IgA肾病患儿半乳糖缺乏的IgA1诱生及临床意义  

Production of Galactose-Deficient IgA1 in Children with IgA Nephropathy and Its Clinical Significance

作　　者：邹敏书[1,2] 尹晓玲[1] 周建华[1] 胡长霞[1] 杨凤杰[1] 王嘉[1] 陈瑜[1] 张瑜[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院儿科,武汉430030 [2]广州军区武汉总医院儿科,武汉430070

出　　处：《实用儿科临床杂志》2012年第18期1429-1431,1435,共4页Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金面上项目(81070557)

摘　　要：目的观察IgA肾病(IgAN)患儿初始B淋巴细胞在滤泡辅助性T淋巴细胞(Tfh)相关因子作用下的诱导成熟过程,探讨半乳糖缺乏的IgA1(Gd-IgA1)的诱生及其临床意义。方法随机选择IgAN患儿及健康儿童各8例。磁珠分选外周血初始B淋巴细胞(CD27-IgD+),加IL-21和转化生长因子-β1等细胞因子共培养,测定细胞培养上清液J链的表达、IgA水平、Gd-IgA1水平;并分别测定外周血单个核细胞J链的表达及血清IgA、Gd-IgA1水平。结果 IgAN组和健康对照组细胞培养上清液及外周血单个核细胞J链的表达相对值比较差异无统计学意义(Pa>0.05),上清液IgA分泌及血清IgA水平比较差异亦无统计学意义(P>0.05)。与对照组比较,IgAN组细胞培养上清液及血清Gd-IgA1水平均明显升高,差异均有统计学意义(P<0.01,0.05)。结论 IgAN患儿外周血初始B淋巴细胞可分化成熟产生Gd-IgA1。Tfh细胞及相关细胞因子在诱生B淋巴细胞成为分泌型IgA的浆母细胞及分泌Gd-IgA1过程中起关键的调节作用。血清Gd-IgA1可能是间接反映IgAN的无创性指标之一。Objective To investigate the mature process of naive B cells induced by follicular helper T（Tfh） cells and associated cells factors,and discuss the production and clinical significance of galactose-deficient IgA1 （Gd- IgA1 ）in children with IgA nephropathy （IgAN）. Methods Eight children with IgA nephropathy and 8 healthy controls were selected randomly. Magnetic bead was performed to sort peripheral blood naive B cells（ CD27- IgID＋ ）, and they were cultured with interleukin -21 and transforming growth factor - β1. Supernatant was collected to detect the expression of J chain, the excretion of IgA and Gd - IgA1. J chain expressions of peripheral blood mononuclear cells, and the levels of IgA and Gd - IgA1 in serum were detected respectively. Results Expression of J chain in peripheral blood mononuc- lear cells and in serum in children with IgAN had no significant difference compared with those in healthy control group（Pa 〉 0.05 ）. The supernatant of IgA secretion and serum IgA level also had no significant difference between IgAN group and healthy control group（ P 〉0.05 ）. Compared with healthy control group, the levels of Gd - IgA1 in supernatant and serum were significantly increased （ P 〈 0. 01,0.05 ）. Conclusions Naive B ceils can be mature in peripheral blood, and produce Gd - IgA1. Tfh cells and related cell factors may play an important role in B cell differentiation into secreted IgA plasmablast and producing Gd - IgA1. Determination of serum Gd - IgA1 may be a noninvasive indicator of reflectinz IgAN indirectly.

关 键 词：IGA肾病 滤泡辅助性T淋巴细胞 半乳糖缺乏的IgA1 

分 类 号：R726.91[医药卫生—儿科]