| Objective: To investigate the role of interleukin-8(IL-8) and antineutrophil cytoplasmic antibodies(ANCA) in pathogenesis of Henoch-Schonlein purpura(HSP) by detecting serum level of IL-8 and ANCA, and the effect of methylprednisolone(MP) and tripterygiunm wilfordii polyglycosidium(TWP) on them. Methods: Children with HSP were randomly divided into three groups according to diagnostic criterion: common group (without nephritis), nephritis group, nephrotic syndrome group. The children in nephrotic syndrome group were randomly divided again into two groups according to different drugs: MP group and TWP group. There is a healthy normal control group. During acute phase and recover phase in common group and nephritis group, before and after treatment with MP and TWP in nephrotic syndrome group, venous blood was drawn after an overnight fast into standard sterile polystyrene vacuum tubes, allowed to clot at 4℃ for 2hr then centrifuged. Serum samples were aliquot by detecting dosage every time, then stored at -20℃. Samples were thawed only once. IL-8 was measured by enzyme-linked immunoadsorbent assay (ELISA), and ANCA by indirect immunofluoresence (IIF). The samples of renal biopsy were routinely detected by optic microscope, immunopathology and electronic microscope. Results: Serum level of IL-8 in children of common group and nephritis group was significantly higher during acute phase than during recover phase, but serum level of IL-8 in children of common group and nephritis group during recover phase was still higher than that of normal control children. Serum level of IL-8 in children of nephrotic syndrome group after treating with MP and TWP reduced significantly,but that of IL-8 in children treating with MP reduced more quickly than that of IL-8 in children treating with TWP. Positive correlation was showed between serum level of IL-8 and degree of HSP. The results of IL-8 in every group were as follows: healthy normal control group:28.31±4. 82; common group acute phase: 90. 73+5. 21; common group recover phase: 36. 13 + 3. 67; nephritis group acute phase: 101.69 + 5.48; nephritis group recover phase: 43.53 + 3.18; MP group before pulse therapy: 125. 76+6. 80; MP group after pulse therapy: 87. 97 + 5. 08; TWP group before treatment: 126. 38 ± 5. 93; TWP group after treatment: 112. 33 ± 6. 68. ANCA was discovered only in nephrotic syndrome group, positive rate was 40% in TWP group. All of them is IgA sub-style ANCA (IgA-ANCA), but not IgG sub-style ANCA (IgG-ANCA). All of them are perinuclear ANCA (p-ANCA), but not classical ANCA (c-ANCA). After treating with TWP, the children who had been positive for IgA-ANCA were negative for IgA-ANCA. It may be found by renal biopsy that diffuse mesangial proliferative glomerulonephritis(MsPGN), crescentic glomerulonephritis and focal segmental glomerulosclerosis (FSGS), deposit of predominantly IgA in mesangial area. Conclusion: In this study, we have found that there is a significant correlation between serum level of IL-8 and different phases, different degree, different curative effect in HSP. This demonstrates that IL-8 plays a role in HSP, and is a sensitive test for observing illness, estimating curative effect, judging prognosis. It is discovered in this study that the serum level of IL-8 in common group and nephritis group during recover phase was still higher than that of IL-8 in normal control group when the patients with HSP have recovered in clinical. This demonstrates that IL-8 may be a potential relapse factor of HSP. So it is very important to prolong follow-up phase. PM and TWP were effective on treating nephrotic syndrome of HSP, and good for clinical use. At the same time, it is discovered in this study that the reduction of serum level of IL-8 in MP group was quicker than that of serum level of IL-8 in TWP group. This demonstrates...
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