The Change And Significance Of CD4~+ CD25~+ T Regulatory Cells In Children With Primary Nephritic Syndrome

Objective To investigate the change and significance of CD4+CD25+T regulatory(reg)cells and lymphocyte subpopulation in peripheral blood of children with PNS and to explore their role in the pathogenesis in children with Primary Nephritic Syndrome (PNS). Also to Clarify the immunological mechanism of glucocorticoid in treating primary nephrotic syndrome.Methods A total of 51 patients with PNS in Department of pediatrics in Qingdao medicial college affiliated hospital from 2009.8 to 2011.2 were divided into two groups, the simple type nephritic syndrome group (SNS) (n=38) and Nephritis type nephritic syndrome group (NNS) (n=30), and 20 healthy subjects were selected as control group. FCM was used to detecting the percentage of CD4+CD25+Treg, T lymphocyte subpopulation(including CD3+, CD3+CD4+, CD3+CD8+T cells), NK cells and B cells. 30 cases from SNS group were reviewed in their remission period after treatment with glucocorticoid.Results①Compared with the control group, the percentage of CD4+CD25+Treg and NK cells was lower in PNS group(t'=-7.94,t'=-2.72;P<0.01,P<0.05), however the percentage of B cells and activated T cells was higher in PNS (t=3.22,t'=2.53;P<0.05). And the percentage of CD3+,CD3+CD4,CD3+CD8+T cells in patients with PNS there was no change than that of the control group (t=0.55, t=0.69, t=0.53;P>0.05).②The percentage of the activated T cells was higher in NNS group than that in SNS group (t=-2.18,p<0.05),but for CD3+,CD3+CD4+,CD3+CD8+T cells,NK cells,B cells and CD4+CD25+Treg, there was no significant diffience in both SNS and NNS group (t=-1.41～1.01.t'= 1.85;P>0.05).③The percentage of CD4+CD25+Treg in SNS group was significantly higher after treatment with glucocorticoid than before (q=4.31,p<0.01), but still lower than that of the control group (q=3.07,p<0.05). The percentage of NK cells was lower in SNS group than that of the control group (q=4.41,p<0.01),and a little increase was observed after treatment than before, but there was no significant difference (q=2.21,P>0.05). While the percentage of B cells was higher in SNS group than that of the control group(q=3.42, p<0.05), and there was a little decrease after treatment than before, but also there was no significant difference (q=2.17,P>0.05). For CD3+,CD3+CD4+,CD3+CD8+T cells and activated T cells there was no change after treatment than before (F=0.31-13.05, P>0.05)Conclusion①The decrease of CD4+CD25+Treg might play a pathological role in the PNS development, and glucocorticoid might have immunotherapeutic effect by up-regulating CD4+CD25+Treg ratio in PNS.②The excessive activation of T cells and decreased NK cells might also play an important role in the PNS development(especially in NNS group).