| In recent years,multicenter studies have shown that vitamin D(Vit D)deficiency or deficiency is widespread in Chinese,especially infants and young children.Vit D as a fat-soluble vitamin,its basic function is to regulate calcium and phosphorus metabolism.With the deepening of research on Vit D,especially through high-throughput gene sequencing technology,it is discovered that a variety of immune cells not only have the gene encoding vitamin D receptor(Vit DR),but also that protein Vit DR can be found It is expressed in immune cells and participates in and regulates the functions of immune cells.It is closely related to the occurrence and development of various immune diseases.Henoch-Schonlein purpura(HSP)is a form of immune system disease.HSP is a systemic small vascular inflammatory disease,with Immune complexes(IC)as the main pathological feature in the deposition of small blood vessels in affected tissues.It is the most common immune vascular inflammatory disease in childhood,and it occurs in school age.Pre-and school-age children have higher morbidity and recurrence rates.Among the affected children,Henoch-Schonlein purpura nephriti(HSPN)is the most serious.The degree of kidney damage is the most important factor affecting the prognosis.The prognosis of end-stage renal disease is extremely poor,which seriously affects the physical and mental health of the child.One of the diseases.The etiology of this disease is diverse and the pathogenesis is complicated,but as an autoimmune disease,children with HSP are often accompanied by serum Vit D deficiency or deficiency.In order to further confirm the relationship between HSP and its different subtypes with changes in serum Vit D levels,the correlation between Vit D and various immune indicators,and to explore whether Vit D can play a role in the pathogenesis of HSP by regulating the function of immune cells.In this study,the chemiluminescence method was used to detect the serum level of Vit D in children with HSP,the changes in lymphocyte subgroups were detected by flow cytometry,and the changes in the content of various immunoglobulins in serum were detected by immunoturbidimetry.Correlation with changes in Vit D and immune function,in order to provide new ideas and strategies for clinical diagnosis and treatment.Research purposes1.By comparing the differences in serum Vit D levels between children with HSP and healthy children,and the differences in serum Vit D levels between patients with different subtypes of HSP,explore the changes in serum Vit D levels and HSP disease and its different subtypes Relevance.2.By comparing and analyzing the correlation between serum Vit D levels and various immune indicators in children with HSP,to explore whether Vit D can participate in the pathogenesis of HSP by regulating the function of immune cells,and as a predictor of HSP disease progression.research methodSixty-nine children diagnosed with HSP who were admitted to the Third Affiliated Hospital of Zhengzhou University from July 2018 to June 2019 were selected as the HSP group,and the diagnostic criteria were in line with the European Union against Rheumatism and the European Pediatric Rheumatology Association(EULAR/PReS)Unified diagnostic criteria for HSP;the HSP group was further divided into a purpuric nephritis group(HSPN group)and a non-purpuric nephritis group(NHSPN group)based on the diagnostic criteria for purpuric nephritis developed by the nephrology group of the Chinese Medical Association Pediatrics Branch;A total of 70 children undergoing physical examination during the same period were selected as the control group.Children with HSP collected venous whole blood early in the morning within 24 hours after admission,and the control group children received venous whole blood during physical examination for serum 25(OH)D test,lymphocyte subgroup test,and serum immunoglobulin test.SPSS23.0 software was used for data processing and analysis.Quantitative data were expressed as mean±standard deviation(x±s),and qualitative data were expressed as percentage(%);quantitative data comparison between two groups was performed using t test or rank sum test.Multiple groups Data were analyzed by single factor analysis of variance,and qualitative data were compared using the ?2 test;for correlation analysis,Spearman rank analysis was used,taking ?=0.05 as the level of significance,and P<0.05 was considered statistically significant.The blood samples of children used in this study for research purposes were approved by our ethics committee.Result1.Comparison of serum 25(OH)D levels in different groups of childrenCompared with the normal control group,the serum 25(OH)D level in the HSP group was significantly reduced[(20.34 ± 7.43)vs(36.48 ± 1.40)ng/mL],and the difference was statistically significant(P<0.05).Compared with the NHSPN group,the serum 25(OH)D level in the HSPN group was significantly reduced[(14.35± 5.16)vs(21.98± 1.06)ng/mL],and the difference was statistically significant(P<0.05).2.Comparison of serum 25(OH)D levels in children with different HSP subgroupsCompared with the skin-only group,the serum 25(OH)D level in the joint-type group,abdominal-type group,and mixed-type group was significantly reduced[(17.21 ± 5.30)vs(23.60 ± 1.85)ng/mL;(20.46±2.90)vs(23.60±1.85)ng/mL;(20.69± 1.43)vs(23.60± 1.85)ng/mL],the difference was statistically significant(all P<0.05).Compared with the abdominal group and mixed group,the serum 25(OH)D level in the joint group was significantly reduced[(17.21± 5.30)vs(20.46±2.90)ng/mL,(17.21 ± 5.30)vs(20.69 ± 1.43)ng/mL],the difference was statistically significant(all P<0.05).There was no significant difference in serum 25(OH)D levels[(20.69±1.43)vs(20.46±2.90)ng/mL]between the mixed type group and the abdominal type group.3.Comparison of results of lymphocyte subsets in different groups of childrenCompared with the healthy control group,the relative percentage of CD3+CD4+T lymphocytes and CD3-CD16+CD56+NK cells in the HSP group was significantly lower than[(26.1±7.0)vs(33.2±6.2);(11.9±5.9))vs(14.4 ± 3.7)],the difference was statistically significant(P<0.05);the relative percentage of CD19+B lymphocytes in total lymphocytes was significantly increased[(20.7 ± 3.6)vs(18.9 ± 4.4)],the difference It has statistical significance(all P<0.05).The relative percentage of CD3+T lymphocytes in total lymphocytes,the relative percentage of CD3+CD8+ T lymphocytes in total lymphocytes,and the ratio of CD4/CD8 in the HSP group were[(63.2±8.7)vs(65.1±2.4);(27.5±10.3)vs(28.8 ± 4.2);(1.2 ± 0.5)vs(1.3 ± 0.6)]The difference was not statistically significant.4.Correlation analysis between serum 25(OH)D level and lymphocyte subsets in HSP groupThe level of serum 25(OH)D in HSP group was positively correlated with CD3+CD4+T cells,CD3-CD16+CD56+NK cells,and negative correlation coefficients with CD 19+B cells were 0.496,0.312,and-0.231,all P<0.05.The correlation coefficient between serum 25(OH)D level and CD3+CD8+T cell in HSP group was-0.026,P>0.05,there was no significant correlation.5.Comparison of serum levels of Immunoglobulin(Ig)in different groups of childrenCompared with the healthy control group,the serum IgM level in the HSP group was significantly increased[(1.6 ± 0.48)vs(0.7±0.14)g/L];the IgG level was significantly reduced[(10.64 ± 2.34)vs(12.32± 2.15)g/L]The differences were statistically significant(all P<0.05).Compared with the healthy control group,the serum IgA level was[(1.15 ± 0.73)vs(1.12 ± 0.56)g/L],the difference was not statistically significant.6.Correlation analysis between serum 25(OH)D level and immunoglobulin in HSP groupThe serum 25(OH)D level in HSP group was negatively correlated with IgA,the correlation coefficient was-0.354,P<0.05;the correlation coefficients with IgG and IgM were-0.137,-0.212,respectively,there was no significant correlation,all P>0.05.conclusion1.Serum 25(OH)D is related to immunomodulation and may be involved in the pathogenesis and progression of HSP;2.Simultaneous detection of Vit D and detection of changes in lymphocyte subsets can monitor the progress of HSP. |
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