Relationship between renal Th1/Th2 ratio and renal microvascular injury in children with Henoch-Schonlein purpura nephritis

HUANG  Dan-Lin; XU  Zi-Chuan; DANG  Xi-Qiang; ZENG  Xue-Qi; HE  Xiao-Jie; YI  Zhu-Wen; HE  Qing-Nan

PDF(1698 KB)

Chinese Journal of Contemporary Pediatrics ›› 2011, Vol. 13 ›› Issue (4) : 273-277.

Relationship between renal Th1/Th2 ratio and renal microvascular injury in children with Henoch-Schonlein purpura nephritis

HUANG Dan-Lin, XU Zi-Chuan, DANG Xi-Qiang, ZENG Xue-Qi, HE Xiao-Jie, YI Zhu-Wen, HE Qing-Nan

Author information +

History +

Abstract

OBJECTIVE: To explore possible correlations between renal Th1/Th2 ratio and renal microvascular injury in children with Henoch-Schonlein purpura nephritis (HSPN). METHODS: Thirty-two children with HSPN were enrolled. They were classified into four groups by renal pathology: HSPN class II (n=8), HSPN class IIIa (n=7), HSPN class IIIb (n=10) and HSPN class IV/V (n=7). Five patients undergoing nephrectomy due to trauma were used as the controls. INFγ, IL-4 and CD34 in the renal tissues were measured by immunohistochemical analysis. INFγ was used as a marker of Th1, IL-4 was used as a marker of Th2 and CD34 was used as a marker of microvessel. The renal microvessel density was evaluated according to the Weidner standard. The relationships among the local Th1/Th2 ratio, renal pathological grade, microvessel score and microvessel density were studied. RESULTS: Immunohistochemical analysis showed a lower expression of INFγ and a higher expression of IL-4 in the HSPN groups than in the control group. The local Th1/Th2 ratio in the HSPN groups decreased and correlated significantly with the renal pathological grade. There were significant differences among four HSPN subgroups (P<0.05). Compared with the control group, the renal microvessel density in the HSPN class II and class IIIa groups increased significantly (P<0.05), but it decreased in the HSPN class IV/V group (P<0.05). The renal microvessel scores in the HSPN class IIIa, class IIIb and class IV/V groups increased significantly compared with those in the control and the HSPN classⅡ. The increased renal microvessel scores were associated with more severe renal pathological changes. A negative correlation was found between the local Th1/Th2 ratio and the microvessel density in kidneys (r=-0.921, P<0.01). CONCLUSIONS: The decrease of Th1/Th2 ratio in kidneys might be responsible for renal microvascular injury in children with HSPN.

Key words

Henoch-Schonlein purpura nephritis / Th1/Th2 ratio / Microvascular injury / Child

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

HUANG Dan-Lin, XU Zi-Chuan, DANG Xi-Qiang, ZENG Xue-Qi, HE Xiao-Jie, YI Zhu-Wen, HE Qing-Nan. Relationship between renal Th1/Th2 ratio and renal microvascular injury in children with Henoch-Schonlein purpura nephritis[J]. Chinese Journal of Contemporary Pediatrics. 2011, 13(4): 273-277

References

［1］Del Prete G. The concept of type-1 and type-2 helper T cells and their cytokines in humans［J］.Int Rev Immunol, 1998, 16(3-4): 427-455.

［2］Jancovic D, Liu Z, Gause WC. Th1-and Th2-cell commitment during infectious disease: asymmetry in divergent pathways［J］.Trends Immunol, 2001, 22(8): 450-457.

［3］Qin W, Hongya W, Yongjing C, Fang X, Yue M, Xuekun Z, et al. Increased OX40 and soluble OX40 ligands in children with Henoch-Schonlein purpura: association with renal involvement［J］. Pediatr Allergy Immunol, 2011, 22（1 Pt 1）: 54-59.

［4］周承，王振开. 过敏性紫癜早期肾损害患儿T细胞亚群的变化及意义［J］. 实用临床医药杂志,2009,13(13): 96-98.

［5］陶红，李秋，王莉，李翠萃，阳海平，张高福. 过敏性紫癜发病中树突状细胞与T辅助细胞分化失衡的关系［J］. 第三军医大学学报, 2010, 32(7): 677-679.

［6］杨军，李成荣，祖莹，王国兵，李永柏. 调节性T细胞在儿童过敏性紫癜发病机制中的作用初探［J］.中华儿科杂志, 2006, 44(6): 411-414.

［7］孙大庆, 张秋业, 董增义, 白枫. 过敏性紫癜病儿树突细胞分泌白细胞介素12水平与TH1/TH2的变化［J］. 中国当代儿科杂志, 2006, 8(4): 307-310.

［8］许自川，曾雪琪，党西强，何小解. Thl/Th2迁移与紫癜性肾炎的研究进展［J］. 国际病理科学与临床杂志, 2007, 27(1): 64-67.

［9］曾雪琪, 许自川, 党西强, 何小解, 易著文. 血管内皮生长因子与紫癜性肾炎肾间质微血管损伤的关系［J］. 中国当代儿科杂志, 2009, 11(9): 717-721.

［10］张建江，易著文，何小解，杨华彬，丁娟娟，莫双红. 紫癜性肾炎患儿肾间质血管损害与临床的关系［J］.实用儿科临床杂志,2006,21(8):487-489.

［11］Kaneyama T, Kobayashi S, Aoyagi D, Ehara T. Tranilast modulates fibrosis, epithelial-mesenchymal transition and peritubular capillary injury in unilateral ureteral obstruction rats［J］. Pathology, 2010, 42(6): 564-573.

［12］Kang DH, Kanellis J, Hugo C, Truong L, Anderson S, Kerjaschki D, et al. Role of The microvascular endothelium in progressive renal disease［J］. J Am Soc Nephrol, 2002, 13(3): 806-816.

［13］Wu L, Tiwari MM, Messer KJ, Holthoff JH, Gokden N, Brock RW, et al. Peritubular capillary dysfunction and renal tubular epithelial cell stress following lipopolysaccharide administration in mice［J］. Am J Physiol Renal Physiol, 2007, 292(1): F261-F268.

［14］Ohashi R, Kitamura H, Yamanaka N. Peritubular capillary injury during the progression of experimental glomerulonephritis in rats［J］. J Am Soc Nephrol, 2000, 11(1): 47-56.

［15］中华医学会儿科学分会肾脏病学组.小儿肾小球疾病的临床分类、诊断及治疗［J］.中华儿科杂志, 2001, 39(12):746-749.

［16］Mosmann TR, Coffman Rl. TH1 and TH2 cells: different patterns of lymphokine secretion lead to different functional properties［J］.Annu Rev Immunol, 1989, 7: 145-173.

［17］Yano T, Tanikawa S, Fujie T, Masutani M, Horie T. Vascular endothelial growth factor expression and neovascularisation in non-small cell lung cancer［J］. Eur J Cancer, 2000, 36(5): 601-609.

［18］Weidner N. Tumoural vascularity as a prognostic in cancer patients: the evidence continues to grow［J］. J Pathol, 1998, 184(2):119-122.

［19］吴杰，陈香美，师锁柱. 血管病变在1005例IgA肾病中的意义及其影响因素［J］. 中华医学杂志, 2003，83（4）: 289-293.

［20］解德琼，甘华，杜晓刚，李正荣，巫江.终末期肾病患者Th1/Th2型细胞因子的特征与外周血T细胞凋亡的关系［J］.细胞与分子免疫学杂志， 2006， 22（6）：763-766.