儿童IgA肾病并发急性呼吸道感染B淋巴细胞Comsc表达和免疫球蛋白分子异常糖基化  

Effect of acute respiratory tract infection on expression of peripheral blood B lymphocyte core 1β3 galactosyltransferase chaperone protein and abnormal glycosylation of immunoglobulin molecules in children with IgA nephropathy

作　　者：杨玉京[1] 常绍鸿[1] 王成祥[1] 谢遂亮 王向华 YANG Yu-jing;CHANG Shao-hong;WANG Cheng-xiang;XIE Sui-liang;WANG Xiang-hua(Xinxiang Central Hospital,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市中心医院儿科一病区,河南新乡453000

出　　处：《中华医院感染学杂志》2021年第13期2076-2080,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划(联合共建)基金资助项目(LHGJ20191319)。

摘　　要：目的探究IgA肾病(IgAN)并发急性呼吸道感染儿童B淋巴细胞核心1β3半乳糖基转移酶伴侣蛋白(Comsc)表达和免疫球蛋白分子异常糖基化。方法选择2015年11月-2019年11月新乡市中心医院儿科收治的IgAN患儿80例,根据肾穿刺活检前1个月以内是否伴有急性呼吸道感染,将患儿分为感染组(n=46)和无感染组(n=34),比较两组患儿外周血B淋巴细胞Comsc表达、免疫球蛋白(Ig)A1水平及IgA1分子与蚕豆凝集素结合力,分析外周血B淋巴细胞Comsc表达、IgA1水平及IgA1分子与蚕豆凝集素结合力对IgAN患儿感染的诊断价值。结果感染组患儿Comsc mRNA、蛋白表达水平低于无感染组(P<0.05);感染组患儿IPS评分、IgA1水平及IgA1分子与蚕豆凝集素结合力高于无感染组(P<0.05);受试者工作特征曲线(ROC)结果显示,Comsc mRNA、Comsc蛋白、IgA1及IgA1分子与蚕豆凝集素结合力对IgAN患儿感染均具有一定的诊断价值,其中Comsc mRNA诊断价值最高,联合诊断AUC为0.943,高于各指标单独诊断。结论急性呼吸道感染可能在IgAN患儿发病中发挥着重要作用,其调控机制可能是影响Comsc表达和免疫球蛋白分子异常糖基化。OBJECTIVE To explore the effect of acute respiratory tract infection on expression of peripheral blood B lymphocyte core 1β3 galactosyltransferase chaperone protein(Comsc)and abnormal glycosylation of immunoglobulin molecules in children with IgA nephropathy(IgAN).METHODS A total of 80 children with IgAN who were treated in the pediatrics department of Xinxiang Central Hospital from Nov 2015 to Nov 2019 were enrolled in the study and divided into the infection group with 46 cases and the no infection group with 34 cases according to the status of acute respiratory tract infection within 1 month before the renal biopsy.The expression of B lymphocyte Comsc,immunoglobulin(Ig)A1 level and binding capacity of IgA1 molecule and vicia villosa lectin were compared between the two groups of children,and the values of expression of B lymphocyte Comsc,IgA1 level and binding capacity of IgA1 molecule and vicia villosa lectin in diagnosis of the infection were analyzed.RESULTS The Comsc mRNA and expression level of proteins of the infection group were significantly lower than those of the no infection group(P<0.05).The IPS score,IgA1 level and binding capacity of IgA1 molecule and vicia villosa lectin of the infection group were significantly higher than those of the no infection group(P<0.05).Receiver operating characteristic(ROC)curves showed that the Comsc mRNA,Comsc protein,IgA1 and binding capacity of IgA1 molecule and vicia villosa lectin had certain value in diagnosis of the infection in the IgAN children,the diagnostic value of the Comsc mRNA was the highest,AUC of the joint detection of above indexes was 0.943 in diagnosis of the infection,higher than that of the single index.CONCLUSION The acute respiratory tract infection plays an important role in pathogenesis of IgAN,and its regulating mechanism may affect the expression of Comsc and abnormal glycosylation of immunoglobulin molecules.

关 键 词：急性呼吸道感染 IgA肾病 核心1β3半乳糖基转移酶伴侣蛋白 糖基化 儿童 

分 类 号：R726.9[医药卫生—儿科]