The Role Of Interleukin-33 And Regulatory T Cells In Minmal Change Nephrotic Syndrome

Objective: We all know that minmal change nephrotic syndrome(MCNS)is one of the common types of primary glomerular diseases.Numerous epidemiological data show that a variety of cytokines are involved in this pathogenesis.The main diagnostic method of MCNS still relies on renal biopsy.The main treatment methods are glucocorticoids(GC)or glucocorticoids combined with cyclophosphamide(CYC),Mycophenolate Mofetil(MMF)and other immunosuppressive agents.At present,the most common side effects from these treatment methods including severe infections,rarefaction of bone,fracture,even femoral head necrosis,peptic ulcer,hypertension,atherosclerosis,metabolic abnormalities,etc.Therefore,it is important to clarify the pathogenesis of minimal change nephrotic syndrome to replace invasive diagnostic operations,improve diagnostic methods and treatment methods,improve the quality of life of patients,delay or prevent recurrence of disease or eventually progress to Chronic Kidney Disease(CKD).This assay mainly studies the role of interleukin-33(IL-33)and regulatory T cells(Treg cell)in the pathogenesis of minimal change nephrotic syndrome.We focus on the role of interleukin-33(IL-33)and CD4+CD25+T cells and CD4+CD25+foxp3+ T cells(regulatory T cells,Treg cells)in the pathogenesis of minimal change nephrotic syndrome(MCNS),and the correlation between these two factors.Methods: Serum samples from 30 MCNS patients(all the patients are diagnosed with MCNS by renipuncture biopsy)and 30 healthy subjects were collected,ELSA was applied to measure the level of serum IL-33,and flow cytometry was employed to measure the peripheral blood lymphocyte subsets and the proportions of Treg cells.Thetwo groups were compared to analyze their difference in the level of serum IL-33 and the proportion of Treg cells in peripheral blood CD4+T cells,and the relation of changing proportion of Treg cells and serum IL-33 with pathogenesis of MCNS is analyzed.Results: The proportions of peripheral blood CD4+CD25+T cells(4.1%±1.03%)and CD4+CD25+foxp3+ T cells(0.91%±0.35%)in MCNS patients are clearly lower than the proportions of CD4+CD25+ T cells(11.28%±2.65%)and CD4+CD25+foxp3+T cells(4.57%±0.57%)in healthy control group(P<0.05).In the MCNS group the proportions of peripheral blood CD4+CD25+foxp3+ T cells are negatively correlated with 24-h urinary protein(P<0.05,r=-0.66464)and has no correlation with age,gender,serum creatinine and serum urea nitrogen(P<0.05,r=0).Between the two groups,the level of serum IL-33 in MCNS patients((99.1 ±2.9)pg/ml)is higher than in the healthy control group((58.8 ±1.8)pg/ml)(p<0.05).In the MCNS group,the level of serum IL-33 is positively correlated with 24-h urinary protein(p<0.05,r=0.85284)and has no correlation with age,gender,serum creatinine and serum urea nitrogen(P<0.05,r=0).In MCNS patients,the proportion of peripheral blood Treg cells are negatively correlated with the serum IL-33 level(r=-0.7001,P<0.05).Conclusion: The proportion of peripheral blood Treg cells in MCNS patients evidently decreases,accompanied with clear increase of the level of serum IL-33.A new treatment for MCNS probably involves inhibition of IL-33 expression to increase the level of peripheral Treg cells in MCNS patients.