| Primary nephrotic syndrome(PNS)is a kind of clinical syndrome whose pathogenesis and related etiology and pathology are not clear.The high incidence of PNS in children is preschool children,there are more boys than girls,and most of them have chronic course of disease.Massive albuminuria and hypoalbuminemia are the necessary conditions for clinical diagnosis of PNS.In addition,the clinical manifestations include secondary obvious edema and hypercholesterolemia.Often eyelid edema is the first to be observed.The blood pressure of most PNS patients is within the normal range.These clinical manifestations run through the pathogenesis and development of PNS.There are many pathological types of PNS,but according to clinicopathological observation,the main pathological types of primary nephrotic syndrome are minimal nephrotic syndrome((minimal change nephrotic syndrome,MCNS)accounting for about 77.1%and focal segmental glomerulosclerosis((focal segmental glomerulosclerosis,FSGS)accounting for about 7.9%.The loss of protein from the kidney is the main damage mechanism of PNS.Many studies have shown that proteinuria occurs when glomerular filtration membrane permeability is impaired and tubular reabsorption is impaired.It has been reported that the glomerular filtration barrier is composed of podocyte foot process layer,glomerular basement membrane(glomerular basement membrane,GBM)and endothelial cell layer from outside to inside.Recent research suggests that podocyte deficiency is the beginning of glomerulosclerosis.With the progress of the research on childhood nephrotic syndrome,some researchers have injected the serum of PNS patients into experimental mice and found that albuminuria will occur after some time,which provides strong evidence that the pathogenesis of nephrotic syndrome is related to immunity,but the exact mechanism of PNS is still not very clear.Some studies have confirmed that there is a great relationship between the pathogenesis and disease progression of PNS and the balance of Th17/Treg axis.At the same time,the balance of this axis also plays an important role in maintaining the normal immune response of the body.whether the increase of the expression of Th17 or the decrease of the expression of Treg will destroy the balance of Th17/Treg axis,which will also lead to the disturbance of normal immune balance,which may be related to the production of albuminuria in PNS.Under certain special environment and stimulation in the body,T lymphocytes of CD4+differentiate into Th17 cells through a series of orderly and complex cells,while Th17 cells mainly secrete cytokines such as Interleukin-17 IL-17.At present,many studies have focused on the relationship between IL-17 and related cytokines and the occurrence and development of autoimmune diseases.At present,the research of IL-17 in renal disease is mainly focused on lupus nephritis,diabetic nephropathy,glomerulonephritis and renal transplant rejection injury,but there are relatively few reports about IL-17 in nephrotic syndrome,so whether IL-17 is also involved in the pathogenesis of nephrotic syndrome is a question worth studying.Objective:to observe the expression of inflammatory factor interleukin-17(interleukin-17)in the occurrence and progression of puromycin aminonucleoside nephrotic rat model(PAN model),and to further clarify the role and significance of IL-17 in the pathogenesis and development of PNS in children,so as to provide theoretical basis for finding targets for the treatment of nephrotic syndrome in the future.Methods:male SPF SD rats aged 7 weeks were randomly divided into model group(n=18)and control group(n=18).After 3 days of adaptive feeding,the PAN group was injected with 100mg/kgPAN into the tail vein to establish the rat model of puromycin nephropathy,and the control group was injected with normal saline.The general condition of the rats was observed during the experiment.6 rats in each group were killed 3,7 and 14 days after PAN injection.The amount of 24-hour proteinuria was determined by CBB method,and the IL-17 in serum and urine of rats in each group was detected by enzyme-linked immunosorbent assay((ELISA)).Results:(1)the 24-hour proteinuria of rats in the PAN group was significantly higher than that in the normal control group,and the peak value was about 307.87 mg/day on the 7th day.(2)the amount of serum IL-17 in the PAN group was significantly higher than that in the control group on the 3rd,7th and 14th day.(3)the urine IL-17 in the PAN group was significantly higher than that in the control group on the 3rd,7th and 14th day.(4)24-hour urinary protein was positively correlated with IL-17 in serum and IL-17 in urine,and the difference was statistically significant.Conclusion:In the rat nephropathy model induced by puromycin,there were significant differences in 24-hour urinary protein and the content of IL-17 in serum and urine between the PAN group and the control group,and there was a positive correlation between the amount of 24-hour urinary protein and IL-17 in serum and urine of rats. |
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