特发性膜性肾病患者外周血髓系来源抑制性细胞水平研究  

Expression of myeloid-derived inhibitory cells in peripheral blood of patients with idiopathic membranous nephropathy

作　　者：陈卫玲 齐向明[2] CHEN Weiling;QI Xiangming(Department of Nephrology,Hospital of Huoshan County,Lu’an 237299,China;Department of Nephrology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽省霍山县医院肾脏内科,六安237299 [2]安徽医科大学第一附属医院肾脏内科,合肥230022

出　　处：《国际免疫学杂志》2024年第4期365-369,共5页International Journal of Immunology

摘　　要：目的探究单核细胞型髓系来源抑制性细胞(monocytic myeloid-derived suppressor cells, M-MDSC)及相关细胞因子在特发性膜性肾病(idiopathic membranous nephropathy, iMN)患者外周血中的表达水平以及与临床指标相关性。方法收集2018年1月至2022年12月于安徽医科大学第一附属医院和安徽省霍山县医院52例初诊iMN患者为实验组。另外, 收集40例健康志愿者作为对照组。采用流式细胞仪检测两组研究对象外周血中M-MDSC水平, 酶联免疫吸附试验(enzyme-linked immunosorbent assay, ELISA)方法检测白细胞介素(interleukin, IL)-6和磷脂酶A2受体(hospholipase A2 receptor, PLA2R)水平, 聚合酶链式反应(polymerase chain reaction, PCR)方法检测精氨酸酶(arginase-1, Arg-1)mRNA水平。并分析M-MDSC与iMN病情活动度和治疗相关性。结果与对照组相比, 初诊iMN组患者外周血中M-MDSC表达水平明显升高, 差异具有统计学意义[(23.25±5.72)%比(9.12±4.23)%, t=18.85, P<0.001]。根据iMN患者病理分期, Ⅲ-Ⅳ组患者外周血中M-MDSC表达水平与Ⅰ-Ⅱ组相比明显升高, 差异具有统计学意义[(25.12±5.21)%比(19.35±4.71)%, t=4.85, P<0.01]。IL-6和Arg-1 mRNA在初诊iMN患者外周血中表达水平相比对照组明显升高, 差异具有统计学意义[(43.16±7.67)pg/mL比(6.31±2.23)pg/mL;(6.12±1.58)比(1.53±0.52);t值分别为11.58、7.22, P值均<0.05]。PLA2R以及24 h尿蛋白作为评估iMN患者疾病活动度的指标, 其在初诊iMN患者外周血中表达水平相比对照组亦明显升高, 差异具有统计学意义[PLA2R:(17.21±4.13) ng/L比(2.15±0.71) ng/L;尿蛋白:(4.81±1.26)g/24 h比(0.08±0.02)g/24 h;t值分别为18.86、50.82, P值均<0.001]。52例初诊iMN患者中, M-MDSC水平与IL-6、PLA2R以及24 h尿蛋白表达水平呈正相关(r值分别为0.613、0.502、0.637, P值均<0.05)。治疗前相后相比, M-MDSC水平显著下降, 差异具有统计学意义[(23.25±5.72)%比(10.18±3.27)%, t=6.84, P<0.01]。结论 iMN患者�Objective To investigate the expression levels of monocytic myeloid-derived suppressor cells(M-MDSCs)and related cytokines in the peripheral blood of patients with idiopathic membranous nephropathy(iMN)and explore their role in the pathogenesis of iMN.Methods Total of 52 newly diagnosed iMN patients and 40 healthy volunteers were enrolled from the First Affiliated Hospital of Anhui Medical University and the Hospital of Huoshan County in Anhui Province from January 2018 to December 2022 in this study.M-MDSC were detected by flow cytometry,while IL-6 and PLA2R levels were measured by ELISA,and Arg-1 mRNA levels were detected by PCR.The correlation between M-MDSC and iMN disease activity and treatment was analyzed.Results Compared with the control group,the expression level of M-MDSCs in the peripheral blood of the newly diagnosed iMN group was significantly increased[(25.12±5.21)%vs(19.35±4.71)%,t=4.85,P<0.01].Compared with the I-II group,the expression level of M-MDSCs in the III-IV group was significantly increased[(25.12±5.21)%vs(19.35±4.71)%,t=4.85,P<0.01].The levels of IL-6 and Arg-1 mRNA in newly diagnosed iMN patients were significantly higher than those in the control group[(43.16±7.67)pg/mL vs(6.31±2.23)pg/mL;(6.12±1.58)vs(1.53±0.52);t=11.58、7.22,all P values<0.05].PLA2R and 24 h urine protein,which were used to evaluate disease activity in iMN patients,showed significantly higher expression levels in newly diagnosed iMN patients compared with the control group[PLA2R:(17.21±4.13)ng/L vs(2.15±0.71)ng/L;Urine protein:(4.81±1.26)g/24h vs(0.08±0.02)g/24 h;t=18.86、50.82,all P values<0.001].In the 52 newly diagnosed iMN patients,M-MDSC levels were positively correlated with IL-6,PLA2R,and 24 h urine protein(r=0.613、0.502、0.637,all P values<0.05).After treatment,the level of M-MDSCs significantly decreased[(23.25±5.72)%vs(10.18±3.27)%,t=6.84,P<0.01].Conclusion The expression of M-MDSC in peripheral blood of patients with iMN is increased,and it may become a potential biomarker and therapeut

关 键 词：特发性膜性肾病 细胞型髓系来源抑制性细胞 疗效 细胞因子 

分 类 号：R692[医药卫生—泌尿科学]