| Background Primary membranous nephropathy(PMN)is a common disease of primary glomerular disease,and one of the common types of primary nephrotic syndrome.The incidence of PMN has increased in the past few years.The mechanism of PMN has made great progress,such as on the parts of target antigen,immune mediated,genetic factor,and so on.But the mechanism is still not quite clear.At present,people think that immune mediated is the major factor.The recent studies of the mechanism of PMN have found that not only involved B lymphocyte and T helper cells(Th1 and Th2),Treg and Th17 are also involved in some literature reported at home and broad,but the specific mechanism is not clear.At present,the therapeutic method of PMN almost use glucocorticoid combined with immunosuppressor.These years,the therapeutic effect of calcineurin inhibitor(cyclosporine?tacrolimus,et al.)is well.Side effect of tacrolimus is low,and it is one type of immunosuppressor,that can selectively and powerfuly inhibit the proliferration and excitation of T lymphocyte.But there is little reports on the influence effect about changes of peripheral blood and renal tissues lymphocyte in patients with primary membranous nephropathytacrolimus at home and abroad in the papers.Objective To observe the changes of Th17,Treg in peripheral blood and renal tissues for the patients with primary membranous nephropathy(PMN).To explore the significance of mechanism in patients with PMN.And analyze its value of etiological therapy.Methods 40 cases of PMN in the nephrology department of the First Affiliated Hospital of Xinxiang Medical College were selected,and they had a lot of proteinuria(4g/24h).To detect the level of Th17,Treg and lymphocyte subgroups(CD3+?CD4+?CD8+?CD4+/CD8+?CD16+CD56+?CD19+)in peripheral blood by the flow cytometry.To observe the expression of Th17 and Treg in renal tissues of 15 cases from these selected patitents by immuohistochemistry.Simultaneous 40 healty volunteers were selected as the control group in peripheral blood and 10 renal of person with cancer were selected as the control group.To compare the differences between the group of PMN and the health.To choose 15 cases from the group of PMN,and given FK506 therapy.To compare the experimental results after 3 and 6 months by the flow cytometry and analysis their possible clinical significance.Results(1)Compared with the healty control group,the Treg cell ratio was significantly increased(P<0.01),and the Th17 cell ratio was signicantly decreased(P<0.01).Compared with the untreated group,after cured for 3 or 6 months,the ratio of Treg and Th17 was improved(P<0.01).(2)The expression of IL-17(30.54±4.91%)with the PMN group is far more than the control group(3.96±0.51%),it was significantly decreased(t=11.017,P<0.01).The expression of Foxp3(68.36±4.81% with the PMN group is far more than the control group(6.29±0.57%),it was significantly decreased(t=40.505,P<0.01).(3)Compared with the healthy control group,the CD3+,CD8+ cell levels had a downward trend(P>0.05),and the level of CD4+ cell had a rising trend(P>0.05)in the PMN patients,while the CD4+/CD8 ratio was increased(P<0.05).The CD16+CD56+ cells level had a downward trend(P<0.05),and the CD19+ cells level had a rising trend(P<0.05).After cured for 3 or 6 months,all of the dates belonged with the dates of healty control group,but it was no significative(P>0.05).(4)Compared the level of proteinuria with the healty control group,the date was significantly increased(P<0.01),and after cured for 3 or 6 months,it was significantly decreased(P<0.01).Conclusions There were abnormalities of Th17,Treg in the patients with primary membranous nephropathy(PMN).FK506 can regulate abnormalities of Th17,Treg.And its result maybe to forecast the effect of FK506. |
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