| Objective:To investigate the relation of aberrant glycosylation of IgA1andhepatocyte growth factor(HGF) to different stage and visceral organ injure inchildren Hen ch-Sch nlein purpura(HSP) through detecting the concentration of inserum of in children HSP in acute-stage and remittent-stage，and observing theexpression of IgA,IgA1,HGF in gastrointestinal tract and renal.To comprehensiveanalysis those two factors’ effect on the pathogenesis of HSP,and to provide newideas for clinical diagnosis,differential diagnosis,remedy of HSP.Methods:1.72children with HSP in nitialdose happen symptom and at acute stagewho were in Nephrology department of Children Hospital from2011Jul to2012Nov,were enrolled in the study.The diagnosis of HSP was made according to theEuropean League against Rheumatism criteria in2005.None of patients had seriousinfection,severe disease of heart,kidney and blood system，received glucocoritcoidsand immunosuppressants.According to the clinical manifestation,all patients were classified into8groups:simple group(20children),abdominal group(20children),Hen ch-Sch nleinpurpura nephrology(HSPN)(20children),gastrointestinal tract hemorrhage group(20children),and the other groups were72children at remittent stage throughthe treatment;20children in acute gastroenteritis or peptic ulcer and to20he-althy children were divided into control group.The gastric mucosa of HSP(20children) were experimental group,non-HSP gastroenteritis(20children) and sto-mach neoplasm’s(4children) gastric mucosa were control group;meanwhile thekidney tissue of HSP(40children) were experimental group,and renal carcino-ma’s(10children) kidney tissue were control group.To detect the concentration of aberrant glycosylation of IgA1and HGF inserum of four HSP groups and controll gourps at the acute stage and the remittent stage through IgAl-Vicia Villosa Lectin hinge method and enzyme-labeledimmunosorbent assay method,and with immunohistochemistry method to observethe expression of IgA,IgA1,HGF in gastrointestinal tract and renal,in addition useindirect immunofluorescence to investigate the express of IgA1in renal.Results:1.The concentration of aberrant glycosylation of IgA1in serum(mg/L):at acutestage,compare with simple group(3.38±1.35),abdomina group(3.47±1.59),HSPNgroup(5.06±0.96),gastrointestinal tract hemorrhage group(3.90±1.06),HSPN groupwas all significantly higher than the other three groups,but four HSP groups were allhigher than non-HSP gastroenteritis group(2.53±1.06) and normal control(2.51±0.83)(P<0.05);at remittent stage,simple HSP group(2.45±1.29),abdominalgroup(2.37±1.38),gastrointestinal tract hemorrhage group(2.60±1.00) wereobviously lower than the acute stage,but HSPN group(4.66±1.38)was assame(P>0.05);2.The concentration of HGF in serum(ng/L):at acute stage,simple group(2.86±1.31),abdominal group(2.57±1.90),HSPN group(3.91±0.91),gastrointestinal tracthemorrhage group(3.85±0.71) were obviously higher than normal controlgroup(1.04±0.55),compare with four HSP groups,HSPN group and gastrointestinaltract hemorrhage group were higher than the other two groups,and also higher thannon-HSP gastroenteritis group(2.28±1.26)(P<0.05);at remittent stage,simplegroup(1.21±1.26),abdominal group(1.37±0.87),HSPN group(1.91±0.76),gastrointestinal tract hemorrhage group(1.84±1.24) were obviously lowerthan the acute stage，but HSPN group and gastrointestinal tract hemorrhage groupwere still higher than the other two groups(P<0.05);HSP children’s level of aberrantglycosylation IgA1and HGF were positive correlation(P<0.05);3.Aberrant glycosylation IgA1and HGF in HSP group were significantlyincreased than control group in gastrointestinal tract and renal(P<0.05),and aberrantglycosylation IgA1and HGF in the same tissue were positive correlation(P<0.05).Conclusion:1.The concentration of aberrant glycosylation of IgA1and HGF in serum of allkinds of HSP group obviously higher than non-HSP gastroenteritis group and normal control，however the remittent stage were lower than the acute stage，point out thataberrant glycosylation of IgA1and HGF play the important role in HSP,and thosefactors are maybe the new serum indexes of HSP for diagnosis,differential diagnosiswith other disease;2.The expression of IgA,IgA1were increased in gastrointestinal tract andrenal,and IgA1/IgA were more higher than non-HSP gastroenteritis group,with thelevel of aberrant glycosylation IgA1in serum,point out that aberrant glycosylationIgA1was participation in the process of gastrointestinal tract and renal injury inHSP;as the same,The expression of HGF were increased in gastrointestinal tract andrenal，and was positive correlation with IgA1,point out that HGF may be protect thetissue and antagonism the function of IgA1,in addition those two factors are maybethe new pathological indicators for diagnosis and differential diagnosis of HSP. |
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