[1]胡 洋a,扬 力b,陈 静c.原发性肾病综合征患儿治疗前后外周血CXCL13 和PD-L1+B 淋巴细胞水平变化及临床意义研究[J].现代检验医学杂志,2023,38(06):92-97.[doi:10.3969/j.issn.1671-7414.2023.06.017]
　HU Yanga,YANG Lib,CHEN Jingc.Changes of Peripheral Blood CXCL13 and PD-L1+B Lymphocyte Levels and Their Clinical Significance in Children with Primary Nephrotic Syndrome before and after Treatment[J].Journal of Modern Laboratory Medicine,2023,38(06):92-97.[doi:10.3969/j.issn.1671-7414.2023.06.017]
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原发性肾病综合征患儿治疗前后外周血CXCL13 和PD-L1+B 淋巴细胞水平变化及临床意义研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
92-97
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Changes of Peripheral Blood CXCL13 and PD-L1+B Lymphocyte Levels and Their Clinical Significance in Children with Primary Nephrotic Syndrome before and after Treatment
文章编号:
1671-7414（2023）06-092-06
作者:
胡 洋a; 扬 力b; 陈 静c
（邯郸市中心医院a. 病案科；b. 内分泌科；c. 生殖科，河北邯郸 056000）
Author(s):
HU Yanga;  YANG Lib;  CHEN Jingc
（a.Department of Case；b.Department of Endocrinology； c.Department of Reproduction, Handan Central Hospital, Hebei Handan 056000, China）
关键词:
原发性肾病综合征; 趋化因子C-X-C 基序配体13; B 淋巴细胞; 程序性死亡受体配体1
分类号:
R692；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.06.017
文献标志码:
A
摘要:
目的 探讨原发性肾病综合征（primary nephrotic syndrome，PNS）患儿治疗前后外周血趋化因子C-X-C 基序配体13（chemokine C-X-C motif ligand 13，CXCL13）及程序性死亡受体配体1(programmed death protein ligand 1，PDL1)+B 淋巴细胞水平变化的临床意义。方法 选取2022 年4 ～ 12 月收治的激素敏感型初发PNS 患儿52 例，给予糖皮质激素治疗；以同期在医院体检的30 例正常儿童作为健康对照。收集两组儿童临床实验室指标，流式细胞仪检测两组儿童外周血中总B 细胞及其PD-L1+B 淋巴细胞比例；酶联免疫吸附法检测两组血清CXCL13，可溶性程序性死亡受体配体1（solubility programmed death protein ligand 1，sPD-L1）及细胞因子[ 转化生长因子-β1(transforming growth factor-β1，TGF-β1)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)、白细胞介素-10（interleukin-10，IL-10）和白细胞介素-1β（interleukin-1β，IL-1β）] 水平；Pearson 相关性分析CXCL13 和PD-L1+B 淋巴细胞及其与实验室指标的相关性。结果 与健康对照组比较，治疗前PNS 组外周血总B 细胞（12.54%±4.23% vs 4.95%±2.83%）和PD-L1+B 淋巴细胞比例（1.17%±0.38% vs 0.35%±0.12%），血清CXCL13（121.03±30.52 pg/ml vs 53.67±12.42 pg/ml）和sPD-L1（116.25±25.68pg/ml vs 47.27±8.14 pg/ml）水平及细胞因子TGF-β1（17.91±2.04 ng/ml vs 12.53±1.62 ng/ml），TNF-α（77.65±7.27ng/ml vs 52.43±4.68 ng/ml），IL-10（14.21±3.56 pg/ml vs 4.76±1.25 pg/ml），IL-1β（64.38±7.46 ng/ml vs 35.57±5.92ng/ml）水平均明显升高，差异具有统计学意义（t=-10.754，-11.468，-11.526，-14.271，-12.360，-17.048，-14.017，-18.103，均P<0.05）。与治疗前相比，PNS组患儿治疗后外周血总B细胞（6.20%±2.48%）和PD-L1+B淋巴细胞比例（0.43%±0.25%），血清CXCL13（65.27±14.16 pg/ml），sPD-L1（55.63±11.44 pg/ml），TGF-β1（14.35±1.82ng/ml），TNF-α（56.48±4.16ng/ml），IL-10（5.15±1.09 pg/ml），IL-1β（39.38±4.05 ng/ml）均明显降低，差异具有统计学意义（t=9.324，11.731，11.951，15.549，9.930，18.226，17.548，21.237，均P<0.05）。PNS 患儿PD-L1+B 淋巴细胞比例与血清ALB 和IgG 水平呈负相关（r=-0.619，-0.587，均P<0.05），与IgM 水平呈正相关（r=0.563，P<0.05）。CXCL13 表达水平与血清ALB和IgG 水平呈负相关（r=-0.574，-0.522，均P<0.05）。PD-L1+B 淋巴细胞比例与CXCL13 表达水平呈正相关（r=0.632，P<0.05）。结论 外周血CXCL13 和PD-L1+B 淋巴细胞比例升高与PNS 患儿体液免疫紊乱相关。CXCL13 可能通过促进外周血中B 淋巴细胞趋化性，促进免疫细胞生产炎症细胞因子，加重PNS 过度免疫炎症反应。
Abstract:
