The Clinical Significances Of CXCL16 In Children With Henoch-Schonlein Purpura

Background:Henoch-Schonlein purpura(HSP)is a disease involving inflammation of small blood vessels.Although HSP can affect people at any age,most cases occur in children between the ages of 2 and 8.It is more common in boys than girls.The dominant manifestation is the cutaneous component and the prognosis and outcome depend mostly on renal manifestations.HSP is an acute self-limited illness and usually resolves without treatment,but may rarely lead to complications.Nephritis is observed in about 30%of children with HSP.Renal damage eventually leads to kidney failure in 1%-3%of the children with kidney deficiency.HSPN,implicated in glomerular injury,is a rare kidney disease which can lead to chronic renal insufficiency in a minority of the patients.Renal failure even occurs in 1%-3%of these patients.However,our knowledge on HSPN is quite limited.Both humoral and cellular immunity,as well as an activated inflammatory cascade,have been implicated as effector mechanisms of this disease.Chemokines are proinflammatory cytokines that function in leukocyte chemoattraction and activation.CXC Chemokine Ligand 16(CXCL16)was a new number of CXC family reported by Matoubian and Wilbonks in 2010 and 2011,respectively.It has been reported that CXCL16 play roles in atherosclerosis progression,tumor infiltration,transplant rejection and inflammation.Moreover,it has been found that the content of CXCL16 in the peripheral vascular and kidney tissues is related to the progress of diabetic nephropathy and nephritic syndrome.However,it still remains unknown whether CXCL16 participate in pathogenesis of HSPN.Objective:This study was designed to investigate the relationship between CXCL16 and the initiation and progression of HSPN,by determining the content of CXCL16 in the blood and urine of the HSPN patients.We aimed to provide new methods for HSPN diagnosis and treatment.Methods:110 patients were enrolled from paediatrics department of Qilu hospital between December 2014 and June 2016,including 56 HSP patients and 54 HSPN patients.20 volunteers were served as control.In HSPN group,the patients were subdivided into 3 groups:group I(<25mg/kg.24h),group II(25-50mg/kg.24h)and group III(>50mg/kg.24h),according to their urine protein content.All blood and urine from the patients were collected before they accepted therapy.The content of CXCL16 in the plasma and urine were detected by ELISA.Statistical analysis was performed with SPSS 17.0 software package.Results:1.The content of CXCL16 in plasmaThe content of CXCL16 in plasma of HSPN group and HSP group is significant higher than that in control group(both p<0.01,HSPN vs.control;both p<0.01.HSP vs.control).The content of CXCL16 in plasma of HSPN group is significant higher than that of HSP group(both p<0.05,HSPN vs.HSP).2.The content of CXCL 16 in urineThe content of CXCL16 in urine of HSPN group and HSP group is significant higher than that of control group(both p<0.01,HSPN vs.control;both p<0.01,HSP vs.control).The content of CXCL 16 in urine of HSPN group is significant higher than that of HSP group(both p<0.01,HSPN vs.HSP).3.The level of urine CXCL 16 with different levels of proteinuria in HSPN groupThe 24-hour-urine protein level in group ? group is significant higher than that of group ?(p<0.01,group ? vs.group II),while the latter is significant higher than that of group I(p<0.01,group ? vs.group ?).4.The correlation of urine CXCL 16 level and 24h urine protein in HSPN groupThe content of CXCL16 was positively correlated(r=0.589,p<0.05)to 24-hour-urine protein level in HSPN group.Conclusion:1.The content of CXCL16 in plasma of HSPN group is significant higher than that of HSP and control group and so is the content of CXCL16 in urine.These data suggest the possibility of CXCL16 as a biomarker for HSPN progression.2.The content of CXCL16 in plasma of HSP group is significant higher than that of control group and so is the content of CXCL16 in urine.These data suggest the possibility of CXCL16 as a biomarker for early diagnosis.3.The content of CXCL16 in urine is positively correlated with the content of 24-hour-urine protein in HSPN group,which further implicate the possibility of CXCL16 as a biomarker HSPN progression and one of the indicators to predict the severity of HSPN.