留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

淋巴细胞亚群检测在肾病综合征患儿免疫功能评价中的意义

刘宇萌 安东

刘宇萌, 安东. 淋巴细胞亚群检测在肾病综合征患儿免疫功能评价中的意义[J]. 中华全科医学, 2022, 20(4): 661-664. doi: 10.16766/j.cnki.issn.1674-4152.002424
引用本文: 刘宇萌, 安东. 淋巴细胞亚群检测在肾病综合征患儿免疫功能评价中的意义[J]. 中华全科医学, 2022, 20(4): 661-664. doi: 10.16766/j.cnki.issn.1674-4152.002424
LIU Yu-meng, AN Dong. Significance of lymphocyte subset detection in immune function evaluation of children with nephrotic syndrome[J]. Chinese Journal of General Practice, 2022, 20(4): 661-664. doi: 10.16766/j.cnki.issn.1674-4152.002424
Citation: LIU Yu-meng, AN Dong. Significance of lymphocyte subset detection in immune function evaluation of children with nephrotic syndrome[J]. Chinese Journal of General Practice, 2022, 20(4): 661-664. doi: 10.16766/j.cnki.issn.1674-4152.002424

淋巴细胞亚群检测在肾病综合征患儿免疫功能评价中的意义

doi: 10.16766/j.cnki.issn.1674-4152.002424
详细信息
    通讯作者:

    安东,E-mail:andongsuper@163.com

  • 中图分类号: R692  R726.9

Significance of lymphocyte subset detection in immune function evaluation of children with nephrotic syndrome

  • 摘要: 原发性肾病综合征(primary nephrotic syndrome, PNS)是儿童时期常见的肾小球疾病,也是进展为慢性肾衰竭的主要原因。原发性肾病综合征的发病机制尚未明确,但长期研究证实可能与免疫功能紊乱有关,淋巴细胞亚群作为反映机体免疫功能的指标,对于研究PNS的发病机制及指导治疗、预后都具有意义。几十年前已有研究证实T淋巴细胞亚群异常可能与肾病综合征的发病机制有关,在这之后的许多研究进一步证实T淋巴细胞介导的细胞免疫在PNS发病中的主导作用。对于B淋巴细胞介导的体液免疫,近年来多数文献报道Rituximab(CD20单克隆抗体)用于治疗儿童难治性肾病综合征,尤其是激素依赖型和频繁复发型肾病综合征的患儿,可使其得到显著缓解,提示B淋巴细胞功能的异常可能与儿童原发性肾病综合征的发病有关。NK细胞作为人体的一种免疫细胞,对于PNS患儿的预后也有很大的价值,NK细胞水平较低的患儿更易复发,且激素治疗后NK细胞水平较低的患儿发生感染的风险更高,可以看出NK细胞在PNS的发生、发展中有着重要作用。本文主要对T淋巴细胞亚群、B淋巴细胞及NK细胞进行简要综述,探讨它们与PNS的关系。

     

  • [1] 王卫平, 孙锟, 常立文. 儿科学[M]. 9版. 北京: 人民卫生出版社, 2018: 300-301.

    WANG W P, SUN K, CHANG L W, Pediatrics[M]. 9th Edition. Beijing: People's Medical Publishing House, 2018: 300-301.
    [2] 中华医学会儿科学分会肾脏学组. 儿童激素敏感、复发/依赖肾病综合征诊治循证指南(2016)[J]. 中华儿科杂志, 2017, 55(10): 729-734. doi: 10.3760/cma.j.issn.0578-1310.2017.10.003

    Chinese Medical Association Pediatrics Branch Nephrology Group. Evidence-based guidelines for the diagnosis and treatment of hormone-sensitive, recurrent/dependent nephrotic syndrome in children (2016)[J]. Chinese Journal of Pediatrics. 2017, 55(10): 729-734. doi: 10.3760/cma.j.issn.0578-1310.2017.10.003
    [3] 高洁, 陈朝英, 涂娟, 等. 儿童原发肾病综合征并发急性肾损伤相关因素分析[J]. 中国医刊, 2020, 55(2): 217-220. doi: 10.3969/j.issn.1008-1070.2020.02.030

