MDSC、sPD-1与原发性膜性肾病活动度的相关性研究OA

Objective To explore the expression of peripheral blood myeloid-derived suppressor cell(MDSC),T helper cell 17(Th17),interleukin(IL)-17A and soluble programmed death-1(sPD-1)in patients with primary membranous nephropathy(PMN),as well as their correlations with the disease activity of PMN.Methods Data were collected from patients who visited the Department of Nephrology,Ningbo Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to November 2022 and were diagnosed with PMN by renal biopsy.30 patients with nephrotic syndrome and 30 patients without nephrotic syndrome were enrolled.Additionally,30 healthy individuals who underwent physical examinations at the same hospital during the same period were included as healthy control group.Peripheral blood MDSC and Th17 proportions were measured by flow cytometry.Serum levels of IL-17A,sPD-1,anti-phospholipase A2 receptor(PLA2R)antibody,and anti-thrombospondin type-1 domain-containing 7A(THSD7A)antibody were detected by enzyme linked immunosorbent assay(ELISA).Spearman correlation analysis was used to evaluate the correlations of peripheral blood MDSC,Th17,IL-17A and sPD-1 with PMN disease activity.Results The proportions of peripheral blood MDSC and Th17,as well as serum levels of IL-17A and sPD-1,were significantly higher in PMN group than in healthy control group(P<0.05).Peripheral blood MDSC(r=0.514,P<0.001),Th17(r=0.522,P<0.001),IL-17A(r=0.598,P<0.001)and sPD-1(r=0.302,P<0.05)were positively correlated with the urinary microalbumin-to-creatinine ratio.Peripheral blood MDSC(r=0.376,P=0.003),Th17(r=0.560,P<0.001)and IL-17A(r=0.415,P<0.01)were positively correlated with anti-PLA2R antibody levels.Peripheral blood MDSC(r=-0.439,P<0.001),Th17(r=-0.603,P<0.001),IL-17A(r=-0.639,P<0.001)and sPD-1(r=-0.226,P<0.05)were negatively correlated with serum albumin levels.Conclusion The proportion of peripheral blood MDSC and Th17,the level of IL-17A,sPD-1 were higher in PMN patients in comparison with healthy control group.The proportions of peripheral blood MDSC,Th17,and the levels of IL-17A,sPD-1 were positively correlated with the activity of PMN which indicated MDSC,Th17,IL-17A and sPD-1 may be involved in the pathogenesis of PMN.