The Expression And Significance Of NF-κB And MMP-9 IN Children With Henoch-Schonlein Purpura

ObjectiveHenoch-Schonlein purpura(HSP)is an allergic disease mainly composed of whole body diffuse small blood vessel inflammation.It’s the most common in children.The pathogenesis of the disease is not yet completely clear.Most of them are related to immune disorders and infections.Nuclear transcription factor-κB(NF-κB),as a signaling pathway mediating inflammation,and matrix metalloproteinase-9(MMP-9)as a marker of extracellular matrix damage,are involved in the body’s immune response.This study investigated the expression of both in the blood of anaphylactoid purpura,to explore the possible role of the two in the pathogenesis and disease progression of the disease,also analyzed the relationship between of them in relation to renal injury.It provides clinical value for early diagnosis and treatment of allergic purpura and purpura nephritis(HSPN)and improvement of prognosis.MethodsFor the Department of Pediatrics of our hospital who was hospitalized from February 2016 to October 2017,clinically and laboratoryly assisted examinations diagnosed 138 cases of allergic purpura(aged ≤14 years)with whole blood were enrolled into the experimental group.And it divided them into no kidney damage in the allergic purpura group(HSP group,80cases)and allergic purpura group with renal damage(HSPN group,58 cases).Among them,the HSP components was enrolled into simple type,joint type,abdomen type,and mixed type allergic purpura.Meanwhile,HSPN group included 32 cases of renal perforation group and 26 cases of conservative treatment.Renal puncture group was divided into group A II grade(10cases),B group: III grade(16 cases),C group: IV grade(6cases)according to different pathological grades.At the same time,40 cases of normal children(≤14years old)in our pediatric outpatient physical examination were selected as the study control group.The expression of NF-κB and serum MMP-9 in peripheral blood weredetected by enzyme-linked immunosorbent assay(ELISA).Results1.The expression of NF-κB in the peripheral blood of the experimental group was significantly higher than that of the normal control group(51.62±9.53umol/L)(16.71±7.82umol/L),and the difference was statistically significant(P<0.05).The expression of MMP-9 in the serum of children with purpura in the experimental group(161.51±73.93)ng/ml was higher than that in the normal control group(22.42±10.21)ng/ml,which was statistically significant(P<0.05).2.The expression of NF-κB in peripheral blood of allergic purpura with renal damage(71.10±10.21umol/L)was higher than that of non-renal damage anaphylactoid purpura(49.45±8.92umol/L).The expression of MMP-9 level in serum(218.73±66.72)ng/ml was significantly higher than that in non-renal damage anaphylactoid purpura group(98.69±23.25)ng/ml,and both of the difference were statistically significant(P<0.05).3.There was no significant difference in the clinical manifestations of NF-κB between allergic purpura groups(P>0.05).The expression of MMP-9 in the anaphylactoid purpura mixed group was higher than that in the simple type,joint type and abdominal type.And the difference was statistically significant(P<0.05).4.The level of NF-κB in the purpura nephritis group was significantly higher in the macroalbuminuria group than that in the non-heavy proteinuria group.There was no significant difference between the two groups(P>0.05).While the difference of MMP-9 between the two groups was statistically significant(P<0.05).There was a positive correlation between MMP-9 and 24-hour urine protein quantification(r=0.255,P<0.05).While the NF-κB and 24-hour urinary protein quantification was a slight correlation(r=0.171,P>0.05).And the difference was not statistically significant.There was no significant difference in the level of NF-κB between different renal pathological grades.While there was a statistically significant difference in serum MMP-9 expression between different renal pathological grades.There was a positive correlation between NF-κB and MMP-9(r=0.451,P<0.05).ConclusionsBoth NF-κB and MMP-9 are involved in the development of anaphylactoid purpura and purpura nephritis.Both can be used as a marker for predicting kidney damage in allergic purpura.Both may serve as a target for drug therapy and provide clinical value for the treatment and prognosis of allergic purpura preventing renal involvement and purpura nephritis...