The Role Of CD28/B7-1 Signal In Children With Nephrotic Syndrome

Background:CD28/B7-1 is a pair of critically important molecules involved in the body,s specific immunity response. CD28 mainly exists in the surface of T lymphocytes. As one of the ligands of CD28, B7-1 can be expressed in the podocyte of kidney. Preliminary studies have shown that B7-1 may expressed on the injured podocyte, which in turn participates in the immunopathological process of nephrotic syndrome, especially in minimal change nephropathy. Recently there are many related research and achievements based on animal experiment and some clinical trials. By intervening CD28/B7-1 signal to cure nephrotic syndrome,it will provide new target for the treatment of nephrotic syndrome in children.Objectives: To explore the role of CD28/B7-1 molecule by studying the CD28/B7-1 molecule level on the lymphocyte surface and serum during the different stages of nephritic syndrome in children.Methods: To detect the percentage of peripheral blood cell membrane CD28 and B7-1 signal with the method of flow cytometry; measure the soluble CD28 and B7-1 molecule level of serum and urine with the method of ELISA, gather these clinical statistical data to analyse the internal relationship among them.Results: 1. The result of flow cytometry shows that CD3+CD28+ and CD3+CD8+CD28+ and CD19+CD80+ expressed with higher levels during the relapse stage of nephritic syndrome than remission and healthy control group(P<0.05).2. The soluble CD28/B7-1 molecule level of serum and urine rose during the attack stage(P<0.05).3. In compared with healthy control group, there is no obvious difference in peripheral blood CD3+ lymphocytes(P>0.05), CD8+T cells increased and CD4+T cells decreased, CD19+ B cells elevated in child with nephrotic syndrome.Conclusions: CD28/B7-1 signal involved in the process of pediatric nephrotic syndrome, together with the Disturbance of cellular immunity which is mediated by T lymphocyte and B lymphocyte. Further researches were need to study the roles of CD28/B7-1 signals on T lymphocytes and B lymphocytes and podocyte. All these will explain the pathogenesis of nephrotic syndrome in Children with nephrotic syndrome further.