Serum Level Of Advanced Oxidation Protein Products (AOPPs) In HSP Patients And The Relationship Among AOPPs,Galactose-deficient IgA1 And Cosmc MRNA

Henoch-Schonlein purpura(HSP)is an systemic vasculitis with IgA1 type immune complex deposition.But the exact etiology and pathogenesis of HSP are still not well known[20].Studies have shown that Oxidative stress,low galactose-deficient IgA1(Gd-Ig Al)and Cosmc(the molecular chaperone of T-synthase),play a key role in the pathogenesis of HSP.But how do they work? May Oxidative stress increase abnormal glycosylation of IgAl and the following kidney toxicity? Such research is seldom.Their is imbalance between Oxidative and antioxidative sysytem in the pathogenesis of HSP in children,and the effect of Oxidative system is more dominant than antioxidative sysytem.The main ingredient of advanced oxidation protein products(AOPPs)is one kind of makers of protein oxidation,whose specififity and sensitivity is good.Camilla's study have shown that the levels of serum AOPPs and Gd-IgAl of IgA nephropathy patients were obviously higher than healthy control group,and were positively correlated.But studies about the effection of AOPPs in the pathogenesis of HSP are seldem now.And there is still no related report.Objective: By detecting the serum level of AOPPs and Gd-IgAl and the expression of Cosmc mRNA in peripheral B lymphocytes from patients with HSP,we try to explore their roles in the pathogenesis of HSP.Methods:1 Research Objects:The cases group include 51 HSP patients that were recruited from the Second Hospital of Hebei Medical University.Among them,27 were male and24 were female,the age was from 8 to 54.The course was a period from 2 days to 2 months.All of them have no allergic or autoimmune diseases,no cancer orother serious systemic diseases.Glucocorticoid,antioxidant and immunosuppressants had not been used within 4 weeks.Both blood platelet count and coagulation function test were normal.According to the diagnostic criteria of HSP which is revised by European rheumatism society in2006[19],patients were divided into 4 groups based on clinical symptoms and laboratory examination:(1)skin type-20 cases;(2)joint type-8 cases;(3)abdominal type-12 cases;(4)kidney type-11 cases.And undertakeing grading by serious degree of symptoms of HSP.18 healthy volunteers healthy donors were enrolled in as control group.2 Research Methods:Serum levels of AOPPs and Gd-IgA1 were quantified by an HAA-lectin-based ELISA.The mRNA of Cosmc expressed in peripheral B lymphocytes from HSP patients and normal controls were measured by RT-PCR.The results were analyzed via statistical software.3 Statistical Analysis:Data were analyzed by statistical software SPSS21.0,statistical difference was considered if P<0.05.Normally distributed data were expressed as mean±standard deviation(x ±s).Median(Interquartile range)[MD(IQR)] was used when data does not comply with the normal distribution.One-way ANOVA was used for comparison of multipole independent samples and the following pairwise comparisons were performed by LSD test.The Spearman's rank correlation coefficient test were applied to assess correlations.Results:1 Serum levels of AOPPs in HSP patients group [67.570(60.80)?mol/L ]were all significantly higher than the normal control [13.890(25.19)?mol/L)U/ml](t'=6.277,P=0.00<0.05).2 Serum levels of AOPPs in different sub-groups of HSP [pure skin type,37.585(28.99)?mol/L;joint type,68.610(67.70)?mol/L;abdominal type,65.710(34.19)?mol/L;kidney type,121.750(139.49)?mol/L] were all significantly higher than the normal control [13.890(25.19)?mol/L](F=23.068,P=0.00<0.05).What's more,the serum AOPPs levels in kidney type was significantly higher than skin type,joint type,and abdominal type(P<0.05),the serum AOPPs levels in skin type was lower than kidney type,joint type and abdominal type(P<0.05),but there were no significantly differences between joint type and abdominal type(P>0.05).3 Spearman correlation analysis:(1)Serum level of AOPPs in HSP patients were positively correlated with Gd-IgAl(the correlation coefficient R=0.876,P<0.05).(2)Serum level of AOPPs in HSP patients were negatively correlated with relative expression value(RQ)of Cosmc mRNA(R=-0.678,P<0.05).(3)Serum level of AOPPs in HSP patients were negatively correlated with the severity score of disease(R=0.796,P<0.05).Conclusions:1 Serum AOPPs level in HSP patients group were higher than the normal control,suggesting that the AOPPs take an important role in the pathogenesis of HSP.2 Compared with other three types of HSP,serum level of AOPPs in kidney type were elevated more obviously.It means that the AOPPs may be involved in renal injury.3 Serum AOPPs level in HSP patients was positively correlated with the severity of the disease,suggesting that AOPPs may be an indicator of the severity of HSP4 Serum level of AOPPs and Gd-IgAl were both elevated in HSP,and they were positively correlated;but serum AOPPs was negatively correlated with the expression of Cosmc,which were decreased.AOPPs and Gd-IgA1 play an important and synergistic role in the pathogenesis of HSP.