| Objective:Our research is aimed to detect the changes of serum Ig A1?Gd-Ig A1(galactose-deficient Ig A1)?IL-4(interleukin 4)?IL-6(interleukin 6)and BAFF(B cell-activation factor)levels between children who are involved with HSP(Henoch-Sch?nlein purpura)in acute stage and healthy children;To explore the role of serum Ig A1,especially galactose-deficient Ig A1,playin the pathogenesis of HSP;to investigate the correlation among serum galactose-deficient Ig A1,IL-4,IL-6 and B cell activation factor(BAFF)levels in children with HSP,In other words,exploring what role of IL-4,IL-6 and BAFF play on the generation mechanism of galactose deficient Ig A1 in HSP;to probe into interrelationship among galactose-deficient Ig A1,Ig A1,different kinds of cytokine such as IL-4,IL-6,BAFF,and analyse the correlation between serum galactose-deficient Ig A1 ?Ig A1? IL-4?IL-6 ?BAFF levels and varied clinical manifestation in HSP;finally,What we hope is our research could provide some experimental date for the further recognition of how the galactose-deficient Ig A1 produced and how to take part in the pathogenesis of HSP;menwhile,providing new ideas and new strategies for the treatment of HSP.Methods : children who were involved with HSP at acute stage and admitted in our hospital from June 2015 to October 2016 were enrolled in this study as HSP group,and all of them are divided into four groups according to different clinical manifestation.Including general HSP group(20 cases),Joint type HSP group(19 cases),mixed type HSP group(15cases),HSP nephritis group(22cases).40 cases of healthy Children undergoing physical examination in our hospital were simultaneously taken as the control group.The serum level of galactose-deficient Ig A1 were measured bysandwich ELISA using the vicia villosa lectin(VVL).meanwhile,serum levels of Ig A1?IL-4?IL-6 and BAFF were detected by ELISA.Results: 1.The serum levels of Ig A1(2.64 ± 0.69g/L),galactose-deficient Ig A1(0.20 ± 0.06),IL-4(45.07 ± 7.71pg/ml),IL-6(72.94 ± 15.07pg/ml),BAFF(797.03±0.02 pg/ml)in acute stage of HSP were higher than the serum levels of Ig A1(1.81±0.18g/L),galactose-deficient Ig A1(0.13±0.02),IL-4(22.12±2.17pg/ml,IL-6(29.37±2.91pg/ml),BAFF(392.65±35.78pg/ml)in control group,the serum levels of different kinds of cytokine such as IL-4,IL-6,BAFF between two groups showed Statistical difference(P <0.01).2.The serum levels of Ig A1,Gd-Ig A1,IL-4,IL-6,BAFF in different type group of HSP had remarkable differernce.(P <0.01),especially,the nephritis HSP group were highest when compared with the other groups of HSP,no matter to the serum Ig A1(3.454 ±0.680g/L),galactose-deficient Ig A1(0.26 ±0.05),IL-4(54.54 ± 2.74 pg/ml),IL-6(88.30 ± 12.57pg/ml)levels or the serum BAFF(1176.17±309.66pg/ml)level,in addition,the difference could not be ignored(P<0.01);serum Ig A1(2.76 ± 0.19g/L),galactose-deficient Ig A1(0.21± 0.05),IL-4(48.75±1.39pg/ml),BAFF(800.25±53.06 pg/ml)levels of mixed HSP group were higher than that of joint type HSP group and general type HSP group,and the serum levels of different cytokines in nephritis HSP group had shown significant difference from the other groups(P<0.01);compared serum Ig A1(2.16±0.21g/L),galactose-deficient Ig A1(0.16±0.02),IL-4(39.02± 3.24pg/ml),BAFF(574.40±69.92pg/ml)levels of joint type HSP group with serum Ig A1(2.13±0.20g/L),galactose-deficient Ig A1(0.16±0.02),IL-4(37.66±2.18 pg/ml)and BAFF(589.06±71.76 pg/ml)levels of general type HSP group,There were no significant difference(P > 0.05).However,the serum IL-6(70.03±15.07pg/ml)levels of the mixed type HSP group did not show statistical difference from those of the joint HSP group(IL-6,70.11±11.48pg/ml)and the general type HSP group(IL-6,68.23±14.94pg/ml)(P > 0.05);at the same time,when compared the serum IL-6 level of the joint HSP group(IL-6,70.11±11.48pg/ml)with the serum IL-6 level of general type HSP group(IL-6,68.23±14.94pg/ml),there did not exist difference(P > 0.05).3.The serum levels of Ig A1,IL-4,IL-6 and BAFF in children involved with different clinical manifestation of HSP were significantly higher than the control group,and the serum levels of those cytokines were positively correlated with the expression levels of serum galactose-deficient Ig A1.The correlation coefficients were 0.72(P <0.01)?0.77(P <0.01)?0.61(P <0.01)?0.70(P <0.01),respectively.Conclusion:1.compared with the control group,children with HSP shows higher serum levels of Ig A1,which is dominated by Gd-Ig A1,suggesting that Ig A1,especially Gd-Ig A1,plays an important role in the pathogenesis of HSP.2.the serum levels of Ig A1?IL-4?IL-6 and BAFF significantly increased in the acute stage of HSP,and they are positively correlated with the serum Gd-Ig A1 expression levels,which suggest that Ig A1?IL-4?IL-6 and BAFF are involved in the pathogenesis of HSP and the generation of Gd-Ig A1,besides,Gd-Ig A1 and the four cytokines interact as both cause and effect.3.The serum levels of Ig A1,Gd-Ig A1,IL-4,IL-6 and BAFF in different clinical types of HSP have significantly difference,suggesting that the varition of serum Ig A1,Gd-Ig A1,IL-4,IL-6 and BAFF levels in children with HSP are related to the different clinical characteristics and varied degrees of organ involvement. |
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