Expressions Of TLR-2?TLR-4 And TLR-6 In Peripheral Blood Mononuclear Cells And The Association Of Serum IgG And IgM Levels In Children With Idiopathic Nephrotic Syndrome

BackgroundAlthough the pathogenesis of idiopathic nephrotic syndrome(INS)in children is poorly defined,INS is believed to be related to immune disorders for many years.It was proposed that T cells were mainly involved in the occurrece and development of INS in recent years.Some studies have shown that serum immunoglobulin(Ig)level is associated with the occurrence,development and prognosis of INS.Toll-like receptors(TLRs)are a kind of pattern recognition receptors that play an important role in innate and specific immune responses.Our previous studies indicated the expressions of TLR-1,TLR-3TLR-9 in peripheral blood mononuclear cell(PBMC)of pediatrics INS,suggesting that TLR-1,TLR-3 and TLR-9 may be related to the activity of the disease.However,the expression of TLR-2,TLR-4 and TLR-6 in PBMC of pediatrics INS have not rarely reported,and correlation between TLR-2,TLR-4,TLR-6 and Ig is not clear.Therefore,it is essential that the possible roles of TLR-2,TLR-4,TLR-6 and serum IgG and IgM in the pathogenesis of pediatrics INS were discussed.ObjectiveTo detect and observe TLR-2,TLR-4 and TLR-6 expressions of PBMC and serum IgG and IgM levels of pediatric INS at different stages of activity and remission.To discusse the possible roles of TLR-2,TLR-4,TLR-6 and serum IgG and IgM in the pathogenesis of pediatrics INS.Methods42 INS patients and 29 healthy individuals were enrolled in the present study fromJune,2017 to October,2018 in the First Affiliated Hospital of Xinxiang Medical University.All children were divided into two groups: INS experimental group(32 boys,10 girls)and healthy control group(19 boys,10 girls).TLR-2mRNA,TLR-4mRNA and TLR-6 mRNA expressions of PBMC were evaluated using real-time quantitative polymerase chain reaction(qPCR)in INS children with active(AS)and remission stages(RS)and healthy children resppectively,Meanwhile the blood sample was drawn to evaluate serum levels of IgG,IgM by immune turbidimetry in INS children with AS and healthy children respectively.Results1.The expressions levels of TLR-2mRNA,TLR-4mRNA and TLR-6mRNA in PBMC were significantly higher in the INS children with AS than in the INS children with RS(P<0.05)and in the control group(P<0.05).Similarly,the TLR-2,TLR-4 and TLR-6mRNA expressions were higher in INS children with RS than in the control group(P all<0.05).2.Compared with healthy control group,the serum IgG level was lower and the serum IgM level was higher in INS children with AS(P all <0.05).3.No significant correlations were noted between Toll-like receptors(TLR-2mRNA,TLR-4mRNA,TLR-6 mRNA)and serum immunoglobulin levels(IgG,IgM)(P all >0.05).Conclusion1.The increased expressions of TLR-2mRNA,TLR-4mRNA and TLR-6 mRNA in PBMC of INS children indicate that TLR-2,TLR-4 and TLR-6 may be involved in the pathogenesis of INS.2.The differential level changes of serum IgG and IgM in INS children with AS is of great significance in further exploring pathogenesis of nephropathy.3.The expressions of TLR-2mRNA,TLR-4mRNA and TLR-6 mRNA in PBMC of INS children were not significantly correlated with serum IgG and IgM levels,guessing that TLRs and immunoglobulin may be involved in the pathogenesis of INS in childrenthrough different pathways.