The Effect Of Th1/Th2 Imbalance On The Focal Renal Capillary Injury Of HSPN Children

The effect of Th1/Th2 imbalance on the focal renal capillary injury of HSPN childrenObjective: To detect the expression of Th1/Th2 and VEGF in kidney of chileren with HSPN, and investigate the relationship within Th1/Th2, VEGF and the focal renal capillary injury of HSPN.Methods: To select 32 children with HSPN, and 5 patients accepted nephrectomy due to trauma as control. After renal biopsy, pathological change was observed and evaluated half-quantitatively according to Wu Xiaochuan's method. In order to analysis the correlation in renal Th1/Th2, VEGF, pathological change and capillary injury, INFγas the marker of Th1 cells, IL-4 as the marker of Th2 cells, CD34 as the marker of new vessels with blood vessel endothelium and VEGF was detected by immunohistochemistry.Results:1. According to renal pathological grade, 3 children wereⅡa, 5 wereⅡb, and in gradeⅡ, the average pathological score of renal glomeruli was 2.50±0.76, the average score of tubule was 1.00±0.58. The average score of glomeruli of 7Ⅲa was 4.75±0.71, while the tubule 2.29±0.76. The average score of glomeruli of 10Ⅲb children was 6.50±0.85, while tubule 4.22±1.09. The average glomeruli score of 4Ⅳb and 3Ⅴb children was 10.00±1.00, while tubule 9.29±1.38. The score of renal glomeruli and tubule in different grades was different in statistics.2. The average microvessel density in kidney was 3.00±0.10 in control. In HSPN, according to renal pathological grade, gradeⅡwas 5.42±0.10; gradeⅢa was 4.12±0.34, gradeⅢb was 3.09±0.45, and gradeⅣandⅤwas 1.21±0.46. The control was significant different with gradeⅡ, gradeⅢa, and gradeⅣandⅤ, while it has no difference with gradeⅢb in statistics.3. The average Th1/Th2 in kidney was 0.80±0.18 in control. In HSPN, according to renal pathological grade, gradeⅡwas 0.56±0.04; gradeⅢa was 0.50±0.16, gradeⅢb was 0.46±0.14,and gradeⅣandⅤwas 0.39±0.02. And the differences between any two grades was significant. Besides, according to renal capillary injury, the Th1/Th2 was significant different between any two grades. The correlation between renal Th1/Th2 and score of capillary injury was negative.4. The average VEGF in kidney was 44.70±3.20 in control. In HSPN, according to renal pathological grade, gradeⅡwas 60.91±2.03; gradeⅢa was 49.99±1.96, gradeⅢb was 41.15±1.89, and gradeⅣandⅤwas 27.21±2.78. The gradeⅡwas higher than the control, and the gradeⅣandⅤwas lower than the control, while the gradeⅢa and gradeⅢb had no significant difference with the control. According to renal glomeruli, tubule and capillary injury, the grade 1 was higher than the control, and the grade 3 was lower than the control, while the grade 2 had no difference with the control.Conclution:1. The study showed that there was imbalance of Th1/Th2 in kidney of HSPN children, and the function of ath2 was relatively prevailed.2. This imbalance correlated positively with the renal pathological lesion and capillary injury of HSPN.3. VEGF might be concerned with the renal pathological lesion and capillary injury of HSPN.