    GAO J, TU J, GENG H Y, et al. Analysis of related factors of children with primary nephrotic syndrome complicated with acute kidney injury[J]. Chinese Medical Journal, 2020.55(2): 217-220. doi: 10.3969/j.issn.1008-1070.2020.02.030
    [4] 童科珍, 毛建华, 傅海东, 等. 肾病综合征患儿血清细胞因子水平及T细胞亚群变化的临床意义[J]. 中华临床免疫和变态反应杂志, 2016, 10(4): 351-356. https://www.cnki.com.cn/Article/CJFDTOTAL-OZHL201604007.htm

    DONG K Z, MAO J H, FU H D, et al. Clinical significance of changes in serum cytokines and T cell subsets in children with nephrotic syndrome[J]. Chinese Journal of Clinical Immunology and Allergy, 2016.10(4): 351-356. https://www.cnki.com.cn/Article/CJFDTOTAL-OZHL201604007.htm
    [5] 刘林娜, 陈荣发, 陈慧, 等. 淋巴细胞亚群检测在儿童肾病综合征患者中的应用价值[J]. 中国卫生检验杂志, 2018, 28(18): 2245-2247. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWJZ201818021.htm

    LIU L N, CHEN R F, CHEN H, et al. Application value of lymphocyte subset detection in children with nephrotic syndrome[J]. Chinese Journal of Health Inspection, 2018.28(18): 2245-2247. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWJZ201818021.htm
    [6] 王军, 袁纯辉, 袁文, 等. 肾病综合征患儿外周血T淋巴细胞亚群、免疫球蛋白、补体表达观察[J]. 山东医药, 2019, 59(6): 79-81. doi: 10.3969/j.issn.1002-266X.2019.06.022

    WANG J, YUAN C H, YUAN W, et al. Observation on the expression of peripheral blood T lymphocyte subsets, immunoglobulin and complement in children with nephrotic syndrome[J]. Shandong Medicine, 2019.59(6): 79-81. doi: 10.3969/j.issn.1002-266X.2019.06.022
    [7] 马玉花, 刘志刚, 王小兰, 等. 原发性肾病综合征患者淋巴细胞亚群和免疫球蛋白变化及价值[J]. 中国卫生工程学, 2020, 19(3): 406-408. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWX202003034.htm

    MA Y H, LIU Z G, MA X L, et al. Changes and value of lymphocyte subsets and immunoglobulin in patients with primary nephrotic syndrome[J]. China Health Engineering, 2020.19(3): 406-408. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWX202003034.htm
    [8] OH G, WALDO A, PAEZ-CRUZ F, et al. Steroid-addociated side effects in patients with primary proteinuric kidney diease[J]. Kidney Int Rep, 2019, 4(11): 1608-1616. doi: 10.1016/j.ekir.2019.08.019
    [9] EL MASHAD G M, EL HADY IBRAHIM S A, ABDELNABY S A A, et al. Immunoglobulin G and M levels in childhood nephrotic syndrome: Two centers Egyptian study[J]. Electron Physician, 2017, 9(2): 3728-3732. doi: 10.19082/3728
    [10] GUIMARÃES F T L, MELO G E B A, CORDEIRO T M, et al. T-lymphocyte-expressing inflammatory cytokines underlie persistence of proteinuria in children with idiopathic nephrotic syndrome[J]. J Pediatr (Rio J), 2018, 94(5): 546-553. doi: 10.1016/j.jped.2017.08.005
    [11] DUECHTING A, PRZYBYLA A, KUERTEN S, et al. Delayed activation kinetics of Th2- and Th17 cells compared to Th1 cells[J]. Cells, 2017, 63(3): 29.
    [12] YANG X, TANG X, LI T, et al. Circulating follicular T cells are possibly associated with low levels of serum immunoglobulin G due to impaired immunoglobulin class-switch recombination of B cells in children with primairy nephrotic syndrome[J]. Mol Immunol, 2019, 114(1): 162-170.
    [13] 刘光磊, 杨军, 李成荣. 儿童特发性肾病综合征低IgG血症机制: 哺乳动物雷帕霉素靶蛋白过表达对滤泡辅助性T细胞数量的可能影响[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(2): 171-180. doi: 10.3877/cma.j.issn.1673-5250.2020.02.008

