频繁复发肾病综合征患儿外周血sPD-1和sPD-L1水平及相关性研究

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摘要 目的：探讨频繁复发肾病综合征患儿血清sPD-1 、sPD-L1水平及与临床相关性研究。方法：将68例初发激素敏感的PNS患儿纳入本研究,根据复发的频次,分为频繁复发组（FRNS）31例和非频繁复发组（NFRNS）37例,以28例健康儿童为对照组。各组于糖皮质激素（GC）治疗前后分别取血标本。应用酶联免疫吸附法检测各组儿童血清sPD-1 、sPD-L1水平。结果：GC治疗前,FRNS组、NFRNS组sPD-1、sPD-L1水平高于对照组,FRNS组sPD-1、sPD-L1水平高于NFRNS组;GC治疗后,FRNS组sPD-1、sPD-L1水平较对照组上升,NFRNS组sPD-1 、sPD-L1水平与对照组无明显差异,FRNS组sPD-1、sPD-L1水平高于NFRNS组;与治疗前比较,FRNS组、NFRNS组sPD-1、sPD-L1水平较同组治疗前下降;FRNS组GC治疗前sPD-L1水平与CD19⁺B细胞、NK细胞呈负相关性,sPD-1水平与sPD-L1、CD3⁺T细胞呈正相关性。结论：GC治疗前后高水平的sPD-1、sPD-L1可能与PNS疾病的频繁复发相关;血清sPD-1、sPD-L1可能通过影响淋巴细胞系统和拮抗GC作用参与PNS疾病频繁活动。

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	石梦月
	关凤军

关键词 ：原发性肾病综合征, 频繁复发, 糖皮质激素, 可溶性程序性死亡受体-1, 可溶性程序性死亡受体配体-1

Abstract：Objective To investigate the levels of serum soluble programmed death receptor 1(sPD-1) and soluble programmed death protein ligand 1(sPD-L1) in children with frequent relapse of primary nephrotic syndrome and their clinical correlation. Methods A total of 44 patients were included in this study. they were divided into a frequent relapsing nephrotic syndrome (FRNS) group and a non-frequently relapsing nephrotic syndrome (NFRNS) group according to the frequency of recurrence during the course.24 healthy children were served as normal control; blood samples were collected at different time points before and after GC treatment in each group, including before treatment, stable period after treatment, and initial recurrence after treatment; ELISA was adopted to detect serum sPD-1 and sPD-L1. Results Before GC treatment: The levels of sPD-1 and sPD-L1 in the two study groups were higher than those in the control group, and the levels of sPD-L1 in the FRNS group were higher than those in the NFRNS group. After GC treatment: The levels of sPD-1 and sPD-L1 in children in the NFRNS group were not significantly different from those in the normal control group. The levels of sPD-1 and sPD-L1 in children in the FRNS group were higher than those in the control group. The levels of sPD-1 and sPD-L1 in children in the FRNS group were higher than those in the NFRNS group. Compared with before treatment: The levels of sPD-1 and sPD-L1 in FRNS group and NFRNS group were lower than those in the same group before treatment. Before GC treatment in FRNS group, the level of sPD-L1 was negatively correlated with CD19⁺B cells and NK cells, and the level of sPD-1 was positively correlated with sPD-L1 and CD3⁺T cells. Conclusion The high level of sPD-L1 and sPD-L1 before and after GC treatment may be related to the frequent recurrence of PNS disease; Serum sPD-1 and sPD-L1 may participate in frequent activity of the PNS disease by affecting the lymphocyte system and antagonizing GC effects.

Key words： primary nephrotic syndrome frequent recurrence glucocorticoid SPD-1 SPD-L1

收稿日期: 2023-02-23

中图分类号:

R725

基金资助:国家自然科学基金（82173630）

通讯作者: 关凤军,E-mail：guanxiaomu@sina.com

引用本文:

石梦月, 关凤军. 频繁复发肾病综合征患儿外周血sPD-1和sPD-L1水平及相关性研究[J]. 湖南师范大学学报(医学版), 2023, 20(2): 84-88. SHI Mengyue, GUAN Fengjun. Study on the level and correlation of sPD-1 and sPD-L1 in peripheral blood of children with frequent relapsing nephrotic syndrome. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(2): 84-88.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2023/V20/I2/84

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