IL-17和IL-23在成人原发性肾病综合征患者中的变化及意义

doi:10.3969/j.issn.1673-8640.2015.05.002

检验医学 ›› 2015, Vol. 30 ›› Issue (6): 554-558.DOI: 10.3969/j.issn.1673-8640.2015.05.002

IL-17和IL-23在成人原发性肾病综合征患者中的变化及意义

周韵娇¹, 张丽红², 李鹏², 叶鲜妩², 牛建英²

1. 复旦大学附属上海市第五人民医院中心实验室，上海 200240；2. 复旦大学附属上海市第五人民医院肾内科，上海 200240

收稿日期:2014-09-09 出版日期:2015-06-30 发布日期:2015-07-03
通讯作者: 牛建英,联系电话:021-64308151。
作者简介:周韵娇,女,1981年生,硕士,主管技师,主要从事细胞免疫学研究。
基金资助:
上海市闵行区科委自然基金资助项目(2010MHZ027)；复旦大学985医院优势学科资助项目(复医科办字[2012]1号)

The variation and significance of IL-17 and IL-23 in adult patients with primary nephrotic syndrome

ZHOU Yunjiao¹, ZHANG Lihong², LI Peng², YE Xianwu², NIU Jianying²

1. Central Clinical Laboratory, the Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China; 2. Department of Nephrology, the Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China

Received:2014-09-09 Online:2015-06-30 Published:2015-07-03

摘要/Abstract

摘要：

目的　观察白细胞介素17(IL-17)和白细胞介素23(IL-23)在成人原发性肾病综合征(PNS)中的变化,探讨其在PNS发生及发展中的作用及临床意义。方法　选取初次就诊并激素治疗有效的PNS住院患者35例(实验组),按常规剂量给予强的松治疗;选取同期健康体检者20名作为对照组。检测对照组、PNS患者治疗前和完全缓解时的外周血T细胞亚群及血清和24 h尿液中IL-17、IL-23、白细胞介素6(IL-6)水平,并分别与24 h尿蛋白定量进行相关分析。结果　与对照组相比,PNS患者外周血CD3⁺、CD3⁺CD4⁺细胞数减少(P<0.05),血清IL-17、IL-6和24 h尿液中IL-17、IL-23、IL-6水平明显增加(P<0.05);经治疗,PNS患者CD3⁺、CD3⁺CD4⁺细胞数较治疗前明显增加(P<0.05),24 h尿液中IL-17、IL-23、IL-6水平较治疗前明显降低(P<0.05)。PNS患者血清IL-17、IL-23水平和24 h尿液IL-17、IL-23水平均与24 h尿蛋白定量呈显著正相关(P均<0.01)。结论　IL-17和IL-23可能与PNS患者大量蛋白尿的形成有关;激素治疗能够显著改善PNS患者细胞免疫功能紊乱和T细胞亚群失衡;监测PNS患者血清和24 h尿液中IL-17和IL-23的水平,可能有助于病情的判断和指导临床治疗。

关键词: 白细胞介素17, 白细胞介素23, 白细胞介素6, T细胞亚群, 24 h尿蛋白定量, 原发性肾病综合征

Abstract:

Objective　To investigate the changes of interleukin 17 (IL-17) and interleukin 23 (IL-23) in adult patients with primary nephrotic syndrome (PNS) and their roles and clinical significance of IL-17 and IL-23 variations in the occurrence and development of PNS. Methods　A total of 35 steroid-effective hospitalized patients with PNS and 20 healthy subjects (healthy control group) were enrolled in the study. The patients with PNS were treated with prednisone according to the conventional dose. T cell subsets from peripheral blood and the levels of IL-17,IL-23 and IL-6 from serum and 24 h urine were detected in healthy control group and the patients with PNS before and after treatment. The correlations of 24 h urinary protein quantification with T cell subsets in peripheral blood and the levels of IL-17,IL-23 and IL-6 in both serum and 24 h urine were analyzed,respectively. Results　Compared with healthy control group, the percentage of CD3⁺ or CD3⁺CD4⁺ cells from patients with PNS significantly decreased (P<0.05), and the levels of IL-17 and IL-6 from serum as well as IL-17, IL-23 and IL-6 from 24 h urine significantly increased(P<0.05). After treatment, the percentage of CD3⁺ or CD3⁺CD4⁺ cells significantly increased (P<0.05), and the levels of IL-17, IL-23 and IL-6 in 24 h urine significantly decreased (P<0.05). There were positive correlations between 24 h urinary protein quantification and the levels of IL-17 and IL-23 in both serum and 24 h urine respectively (P<0.01). Conclusions　IL-17 and IL-23 may contribute to the proteinuria of PNS. Hormone therapy can improve the disorder of cell immune function and the imbalance of T cell subsets. Monitoring the levels of IL-17 and IL-23 in serum and 24 h urine may be helpful for disease judgement and clinical therapy.

Key words: Interleukin 17, Interleukin 23, Interleukin 6, T cell subset, 24 h urinary protein quantification, Primary nephrotic syndrome

中图分类号:

R446.62

周韵娇，张丽红，李鹏，叶鲜妩，牛建英. IL-17和IL-23在成人原发性肾病综合征患者中的变化及意义[J]. 检验医学, 2015, 30(6): 554-558.

ZHOU Yunjiao, ZHANG Lihong, LI Peng, YE Xianwu, NIU Jianying. The variation and significance of IL-17 and IL-23 in adult patients with primary nephrotic syndrome[J]. , 2015, 30(6): 554-558.

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IL-17和IL-23在成人原发性肾病综合征患者中的变化及意义

The variation and significance of IL-17 and IL-23 in adult patients with primary nephrotic syndrome

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