| Objective:By observing the change characteristics of serum soluble cytotoxic t-cell-associate d antigen 4(sCTLA-4)in patients with allergic purpura(HSP),the role of sCTLA-4 i n the pathogenesis of HSP in children was discussed,and a new direction for the tre atment of HSP was found.Methods:49 patients with allergic purpura who were admitted to the department of pediatri cs of affiliated hospital of Qingdao university and the department of pediatrics of gao mi people’s hospital from October 2017 to May 2018 were selected as subjects(HSP group).62 healthy children with physical examination in the outpatient department we re selected as normal control group.HSP patients were divided into renal lesion group(HSPN group)and non-renal lesion group(NHSPN group)according to the acute pu rpura period and the presence or absence of urinalysis abnormalities(hematuria or/and proteinuria)within 4 weeks after treatment.According to the acute phase without gast rointestinal symptoms(abdominal pain,hematochezia or hematemesis)were divided int o two groups for comparison;According to the presence and absence of precursor infe ctions(fever,cough,etc.)were divided into two groups for comparison.In the morning,3ml fasting venous blood was collected from both HSP patients and children in the control group.After centrifugation,serum was separated and collected and stored in a refrigerator at-80℃.Serum sCTLA-4 level was detected by double antibody sandwich ELISA,and serum immunoglobulin(Ig A,IgG,IgM and IgE)was detected by immu ne projection turbidimetry.Result:The serum sCTLA-4 level of HSP patients in the acute stage was(3749.5±804.5)pg/ml,which was significantly lower than that of the healthy control group(5101.8±566.7)pg/ml,and the difference was statistically significant(P<0.01).The serum sCT LA-4 level of children in the HSPN group was(3801.6±839.7)pg/ml,and the serum sCTLA-4 level of children in the NHSPN group was(3724.3±799.0)pg/ml,with no s tatistically significant difference(P>0.05).However,serum sCTLA-4 level in theHSPN group and the NHSPN group was significantly lower than that in the healthy c ontrol group(P<0.01).The serum sCTLA-4 level of HSP children in the group with precursor infection was(3446.1±773.2)pg/ml,and that of the group without precursor infection was(4065.6±723.0)pg/ml.The difference between the two groups was not statistically significant(P>0.05).The serum sCTLA-4 level of HSP children with gastr ointestinal symptoms was(3927.8±242.3)pg/ml,and that of HSP children with no gas trointestinal symptoms was(3670.9±126.9)pg/ml.There was no statistically significant difference between the two groups(P>0.05).There was no significant correlation bet ween serum sCTLA-4 level and serum immunoglobulin(IgA,IgG,IgM and IgE)leve ls in HSP children(r=-0.172,0.068,0.068,0.187,P>0.05).Conclusion:Serum sCTLA-4 level was significantly decreased in the acute phase of HSP chil dren,and there was no significant difference in serum sCTLA-4 level between childre n with or without prodrome-infected HSP.The results suggested that there was abnor mal function of cytotoxic T cells(decreased expression of CTLA-4)in the acute phas e of HSP children,which may play an important role in the immune disorder of HSP.There was no significant difference in serum sCTLA-4 level between HSP children with and without early renal impairment.There was no significant difference in serum sCTLA-4 level between HSP children with or without digestive tract symptoms in th e acute phase.It suggested that the change of serum sCTLA-4 level was not related to the involvement of organs in children with HSP. |
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