Study On The Expression Of CD137 In Mononuclear Cells And Its The Correlation With Th1/Th2 Balance In Children With HSP

Objective:To observe the expression of CD137 in peripheral blood mononuclear cells(PBMC)and its correlation with Th1/Th2 balance in children with Henoch Schonlein purpura(HSP)in the acute phase,so as to unearth its significance in the pathogenesis of children with HSP and to provide new ideas for treatment.Method:A total of 42 children with HSP who were hospitalized in the Cardiac and Renal Immunopaediatrics Department of Affiliated Hospital of Qingdao University from August2019 to September 2020 were selected as the objects.The children were divided into the NHSPN group(31 cases,with no renal damage)and the HSPN group(11 cases,with renal damage).Simultaneously,30 healthy children of the same age who had a physical examination in the Child Health Outpatient Department of this hospital were selected as the normal control.The levels of CD137 mRNA in PBMC were detected by real-time quantitative reverse transcription-polymerase chain reaction(RT-q PCR),and the levels of soluble CD137(sCD137),IFN-γ and IL-4 in peripheral blood were detected by enzyme-linked immunosorbent assay(ELISA).Statistical software SPSS22.0 was used for data analysis,and the levels of CD137 mRNA,sCD137,IFN-γ and IL-4 were compared among the groups,and the correlation analysis between CD137 mRNA level in PBMC and serum IL-4 level,IFN-γ level,IFN-γ /IL-4 ratio and sCD137 level was conducted in the HSP group.Results:1.The level of CD137 mRNA in PBMC of children with HSP(1.497±0.401)was higher than that in the control group(0.969±0.259),and the difference was statistically significant(P<0.01);the CD137 mRNA level in PBMC of children in the HSPN group(1.885±0.365)was higher than that in the NHSPN group(1.359±0.317),and the difference was statistically significant(P<0.01).2.The serum IFN-γ level of HSP group(27.24±11.57pg/ml)was significantly lower than that of normal control group(43.55±27.46pg/ml,P<0.01).IL-4 level(35.14 ±18.57pg/ml)was higher than that of normal control group(25.79±14.42pg/ml,P<0.05).The ratio of IFN-γ/ IL-4(1.12±0.99)was significantly lower than that of normal control group(2.24±1.77,P<0.01).3.The CD137 mRNA level in PBMC of HSP group was positively correlated with IL-4level(r=0.410,P<0.01);it was negatively correlated with IFN-γ/IL-4 ratio(r=-0.558,P<0.01);There was no correlation with IFN-γ levels(r=-0.256,P>0.05).4.The sCD137 level in sera of children in the HSP group(101.1±33.05pg/ml)was higher than that in the control group(80.66±33.34pg/ml),and the difference was statistically significant(P<0.05).5.The CD137 mRNA level in PBMC of HSP group was positively correlated with serum sCD137 level(r=0.699,P<0.01).Conclusion:1.The CD137 mRNA levels in PBMC of HSP children were significantly increased,and was positively correlated with Th2 dominant activation,suggesting that the expression of costimulatory molecule CD137 may promote the secretion of Th2 cytokines by assisting the activation of Th cells,and participate in the immune pathogenesis of HSP.2.The level of serum sCD137 in HSP children was significantly increased,and was positively correlated with the level of CD137 mRNA,suggesting that sCD137,as a natural regulator of immune response,had an increased compensatory secretion,which may be involved in the pathogenesis of HSP through negative feedback regulation of CD137 signal.