| Objective: Henoch-Schonlein purpura(HSP) is a kind of small-sized blood vessel vasculitis, mediated by immune complex small-sized blood vessel vasculitis, Which is the most common diseases in children. And it involves kidney easily, called Henoch-Schonlein purpura nephritis(HSPN). Renal injury is an important factor of influence the late prognosis of disease. But its specific pathogenesis is not clear at present, a large of researches think that the pathogenesis of HSP and HSPN related with humoral and cellular immune abnormalities, the change of gene polymorphism, coagulation and fibrinolytic disorders and so on. The cellular immune abnormality is T lymphocyte subsets disorder. In the pathogenetic process of HSP, Th1 /Th2 imbalance, resulting in abnormal secretion of cytokines, can promote the development of HSP and HSPN. Interleukin-33 is a newly discovered cytokines which has a dual action of pro-inflammatory and anti-inflammatory cytokine. Interleukin-33 plays an important role in a variety of inflammatory diseases and autoimmune disease. Interleukin-6 is the core of the inflammatory response factor, participating in a variety of inflammatory reaction. HSP is an autoimmune vasculitis, this study investigate the level variation of acute stage and recovery of serum IL-33 and IL-6 in children with Henoch-Schonlein purpura. We analyse the correlation of both. Then we can explore the pathogenesis of HSP furtherly.Methods:1 The object of study : Selected 50 cases of newly diagnosed Henoch Schonlein purpura children hospitalized children in Nephroloy and Immunol--ogy departmant Children’s Hospital of Hebei Province from April 2014 to July 2014.Among them, 29 cases are male and 21 cases are female, aged(3-12) years old. The average age is(7.0±2.9) years old. We ruled out other autoimmune disease and history of allergic disease. The clinical diagnosis of HSP is based on the "Zhu Fu Tang practical pediatrics" diagnostic criteria; HSPN clinical diagnosis is based on the criteria defined by the Chinese medical association branch of kidney disease of Pediatrics.2 Experimental group(1)Henoch-Schonlein purpura group: The acute phase that all of them were the first onset, and not use any glucocorticoid and immunosuppressants within one week and exclud previous autoimmune diseases or allergic disease history; The convalescence stage that skin purpura, abdominal pain, limb swelling and pain and other clinical manifestation were disapqear. Children with kidney lesion stopped the medicine for more than 2 weeks.NHSPN group and HSPN group: children in the group were closely follow-up six months. They were devided into NHSPN group and HSPN group. Whose kidney was involved were HSPN group, the other were non-HSPN group.(2)Control group: Recruited same period of 20 healthy children who are examined in Our hospital of Child Health Division. their age is from 3 to13 years old, and excluded previous autoimmune disease and allergic disease history.3 Detection indicators and experimental methods: we detected serum IL-33, IL-6 levels of two groups children in acute and convalescent, using the double antibody sandwich ABC-ELISA method. The operating procedures were according to kit instructions strictly. At the same time, analysis the correlation of IL-33 and IL-6. The data were analyzed. By SPSS17.0 software.The data is non normal distribution, levels of cytokines are expressed by the madian and four quartile range. The comparison between groups used Wilcoxon rank sum test and the related analysis use the Spearman correlation analysis. The two-tailed P value is considered significant difference, when the two-tailed P value is <0.05.Results:1 The concentration serum IL-33 [561.66(364.39, 812.49) pg·m L-1] in acute phase of Henoch-Schonlein purpura is significantly higher than the convalescence IL-33 [240.57(167.86, 390.31) pg·m L-1] and healthy control group IL-33 [170.34(125.20, 219.67) pg·m L-1](P<0.01).2 The concentration serum IL-6 [48.81(29.52, 75.58) pg·m L-1] in acute phase of Henoch-Schonlein purpura is significantly higher than the convalescence IL-6[16.66(10.13, 37.40) pg·m L-1] and healthy control group IL-6 [13.51(6.56, 24.88) pg·m L-1](P<0.01).3 The serum IL-33 level is significantly higher in HSPN group than NHSPN group(857.83(393.48, 1034.22) vs 516.37(357.44, 680.89) pg·m L-1, P <0.05), at the acute phase of HSP. There is no difference about the serum IL-6 between the convalescence and the healthy control group.4 The serum IL-6 level is significantly higher in HSPN group than NHSPN group(85.04(53.33, 97.66) vs 35.57(26.06, 59.31) pg·m L-1, P <0.01), at the acute phase of HSP. There is no difference about the serum IL-6 between the convalescence and the healthy control group.5 The correlation analysis of serum IL-33 and IL-6 in childhood in acute phase of Henoch-Schonlein purpura display(r=0.321, P<0.05), which exlpains that there is correlation between IL-33 and IL-6.Conclusion:The research data show: the level of IL-33 and IL-6 in the acute phase is significantly higher than that in healthy control group. It shows that the two are involved the pathogenesis of HSP; And these two values are higher in HSPN group than NHSPN group,which indicates explains that the higher level of IL33 and IL-6, the more esaly involve renal. the formation of Henoch Schonlein purpura nephritis; The correlation analysis between IL-33 and IL-6 showed that there is a correlation between the two, which suggests that IL-33 may through some immune process to regulate the release of IL-6. |
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