Objective To investigate the clinical significance of changes in peripheral blood Chemokine C-X-C motif ligand 13 (CXCL 13) and programmed death receptor ligand 1 (PD-L1)+B lymphocyte level before and after treatment in children with primary nephrotic syndrome(PNS). Methods A total of 52 children with hormone-sensitive initial PNS treated from April 2022 to December 2022 were selected. Thirty normal children admitted for physical examination during the same period were taken as healthy control. Clinical laboratory indicators were collected and total B cells and PD-L1+B lymphocytes in peripheral blood were detected by flow cytometry. Serum CXCL13, solubility programmed death protein ligand 1(sPD-L1) and cytokines [transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), interleukin-1β(IL-1β)] levels in the two groups were detected by enzyme-linked immunosorbent assay. CXCL13 and PD-L1+B lymphocytes and their correlation with laboratory indicators were analyzed by Pearson correlation. Results Before treatment, compared with healthy control group, the proportion of total B cells（12.54%±4.23% vs 4.95%±2.83%） and PD-L1+B lymphocytes（1.17%±0.38% vs 0.35%±0.12%） in peripheral blood, the levels of serum CXCL13（121.03±30.52 pg/ml vs 53.67±12.42 pg/ml） and sPD-L1（116.25±25.68 pg/ml vs 47.27±8.14 pg/ml）, and the levels of serum cytokines TGF-β1（17.91±2.04 ng/ml vs 12.53±1.62 ng/ml）, TNF-α（77.65±7.27 ng/ml vs 52.43±4.68 ng/ml）, IL-10 （14.21±3.56 pg/ml vs 4.76±1.25 pg/ml） and IL-1β（64.38±7.46 ng/ml vs 35.57±5.92 ng/ml）were significantly increased in PNS group, and the differences were statistical significance（t=-10.754, -11.468, -11.526, -14.271, -12.360, -17.048, -14.017, -18.103, all P<0.05). Compared with before treatment, the proportion of total B cells(6.20%±2.48%) and PD-L1+B lymphocytes(0.43%±0.25%) in peripheral blood and the levels of CXCL13(65.27±14.16 pg/ml), sPD-L1(55.63±11.44 pg/ml), TGF-β1(14.35±1.82ng/ml), TNF-α(56.48±4.16 ng/ml), IL-10(5.15±1.09 pg/ml) and IL-1β(39.38±4.05 ng/ml) in serum in the PNS group were significantly decreased after treatment, and the differences were statistical significance (t=9.324, 11.731, 11.951, 15.549, 9.930, 18.226, 17.548, 21.237, all P<0.05). The proportion of PD-L1+B lymphocytes in PNS children was negatively correlated with serum ALB and IgG levels (r=-0.619, -0.5874, all P<0.05), and positively correlated with IgM level (r=0.563, P<0.05).CXCL13 expression level was negatively correlated with serum albumin and IgG levels (r=-0.574, -0.522, P<0.05).The proportion of PDL1+ B lymphocytes was positively correlated with CXCL13 expression level (r=0.632, P<0.05). Conclusion Increased proportions of CXCL13 and PD-L1+B lymphocytes in peripheral blood were associated with humoral immunity disorders in children with PNS. CXCL13 may promote the production of inflammatory cytokines by immune cells by promoting the chemotaxis of B lymphocytes in peripheral blood, and aggravate the excessive immune inflammatory response of PNS.

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备注/Memo

备注/Memo:
基金项目：河北省科学技术厅科研项目（20191516）：补充基金名称。
作者简介：胡洋（1982-），男，本科，主治医师，研究方向：原发性肾病诊治，E-mail：yea_9723@163.com。
更新日期/Last Update: 2023-11-15