T Lymphocyte Subset Populations In Adults With Primary Nephrotic Syndrome

Objective: To investigate the change of T lymphocyte subset in adults with PrimaryNephrotic Syndrome. Discuse the immunopathogenesis of adults with Primary NephroticSyndrome.Methods: Thirty-one patients were set as untreated PNS group who just got the disease andnever been treated by glucocorticoid or immunosuppressive drug. The recruitment period was fromAugust 2010 to January 2012. All the patients got the percutaneous renal puncture biopsy, and theselection of the renal pathology was MCD, MsPGN, IgAN, or FSGS. The blood sample was gotbefore treatment, then all the patients were under the treatment of Prednisone (1mg/kg/d). And theblood sample was taken again eight weeks later. According to urine protein effect and clinicalremission of symptoms, patients were divided into group SSNS and group SRNS. Fifteen peoplewicth came for health examination in the same period were set as control group. For PNS groupand control group ,there was no evidence of Vital organs diseases, infection, autoimmune diseasesand malignant tumor. Testing item: CD3~+CD4~+、CD3~+CD8~+、CD4~+CD25hiCD127lolymphocyte inperipheral blood were detected by flow cytometry.Results:1. Befor treatment: CD3~+CD4~+lymphocyte was reduced both in group SSNS and groupSRNS which compared with control group, while CD3~+CD8~+lymphocyte was increased but withno significant differences. CD4/CD8 was reduced when compared with control group, and thedifference reached statistical significance.2. After treatment: CD3~+CD4~+lymphocyte reduced further both in group SSNS and groupSRNS. CD3~+CD8~+lymphocyte was reduced in group SSNS which compared with relapse andcontrol group. Compared with before treatment and control group, CD3~+CD8~+lymphocyte was reduced too in group SRNS but with no significant differences. CD4/ CD8 were increased thanrelapse in group SSNS, compared with control group the differences were not statisticallysignificant. CD4/ CD8 showed no change compared with before treatment in group SRNS.3. Before treatment: CD4~+CD25hiCD127lolymphocyte decreased slightly in group SSNS,while slightly increased in group SRNS. Compared with control group, all the differences did notreached statistical significance.4. After treatment: CD4~+CD25hiCD127lolymphocyte was increased in group SSNS.Compared with relapse, the difference reached statistical significance. CD4~+CD25hiCD127lolymphocyte was slightly increased in group SRNS but with no significant differences neithercompared with before treatment nor compared with control group.Conclusion:1. In patients with PNS, peripheral blood CD3~+CD4~+lymphocyte and CD4/CD8 werereduced. After treatment, CD4/CD8 was recovery in group SSNS, while in group SRNS,.it showedno changed. It indicated the imbalance of T lymphocyte subset may play a role in adults with PNS.2. The increased of CD4~+CD25hiCD127lolymphocyte in group SSNS after treatmentindicated the regulatory T cells may play an important role in remissions of adults with PNS.