    LIU G L, YANG J, LI C R, Mechanism of hypoIgGemia in children with idiopathic nephrotic syndrome: the possible effect of mammalian target of rapamycin overexpression on the number of follicular helper T cells[J]. Chinese Journal of Maternal and Child Clinical Medicine, 2020.16(2): 171-179. doi: 10.3877/cma.j.issn.1673-5250.2020.02.008
    [14] 曾海江, 黄郁波, 易玲, 等. 原发性肾病综合征患儿T淋巴细胞免疫及细胞因子的临床意义[J]. 中国当代医药, 2020, 27(27): 79-81, 85. doi: 10.3969/j.issn.1674-4721.2020.27.023

    ZENG H B, HUANG Y J, YI L, Clinical significance of T lymphocyte immunity and cytokines in children with primary nephrotic syndrome[J]. Chinese Contemporary Medicine, 2020.27(27): 79-81, 85. doi: 10.3969/j.issn.1674-4721.2020.27.023
    [15] CHEN P, CHEN Y, JIANG M, et al. Usefulness of the cytokines expression of Th1/Th2/Th17 and urinary CD80 excretion in adult-onset minimal change disease[J]. Peer J, 2020, 8(3): e9854. DOI: 10.7717/peerj.9854.
    [16] WANG L, LI Q, YANG H, et al. The role of Th17/IL-17 in the pathogenesis of primary nephrotic syndrome in children[J]. Kidney Blood Press Res, 2013, 37(4-5): 332-345. doi: 10.1159/000350161
    [17] ZHAI S, SUN B, ZHANG Y, et al. IL-17 aggravates renal injury by promoting podocyte injury in children with primary nephrotic syndrome[J]. Exp Ther Med, 2020, 20(1): 409-417. doi: 10.3892/etm.2020.8698
    [18] SHUAI L, CHENG Q, SHEN T, et al. CTLA4-Ig Abatacept ameliorates proteinuria by regulating circulating Treg/IL-17 in adriamycin-induced nephropathy rats[J]. Biomed Res lnt, 2020(1): 1-9.
    [19] ZHANG X M, LIU C Y, SHAO Z H, et al. Advances in the role of helper T cells in autoimmune diseases[J]. Chin Med J (Engl), 2020, 133(8): 968-974. doi: 10.1097/CM9.0000000000000748
    [20] MA J, ZHENG B, GOSWAMI S, et al. PD1Hi CD8+ T cells correlate with exhausted signature and poor clinical outcome in hepatocellular arcinoma[J]. J Immunother Cancer, 2019, 7(1): 331. doi: 10.1186/s40425-019-0814-7
    [21] LIU Y, ZHENG K, LIU Y, et al. Pneumocystis jirovecii pneumonia in patients with nephrotic syndrome: Application of lymphocyte subset analysis in predicting clinical outcomes[J]. Can J Infect Dis Med Microbiol, 2020(1): 4631297. DOI: 10.1155/2020/4631297.
    [22] 寿晓霞, 刘佳谊, 淋巴细胞亚群、hs-CRP、TGF-β1水平与儿童原发性肾病综合征预后的关系研究[J]. 国际检验医学杂志, 2020, 41(12): 1479-1482. doi: 10.3969/j.issn.1673-4130.2020.12.017

