Effect Of Shenkangling On Serum NLRP3 Inflammasome,IL-18 And IL-1β In Children With Primary Nephrotic Syndrome(simple Type)

Objective: Interventien in children with Primary nephrotic syndrome(PNS)by using treatment of shenkangling,observing the change of Nucleotide binding oligomer-ization domain-like receptor protein 3(NLRP3 inflammasome),Interleukin 18(IL-18)and Interleukin1β(IL-1β)before and after intervening PNS kids.In order to explain pathogenesis of PNS and the mechanism of Chinese Medicine Shen Kangling,improving the clinical efficacy of PNS.Methods: Thirty children who met the diagnostic criteria of PNS(simple type)and key points of TCM syndrome diagnosis of kidney deficiency and blood stasis were selected as the treatment group(group A),who were admitted to the People’s Hospital affiliated to Fujian University of Chinese Medicine and the Second People’s Hospital Affiliated to Fujian University of Chinese Medicine from December 2020 to December 2021.At the same time,30 healthy children aged 2-14 were selected as healthy control group(group B)in physical Examination Center of Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine.By combining Chinese and western medicine(hormones and/or immune inhibitor combined Chinese medicine kidney Kang Ling party),observe the health group and treatment group before the treatment,after treatment of 4 weeks,12 weeks after treatment the serum inflammatory corpuscle NLRP3,IL-1 beta,changes in the levels of IL-18 and 24 hours urinary protein quantitative,serum albumin,cholesterol,triglyceride,low density lipoprotein cholesterol(hdl-c).All the measured data were statistically processed by SPSS26.0 software.Results:1.Before treatment,there were no significant differences in gender and age composition between group A and group B(P>0.05).A total of 30 children with PNS were included in this study,among which 2 fell off during the follow-up because the children could not cooperate with clinical observation.1 case with incomplete data loss.The serum levels of NLRP3 inflammasome,IL-18 and IL-1β in group A were higher than those in group B(all P<0.05).2.After 4 weeks of treatment,compared with before treatment,serum NLRP3 inflammatory body,IL-18 and IL-1β levels in group A were decreased(all P < 0.05),serum albumin levels in group A were increased(all P < 0.05),24-hour urine protein quantitative,urine protein qualitative and triglyceride levels were decreased(all P<0.05).The total cholesterol level,low density lipoprotein level and serum creatinine level had no significant changes(P > 0.05).3.After 12 weeks of treatment,compared with 4 weeks of treatment,the levels of NLRP3 inflammatory body,IL-18 and IL-1β in serum of group A were significantly decreased(all P<0.05),and the levels of total cholesterol and low density lipoprotein in group A were significantly decreased(all P<0.05).There were no significant changes in serum albumin,triglyceride,serum creatinine levels,24-hour urine protein quantification and urine protein qualitatively in group A(P>0.05).4.After 12 weeks of treatment,compared with before treatment,the serum levels of NLRP3 inflammasome,IL-18 and IL-1β in group A were significantly decreased(all P<0.05),and serum albumin in group A was significantly increased(P<0.05).The 24-hour urine protein quantification,urine protein qualitative,cholesterol,triglyceride and low density lipoprotein levels were significantly decreased(all P< 0.05),while serum creatinine level had no significant change(P > 0.05).Conclusions: 1.Abnormal increase of serum NLRP3 inflammasome,IL-18 and IL-1βlevels in children with PNS suggests that activation of NLRP3 inflammasome pathway and secretion of cytokines such as IL-18 and IL-1β are involved in the pathogenesis of PNS.2.Integrated traditional Chinese and Western medicine treatment of PNS in children can reduce the levels of NLRP3 inflammasome,IL-18 and IL-1β in serum by reducing immune and inflammatory responses,inhibiting podocellular apoptosis and promoting the repair of glomerular filtration structure.3.Shenkangling combined with western medicine can alleivate the hyperlipemia and of blood and improve the clinical efficacy.4.NLRP3 inflammosome,IL-18 and IL-1β change earlier than serum creatinine level,so they can be used as early biological markers reflecting glomerular ultrastructural damage,and provide objective indicators for the treatment and prognosis of children with PNS.