The Research Of The Correlation Between Cd4~+Cd25~+Foxp3T Cells And IgA Nephropathy

Background:The morbidity of chronic kidney disease was as high as11.8%to13%in our country. It finally might progress to the end stage renal disease (ESRD), and eventually required renal replacement therapy (such as blood dialysis or renal transplantation) to sustain life. From1990to2010, the number of hemodialysis patients in the world increased at an annual rate of7%. The probability of cardiovascular disease (CVD) in patients with ESRD was10-20times of ordinary people, about35%to50%of ESRD patients died of CVD. IgA nephropathy was one of the most common glomerular disease, which accounted for about25%to50%of primary glomerular disease. There were about25%to40%of patients with IgA nephropathy developed to ESRD after the onset of20to25years. IgA nephropathy was put forward for the first time since1968, the disease pathogenesis was still unclear. The researchers found that a large number of abnormal glycosylation IgA1molecules were produced when antigens stimulated the human body, inaddition to the human body to remove abnormal IgAl ability was limited, which led to B lymphocytes synthesis and secretion of specific resistance IgAl antibodies. Circling immune complex (IC) formed after the combination of antigen and antibody. IC combined with receptors in glomerular mesangium, which stimulated cytokine secretion, Induced cell injury, mesangial cell proliferation, mesangial matrix increase and renal tubular epithelial cell activation, all of them caused the renal damage. IgA nephropathy was a kind of disease associated with immune. Humoral immunity and cellular immunity participated into immune response together. The pathogenesis of IgA nephropathy might be related to the patient’s own immune dysfunction such as the abnormal number of T cells and dysfunction of T cells. This study analyzed the relationship between regulatory T cells and IgA nephropathy clinical pathological datas, to reveal the correlation between regulatory T cells and IgA nephropathy, meanwhile, to provide theory basis for IgA nephropathy therapy.Objection:To investigate the correlation between the percentage of Tregs (CD4+CD25+Foxp3/CD4+CD25T cells) in people with the clinical pathology changes in IgA nephropathy (IgAN).Materials and methods:The observation group concluded30cases of IgA nephropathy patients who had been diagnosed by the renal biopsy in our hospital during July2012to December2013. The control group concluded30cases of healthy volunteers in our hospital medical center for the same period. All blood samples were collected early in the morning on an empty stomach for3ml, heparin anticoagulated and were inspeced within4hours. By using flow cytometry and cell intracellular Foxp3protein staining technique, we detected peripheral blood lymphocyte subsets ratio in IgAN patients. We used statistical methods such as t test, single factor ANOVA, chi-square test, bivariate regression and correlation analysis to analyze datas.Result:1. The baseline datas analysis showed there was no significant differences between the two groups, while excepted TC, triglyceride, LDL and Hemoglobin (P<0.05).2.The ratio of Tregs was significantly higher in peripheral blood of IgAN patients than that in control group [(8.0±9.64)%and (3.04±1.84)%, P<0.05)].3.There was no significant differences of the Tregs ratio between the normal serum creatinine group and abnormal creatinine group in IgAN patients (P>0.05).4. There was also no significant differences of the Tregs ratio between the normal eGFR group and abnormal eGFR group in IgAN patients (P>0.05).5.There were significant differences of the Tregs ratio in each pathologic grading of IgAN [(2.60±2.16)%,(8.65±7.93)%,(20.49±16.49)%, P<0.05]. But there was no difference in the three albuminuria groups (p>0.05).6.The ratio of Treg cells was positively correlated with serum creatinine levels(r=0.547,R2=0.299,P<0.05). Controversly, the ratio of Treg cells was negatively correlated with eGFR(r=-0.362,R2=0.131,p<0.05). The ratio of Treg cells had a linear correlation with the IgAN pathological degree (P<0.05) but it had no correlation with the24h urine protein quantitative (r=-0.027, P>0.05).Conclusion:1. Abnormal lipid metabolism, and decreased hemoglobin exists in IgA nephro-pathy patients.2. The dynamic changes of Tregs/CD4+CD25+T cells exists in different periods of IgAN, which displays Tregs ratio participates in IgA nephropathy pathophysiolog-ical process.3.The ratio of Tregs in the IgAN patients peripheral blood is higher than that in the control group. The Tregs rario was significantly correlated with some clinical indexes, which indicates that correcting abnormal peripheral blood Tregs/CD4+CD25+T cells may provide a new way for the treatment of IgA nephropathy.All in all, abnormal Tregs ratio may play an important role in the pathogenesis of IgA nephropathy. Correcting abnormal ratio of Tregs may help block the IgAN progression and improve its prognosis.