    CHOU X X, LIU J Y, Relationship between lymphocyte subsets, hs-CRP, TGF-β1 levels and prognosis of children with primary nephrotic syndrome[J]. International Journal of Laboratory Medicine, 2020.41(12): 1479-1482. doi: 10.3969/j.issn.1673-4130.2020.12.017
    [23] SCHEINECKER C, GÖSCHL L, BONELLI M, et al. Treg cells in health and autoimmune diseases: New insights from single cell analysis[J]. J Autoimmun, 2020, 110(6): 102376. DOI: 10.1016/j.jaut.2019.102376.
    [24] TSUJI S, KIMATA T, YAMANOUCHI S, et al. Regulatory T cells and CTLA-4 in idiopathic nephrotic syndrome[J]. Pediatr Int, 2017, 59(5): 643-646. doi: 10.1111/ped.13255
    [25] EROGLU F K, ORHAN D, INÖZV M, et al. CD80 expression and infiltrating regulatory T cells in idiopathic nephrotic syndrome of childhood[J]. Pediatr Int, 2019, 61(12): 1250-1256. doi: 10.1111/ped.14005
    [26] 冯杏, 赵丽君, 寇敏, 等. 调节性T细胞及其相关细胞因子转化生长因子β1白细胞介素10在儿童激素敏感型原发性肾病综合征发病机制中的作用[J]. 中国药物与临床, 2019, 19(16): 2713-2716. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201916004.htm

    FENG X, ZHAO L J, KOU M, The role of regulatory T cells and their related cytokines transforming growth factor β_1 and interleukin-10 in the pathogenesis of hormone-sensitive primary nephrotic syndrome in children[J]. Chinese Medicine and Clinic, 2019.19(16): 2713-2716. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201916004.htm
    [27] GUIMARÃES F T L, FERREIRA R N, BRITO-MELO G E A, et al. Pediatric patients with steroid-sensitive nephrotic syndrome have higher expression of T regulatory lymphocytes in comparison to steroid-resistant disease[J]. Front Pediatr, 2019, 7(8): 114.
    [28] WU C, CHEN Z, XIAO S, et al. SGK1 governs the reciprocal development of Th17 and regulatory T cells[J]. Cell Reports, 2018, 22(3): 653-665. doi: 10.1016/j.celrep.2017.12.068
    [29] LEE G R. The balance of Th17 versus Treg cells in autoimmunoty[J]. Int J Mol Sci, 2018, 19(3): 730. doi: 10.3390/ijms19030730
    [30] 赵丽君, 冯杏, 寇敏, 等. 辅助性T细胞17/调节性T细胞失衡在儿童激素敏感型原发性肾病综合征发病机制中的研究[J]. 中国药物与临床, 2019, 19(3): 391-393. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201903022.htm

    ZHAO L J, FENG X, KOU M, The role of helper T cell 17/regulatory T cell imbalance in the pathogenesis of hormone-sensitive primary nephrotic syndrome in children[J]. Chinese Medicine and Clinic, 2019.19(03): 391-393. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201903022.htm
    [31] ZHANG L, YAN J, YANG B, et al. IL-23 activated γδT cells affect Th17 cells and regulatory T cells by secreting IL-21 in children with primary nephrotic syndrome[J]. Scand J Immunol, 2018, 87(1): 36-45. doi: 10.1111/sji.12629
    [32] XIA H, WANG F, WANG M, et al. Maresin1 ameliorates acute lung injury induced by sepsis through regulating Th17/Treg balance[J]. Life Sci, 2020, 254(1): 117773.
    [33] 薛苗, 毛小荣, 陈红, 辅助性T淋巴细胞17/调节性T淋巴细胞比值失衡在免疫性肝损伤大鼠模型中的变化特点[J]. 临床肝胆病杂志, 2020, 36(1): 149-152. doi: 10.3969/j.issn.1001-5256.2020.01.033

