| Objective: Ig A nephropathy is the most common primary glomerulon ephritis,it is due to abnormal glycosylation of Ig A1 polymerization, or for ming polymers with Ig G to deposition in the glomerular mesangium, and t hen induced renal inflammation, immune response.The pathological change s in Ig A nephropathy were mesangial cell and matrix proliferation,its was the basic organization change. The pathogenesis of glomerular mesangial proliferation is not yet very clear. Multiple damage factors and harmful su bstances can promote the proliferation of mesangial cell,including the acti vation of immune complex, complement components,lipopolysaccharide, a v ariety of cytokines, vasoactive substances,biological activity,low density li poprotein and cell matrix components etc.Interleukin-17(interleukin-17, IL-17),with is rencent year found and is secreted by Th17 cells, is a proinf lammatory cytokine, and it can promote the secretion of chemokines,recrui te inflammatory cells,inflammatory reaction and expand, resistance to path ogen infection.IL-17 play a key role in the induction of mucosal immunit y and autoimmune diseases.The family members including(IL-17A~F), IL-17A(IL-17) is currently attention by researchers of the members. Interleuki n-23(interleukin-23,IL-23) is a new member of IL-12 family cytokines het erologous dimerization,IL-23 receptors including the IL-12 receptor β1(IL-12Rβ1) and the IL-23 receptor 2 subunit.IL-23 mainly play a proinflammat ory cytokine role,with effects of the immune response,also has the potenti al of antiinfection and antitumor effects, and also plays an very importantrole in the formation and development model of some inflammatory auto immune disease.Previous studies have confirmed that IL-23 can promote T h17 cell differentiation, proliferation, further promote the secretion of IL-17,these results indicate that IL-23/IL-17 pathway has a role in the pathogenesis of some autoimmune diseases. This project aims to detect IL-17 and IL-23 content in serum of patients with different clinical and pathologica l levels in Ig A nephropathy, Ig A nephropathy and the analysis of the relati onship between the two, to explore the role of them in Ig A nephropath y mesangial proliferation and mechanism.Methods: The study patients seclet from the department of nephrol ogy,the second hospital of Hebei Medical University.from 2013 October to2014 August,and diagnosed by renal biopsy in 40 cases of Ig A nephropat hy patients(mean age 36.1+13years old,male 22 and female 18), excludin g secondary purpura nephritis, lupus nephritis, the tumor, blood system dise ases, liver diseases of kidney disease. All patients were informed consen t, and nearly 3 months without the use of glucocorticoid, cytotoxic drugs o r immunosuppressive agents; no recent history of infection or special mate rial allergy history; no autoimmune disease, viral hepatitis, malignant tumo r, thyroid disease history; no metal contact history; but steroidal the anti-infl ammatory drug application history. According to the 2009 Oxford classific ation, grouped by mesangial average integral: M0 integral average is less th an or equal to 0.5, the average M1 integral > 0.5. Ig A nephropathy were devided into three pathological groups by Oxford classification of Ig A n ephropathy in 2009(mild pathological change group T0 0%~25%;moder ate pathological change group T1 26%~50%;severe pathological change group T2>50%).Normal control group of 8 patients(mean age 34.9 + 9 years old, male 3 and female 5). Using enzyme linked immunosorbent as say(ELISA) testing serum IL-17 and IL-23 concentration. Record the ge neral condition of the patient and related clinical indexes, sex, age, 24 ho urs urine protein(24Upro), serum creatinine(Scr), systolic blood pressure(S BP), diastolic blood pressure(DBP) and other clinical indicators for analysi s. All states analyses were performed using Statistical package for socia l sciences(SPSS) 19.0 for Windows. Continuous variabes are expressed as mean±standard, comparison between the groups using variance ANOV A,homogeneity of variance using non parametric test.Results:1 The clinical data: the age,sex, diastolic pressure have no significant difference(P>0.05); group M1 is higher than M0 and control group on s ystolic blood pressure(P<0.05); the experiment group’s glomerular filtrati on rate lower than the control group(P<0.05); group M1 urinary protein q uantitative compared with M0 group,have no statistical learn the differenc e(P>0.05). Grouped by interstitial fibrosis: The age, sex, diastolic and s ystolic blood pressure, had no statistical difference(P>0.05); Glomerular filtration rate with aggravating the degree of interstitial fibrosis reduced(P<0.05); Urine protein quantitative no statistical difference between gro ups(P>0.05).2 The level of serum IL-17 increased gradually tend to anemia wors ens.The difference was statistically significant(P<0.05); The level of seru m IL-17 fibrosis is aggravating gradually increases,the difference was sta tistically significant(P<0.05);the level of serum IL-23 among the three gr oups had no statistical significance(P>0.05).3 Correlation analysis of serum IL-17 with IL-23: serum IL-17 was positively correlated with IL-23(r=0.433, P<0.05).4 Correlation analysis of serum IL-17 and IL-23 with the clinical va rious indicators: the level of serum IL-17 and systolic pressure, diastolic pressure, 24 hours urine protein were positively correlated; the level of se rum IL-23 positively correlated with systolic blood pressure.Conclusion:1 In Ig A nephropathy, the level of IL-17 in serum gradually increas ed along with the aggravation of mesangial proliferation and renal intersti tial fibrosis.At the same time,24UPro、e GFR gradually increased also.Sug gesting that IL-17 is involved in the progression of Ig A nephropathy an d its level in the serum can response to the disease severity.2 The level of serum IL-23 was positively correlated with the level o f serum IL-17, IL-23 and 24 hour urinary protein quantitative and glomerular filtration rate had no correlation. The normal control group and Ig A n ephropathy serum level of IL-23 was no significant difference, suggesting that IL-23 in the IL-17 generation, and not directly involved in the dev elopment of Ig A nephropathy. |
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