The Clinical Significance Of Measurement Of Serum IL-33 And Tim-1 In Children With Henoch-Schonlein Purpura And Henoch-Schonlein Purpura Nephritis

Background Henoch-Schonlein purpura (HSP) is a systemic and nonthrombocytopenic vasculitis affecting small vessels in children. Its main clinical features include cutaneous purpura, arthritis and gastrointestinal symptoms. The long term prognosis depends on the presence and severity of the nephritis. Although the cause is unknown, a lot of researches have shown that humoral and cellular immune function disorder plays a pivotal role in the immunopathogenesis of HSP and Henoch - Schonlein purpura nephritis (HSPN). Increased secretion of inflammatory mediators mediated systemic small vasculitis. The imbalance of helper T cells (Th) subgroup (Th1/Th2) was observed in the pathogenesis of HSP. Meanwhile, cytokines participate in the progression of systemic small vasculitis mediated by inflammatory mediators. Interleukin-33 (IL - 33) combined with ST2 can activate downstream signaling pathways, promote Th2 cells immune response, and rise to adjust the immune response. T-cell immunoglobulin domain and mucin domain protein-1 (Tim-1) mainly expressed in differential Th2 cells, can induces the activation and proliferation of Th2, promotes release of cytokines, and stimulates the Th2 immune response. This study aims to observe the correlation between IL-33 and Tim-1 by measuring the levels of serum IL-33 and Tim-1 at acute stage and convalescent children with HSP and HSPN, respectively. All patients were followed up for 6 months and frequency and severity of renal involvement will be described. The new and beneficial therapeutic target will be suggested based on the role of IL-33 and Tim-1 in the pathogenesis of HSP and HSPN.Objective To discuss the role of IL-33 and Tim-1 in the pathogenesis of HSP and HSPN via measurement of the levels of serum IL-33 and Tim-1 and analysis of the correlation among cytokines (IL-33 and Tim-1), different clinical manifestations and laboratory indexes.Methods Serum IL-33 and Tim-1 were determined in acute stage and convalescent phase children with HSP (n=20) and HSPN (n=20) by double antibody sandwich enzyme-linked adsorption test (ELISA). And 20 healthy children from outpatient were included as control groups. All patients were followed up for 6 months, The statistics analysis was conformed for data from all groups.Results The levels of serum IL-33 and Tim-1 in HSP patients and HSPN patients with acute stage were significantly higher than that of healthy children (P<0.01). And the levels of two factors (IL-33 and Tim-1) in HSPN children were significantly higher than that of HSP group (P<0.01). However, the levels of serum IL-33 and Tim-1 at convalescent phase in HSP patients and HSPN patients were markedly decreased (P<0.01), but still higher than that of healthy children (P<0.01). Compared with normal healthy children, the contents of serum IL-33 and Tim-1 in slight urine abnormal and active nephritis children were higher after following up (P<0.01).Conclusions The levels of serum IL-33 and Tim-1 can reflect the clinical severity and prognosis of HSP and HSPN in children, and the two factors associated with the activity of HSP and HSPN. Therefore, measurement of serum IL-33 and Tim-1 will be beneficial to evaluate the progression and prognosis of HSP and HSPN.