| 摘要: |
| 目的:探讨滤泡辅助性T(Tfh)细胞在儿童初发过敏性紫癜(HSP)、紫癜性肾炎(HSPN)中的变化及其可能机制。方法:选择初发HSP患儿45例,采用流式细胞术检测外周血CD4+CXCR5+ICOS+ T细胞(Tfh细胞) 的比例,荧光实时定量聚合酶链反应(RT-PCR)检测转录因子Bcl-6、Blimp-1的mRNA表达,酶联免疫吸附试验(ELISA)法检测IL-21、IL-4血浆浓度。密切随访HSP患儿6个月。6个月时,根据是否有肾脏受累分为HSPN组19例和HSP组26例。另选取20例健康体检儿童为对照组。结果:(1)HSP组患儿Tfh细胞比例高于正常对照组(3.75%±1.32% vs 2.01%±0.72%,P<0.05);HSPN组患儿Tfh细胞比例高于HSP组(5.86%±1.94% vs 3.75%±1.32%,P<0.05);(2)Tfh细胞正性转录调节因子Bcl-6 mRNA表达HSPN组高于HSP组(P<0.05),均高于正常对照组(P<0.05);负性调节因子Blimp-1 mRNA表达HSPN组低于HSP组(P<0.05),均低于正常对照组(P<0.05);(3)Tfh细胞相关细胞因子IL-21血浆浓度HSPN组高于HS 组(P<0.05),均较正常对照组增高(P<0.05)。抑制Blimp-1表达的IL-4血浆浓度HSPN组和HSP组均高于正常对照组(P<0.05),但HSPN组和HSP组比较差异无统计学意义(P>0.05)。结论:Tfh细胞过度活化可能参与HSP免疫发病机制,Tfh细胞高表达可能是导致HSP患儿肾脏损害的原因之一。 |
| 关键词: 滤泡辅助性T 细胞 Bcl-6 Blimp-1 过敏性紫癜 肾炎 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.01.001 |
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| 基金项目:深圳市医学科技项目基金资助,编号201607048 |
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| Changs of T Follicular Helper Cell in Children Primary Henoch-Schönlein Purpura and Henoch-Schönlein Purpura Nephrits |
| Jia Shilei, Yang Jun, Ma Yijiao, Li Weibin, Li Chengrong, Zhou Houfu |
| (Shenzhen Children's Hospital, Guangdong Shenzhen 518026, China) |
| Abstract: |
| Objective: To explore the changes and mechanism of T follicular helper (Tfh) cells in children with primary Henoch-Schönlein purpura (HSP) and Henoch-Schönlein purpura nephritis (HSPN). Methods: Forty-five children with HSP were enrolled in this study. The proportion of CD4+ CXCR5+ICOS+ T cells in peripheral blood was analyzed by flow cytometry. Real-time PCR was performed to detect the level of Tfh cells transcriptional factor (Bcl-6) and its inhibitor (Blimp-1). The plasma concentrations of IL-21
and IL-4 were determined by ELISA. HSP children were followed up for 6 months, depending on whether the kidney was involved, they were divided into HSP group (26 cases) and HSPN group (19 cases). Twenty health children were selected as the control group. Results: (1) The proportion of Tfh cells in HSP group was significantly higher than control group (3.75%±1.32% vs 2.01%±0.72%, P<0.05). The proportion of Tfh cells in HSPN group was significantly higher than that of HSP group (5.86%±1.94% vs 3.75%±1.32%, P<0.05). (2) The mRNA expression of Bcl-6 was significantly elevated in HSPN group, which was significantly higher than that of HSP group (P<0.05), and both of them were higher than that of control group (P<0.05). Simultaneously, the mRNA expression of Blimp-1 was found to be down-regulated in HSPN group, which was significantly lower than that of HSP group (P<0.05), and both of them were lower than control group (P<0.05). (3) The plasma IL-21 concentration in HSPN group was significantly higher than that of HSP group (P<0.05), and both of them were significantly increased in comparison with control group (P<0.05). There was no significantly difference of the plasma IL-4 concentration between HSP group and HSPN group (P>0.05), but both of them were higher than that of control group (P<0.05). Conclusion: The over-activation of Tfh cells may be correlated with immune pathogenesis in HSP. Aberrant activation of Tfh cells may be one of factors causing disturbed HSPN. |
| Key words: T follicular helper cell Bcl-6 Blimp-1 Henoch-Sch?nlein purpura nephritis |