    XUE M, MAO X R, CHEN H, Change characteristics of helper T lymphocyte 17/regulatory T lymphocyte ratio imbalance in a rat model of immune liver injury[J]. Journal of Clinical Hepatobiliary Diseases, 2020.36(01): 149-152. doi: 10.3969/j.issn.1001-5256.2020.01.033
    [34] LING C, WANG X, CHEN Z, et al. Altered B-lymphocyte homeostasis in idiopathic nephrotic syndrome[J]. Front Pediatr, 2019, 7(1): 377.
    [35] COLUCCI M, CARSETTI R, CASCIOLI S, et al. B cell phenotype in pediatric idiopathic nephrotic syndrome[J]. Pediatr Nephrol, 2019, 34(1): 177-181. doi: 10.1007/s00467-018-4095-z
    [36] 王美秋, 夏正坤, 高春林. 利妥昔单抗在儿童原发性肾病综合征中的应用[J]. 医学研究生学报, 2020, 33(4): 433-437.

    WANG M Q, The application of rituximab in children with primary nephrotic syndrome[J]. Journal of Postgraduate Medicine, 2020.33(4): 433-437.
    [37] KARI J, ALHASAN K, ALBANNA A, et al. Rituximab versus cyclophosphamide as first steroid-sparing agent in childhood frequently relapsing and steroid-dependent nephrotic syndrome[J]. Pediatr Nephrol, 2020, 358(8): 1445-1453.
    [38] BHATIA D, SINHA A, HARI P, et al. Rituximab modulates T- and B-lymphocyte subsets and urinary CD80 excretion in patients with steroid-dependent nephrotic syndrome[J]. Pediatr Res, 2018, 84(4): 520-526. doi: 10.1038/s41390-018-0088-7
    [39] 于跑, 彭倩倩, 董晨, 等, B淋巴细胞表型在激素依赖及频繁复发肾病综合征患儿的临床意义[J]. 实用医学杂志, 2020, 36(7): 954-958. doi: 10.3969/j.issn.1006-5725.2020.07.024

    YU P, PENG Q Q, DONG C, et al, Clinical significance of B lymphocyte phenotype in children with hormone-dependent and frequently relapsing nephrotic syndrome[J]. Journal of Practical Medicine, 2020.36(7): 954-958. doi: 10.3969/j.issn.1006-5725.2020.07.024
    [40] 陈少艳, 刘基铎, 肖明锋, 等, 淋巴细胞亚群检测在感染性疾病中的应用[J]. 国际检验医学杂志, 2017, 38(2): 206-208. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSQ201702024.htm

    CHEN S Y, LIU J D, XIAO M F, et al, Application of lymphocyte subset detection in infectious diseases[J]. International Journal of Laboratory Medicine, 2017.38(02): 206-208. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSQ201702024.htm
    [41] HOOGSTAD-VAN EVERT J, BEKKERS R, OTTEVANGER N, et al. Harnessing natural killer cells for the treatment of ovarian cancer[J]. Gynecol Oncol, 2020, 157(3): 810-816. doi: 10.1016/j.ygyno.2020.03.020
    [42] GIANCHECCHI E, DELFINO D V, FIERABRACCI A, et al. NK cells in autoimmune diseases: Linking innate and adaptive immune responses[J]. Autoimmun Rev, 2018, 17(2): 1442-1154.
    [43] 周晖登, 黄海锋, 唐银琳, 等. NK细胞对激素敏感型肾病综合征患儿预后判断的价值[J]. 现代免疫学, 2019, 39(1): 41-44. https://www.cnki.com.cn/Article/CJFDTOTAL-SHMY201901008.htm

    ZHOU H D, HUANG H F, TANG Y L, et al, The prognostic value of NK cells in children with hormone-sensitive nephrotic syndrome[J]. Modern Immunology, 2019.39(1): 41-44. https://www.cnki.com.cn/Article/CJFDTOTAL-SHMY201901008.htm
  • 加载中
计量
  • 文章访问数:  141
  • HTML全文浏览量:  106
  • PDF下载量:  10
  • 被引次数: 0
出版历程
  • 收稿日期:  2021-04-20

目录

    /

    返回文章
    返回