Detection And Significance Of Level IL-34?IL-6?TNF-? In Serum Of Patients With Henoch-sch(?)nlein Purpura

Background and significance Henoch-Sch(?)nlein purpura(HSP)is one of the most common form of leukocytoclastic vasculitis disease.but up to now the precise pathogenesis remains unclear.A large number of studies have shown that genetic susceptibility and environmental factors are all involved in the pathogenesis of HSP,especially immune dysfunction.Studies have shown that Tumor necrosis factor-?(TNF-?)and Interleukin-6(IL-6)are involved in the pathogenesis of HSP,while its involvement in the pathogenesis of HSPN is still under debate.IL-34,a cytokine which was discovered in recent years,has been reported to be involved in the differentiation,proliferation,and survival of monocyte-macrophages,inflammation responses and immune tolerance.IL-34 plays an important role in the pathogenesis of multiple diseases,especially inflammatory diseases.HSP is an autoimmune vasculitis.However,whether IL-34 is involved in the immunopathogenic process of HSP is still unexplored.In the present study,we tended to explore whether and how IL-34,IL-6,TNF-? play a role in the pathogenesis of HSP/HSPN,We assessed the serum levels of IL-34,IL-6,TNF-? of 38 patients in acute phase of Henoch-Sch(?)nlein purpura and investigated the correlations of the expression level of IL-34 with clinical feature,IL-6 and TNF-?,in order to further explore the significance of IL-34 in the pathogenesis of HSP.Methods 1.Research Subjects and grouping Thirty-eight newly-diagnosed HSP patients from November 2015 to March 2016 in the departments of pediatrics and hematology were recruited and divided into two groups according to the symptoms of hematuria and proteinuria(Referring to the Chinese Medical Association Pediatric Branch of the Department of Nephrology developed HSPN diagnostic criteria)): HSPN(11 cases)and NHSPN group(27 cases).NHSPN group includes general HSP(16 cases),abdominal HSP(7 cases)and arthritis HSP(4 cases).At the same time,21 healthy volunteers in the health examination center of our hospital were recruited as control(allergy,autoimmune disease and recent history of infection were excluded).Detection of indicators and methods.2.Assessment of parameters and methods Serum levels of IL-34 and TNF-? were measured using enzyme-linked immunosorbent assay(ELISA).Serum IL-6 levels were determined by chemiluminescent enzyme immunoassay.hs-CRP levels were assayed using particle-enhanced turbidimetric immunoassay.Levels of Ig A,Ig G,Ig E and Ig M were measured by Turbidimetric inhibition immuno assay.Peripheral blood of subjects was taken for examination.3ml fasting peripheral venous blood of subjects was taken with sodium citrate anticoagulant tube,followed by immediate separation of plasma by centrifugation at 3000 round per minute for 15 min.The plasma was collected in EP tubes and stored in a-80�C refrigerator.Another 2 ml of blood was taken in biochemical tubes.3.Statistical analysis Data were evaluated using the SPSS16.0 statistical software.Shapiro�Wilktest was applied in normal distribution of data.Normally distributed data were expressed as mean � standard deviation(?x � s),skewness distribution data were expressed as median with quartile range [M(P25 ~ P75)].Differences between two groups were assessed using Kruskal-Wails test or T-test.Correlation analysis between parameters were performed using the Pearson's correlation analysis or Pearson correlation analysis.P< 0.05 was considered statistically significant.Results 1.The serum level of IL-34 in acute HSP patients was significantly higher as compared to control [174.96(84.01~416.70)pg/ml vs 59.11(42.79~104.45)pg/ml,P<0.001].2.The serum level of IL-6 in acute HSP patients was significantly higher as compared to control [16.70(7.93~23.35)pg/ml vs 3.41(3.11~5.54)pg/ml,P<0.001].3.The serum level of TNF-? in acute HSP patients was significantly higher as compared to control [248.84(157.32~360.25)pg/ml vs 103.76(60.95~161.15)pg/ml,P=0.007].4.In acute phase,the serum levels of IL-34 and IL-6 have no significant difference between HSPN and NHSPN,while TNF-? in the HSPN group was significantly higher than that in the NHSPN group.[347.06(250.9 ~410.16)pg/ml vs 176.74(147.06~306.94)pg/ml,P=0.009].5.The serum level of IL-34 was positively correlated with that of high sensitive C-reactive protein(hs-CRP)and IL-6(r=0.453,P=0.004 and r=0.469,P=0.003,respectively).Conclusion 1.The serum levels of IL-34,IL-6 and TNF-? in HSP patients are significantly higher than that of healthy controls.IL-34,IL-6 and TNF-? might be involved in the pathogenesis of HSP.2.In HSP,the IL-34 might plays a proinflammatory effect.3.In HSP,the TNF-? might correlates with the HSP nephritis.Which suggests that TNF-? can be a candidate biomarker for HSP nephritis.