The Changes Of IL-23, IL-15Levels In The Serum Of Patients With Henoch-Schonlein Purpura And Their Significance

Objective：Henoch-Schonlein purpura (HSP) is a common systemicvasculitis of the small vesssel.The major clinical characteristics of this diseaseare cutaneous purpura,abdominal pain,hematochezia， arthralgias andproteinuria.It influence the quality of patient’s life because that it oftenrepeated.The patients of HSP exhibit immune dysfunction, increased ininflammatory reaction medium, antigen-antibody complex deposition underthe action of heredity, infection, allergens and so on. And the resulting damagewas the inflammation of capillaries and small blood vessels, leading to avariety of clinical symptoms of HSP.The pathological basis of HSP isextensive inflammation of small blood vessels.HSP can involve not only thecapillaries but also small arteries and small veins.The pathogenesis of HSPinvolves many aspects,but the main pathogenesis is vasculitis that mediatedby the immune responseis,especially T lymphocyte subsets dysfunction in theimmune response and inflammation plays an important role in the process.Thestudy showed that there was imbalance of Th1/Th2in HSP patients,and thefunction of Th2relatively prevailed over Th1.As the development of researchfor CD4+T cells,the simple theory of Th1/Th2balance can not explain thepathogenesis of HSP fully.In recent years, domestic and international researchhas shown that the levels of Th17cells and IL-17in patients with HSP areraised,which demonstrated Th17cells and IL-17involved in the pathogenesisof HSP and play an important role.Th17cells can secrete IL-17and theprocess need the IL-23, and IL-23is an important survival factor for Th17cells,can induce the development of Th17cells and promote the secretion ofIL-17.IL-23can also promote the secretion of IL-6, IL-8,TNF and otherchronic inflammation factor.So IL-23has an important role in autoimmunediseases.After the maturation of Th17cells under the action of TGF-β and IL-6,its cellular homeostasis, amplification and the release of intracellularIL-17mainly under the regulation of IL-15and IL-23.IL-15has the functionof maintenance on memory T cells, so IL-15-IL-17axis has an importantinfluence in chronic inflammation.There are many articles has been reportedthat serum level of IL-15was significantly up-regulated in the patients ofinflammatory bowel disease, multiple sclerosis,systemic lupus erythematosusand vasculitis with renal impaired.But the relationship between IL-15andHSP need more investigation.We detect the expression level of interleukin-23(IL-23) andinterleukin-15(IL-15) in blood serum of HSP, compared with healthy controlsubjects, In order to investigate the correlation between the expression of IL-23, IL-15and the pathogenesis of HSP.To provide a theoretical basis forstudy the pathogenesis of HSP.Methods:The case group involved30typical HSP patients who werechoosed from January2013to June2013in dermatologist out-patient serviceof the second hospital of Hebei Medical University.Select standard;1. Patientswith allergic purpura had typical skin lesions （none of stomachachearthrodynia and kidney damage）and the blood platelet count are normal;2.Notaccompanied with autoimmune diseases,no coagulation disease history;3.Notused glucocorticoid and immunosuppressant or other drugs that affect theimmune function of the body within1month before the test．The case groupconsist of14males and16emales, age range8~27years old, average age was16.57±4.06years old,20cases who were from our health medical staff wasnormal control group. the group consisted of9males and11emales, age range12to28years old, average age was18.05±3.59years old,Through t-test,sexand age had no significant differences with the case group. Adopted elbowvein blood2ml, centrifugated samples with3000revolutions per minute for20minutes. Then the serum samples were frozen at-70℃in the refrigeratorof preservation. Application of double antibody sandwich-type enzyme-linkedimmunosorbent assay (ELISA) detected the expression level of IL-23andIL-15in blood serum,The statistical data was carried out by SPSS19.0 software, The statistical data of IL-23showed normal distribution by the testof normality, so we used two independent sample t-test,The statistical data ofIL-15showed skewness distribution by the test of normality, so we used twoindependent sample Wilcoxon signed-rank test, results describedwith median(quartile rang), for the expressed level of IL-23and IL-15in serum, weanalyzed betweent the case group and the normal control group, P<0.05hadstatistical significance.Result: The result of enzyme-linked immunosorbent assay was showed,the expression level of IL-23in HSP patients serum was (70.66±28.84),thenormal control group was(52.31±29.08),the expression level of IL-23in HSPpatients serum was higher than that in the normal control group (t=2.197P=0.033P<0.05), the difference was statistically significant;the expressionlevel of IL-15in HSP patients serum was M(QR)=16.09(16.59),the normalcontrol group was M(QR)=7.35(6.49),the expression level of IL-15in HSPpatients serum was higher than that in the normal control group (u=-3.456P=0.001P<0.05), the difference was statistically significant.Conclusion:1The expression level of IL-23in the serum of HSP group was higher thanthat in the normal control group.IL-23participated in the process of HSP,confirmed the expression of IL-23has correlation with the pathogenesisof HSP closely.The results may have important significance for thetreatment of HSP.2The expression level of IL-15in the serum of HSP group was higher thanthat in the normal control group.IL-15participated in the process of HSP,confirmed the expression of IL-15has correlation with the pathogenesisof HSP closely.The results may have important significance for thetreatment of HSP.