , P< 0.01 ) and between CD30 + cells and serum IgE (r= 0.74 , P< 0.01 ). NO correlation was noted with IL 5 (r= -0.39 , P> 0.05 ) or with IL 6 levels (r= 0.08 , P> 0.05 ). Conclusions The abnormal increase of CD30 + cells does not mean that all TH2 cells are activated. The TH1/TH2 imbalance in children with SSNS is not proved in this study.