Barbano G, Cappa F, Prigione I, Pistoia V, Cohen A, Chiesa S, Gusmano R, Perfumo F
Department of Pediatric Nephrology, Giannina Gaslini Institute, Children's Hospital, Largo G. Gaslini 5, I-16148 Genoa, Italy.
Nephrol Dial Transplant. 2001 Sep;16(9):1807-13. doi: 10.1093/ndt/16.9.1807.
Previous studies have suggested that in vivo Th2 lymphocyte activation is related to increased soluble CD30 (sCD30) plasma levels. As various hormones (dehydroepiandrosterone, glucocorticoids, progesterone) can regulate the Th1/Th2 balance, and because growth hormone (GH) enhances lymphocyte function, we measured sCD30 plasma levels, before and after treatment with recombinant human GH (rhGH), in children with growth failure due to chronic renal failure (CRF) or to isolated GH deficiency in order to evaluate the potential effects of rhGH treatment on Th1/Th2 balance.
sCD30 plasma levels were determined by ELISA assay in 30 children with CRF (mean age 10.7+/-3.7 years), in five children with isolated GH deficiency (mean age 11.4+/-2.6 years), and in 10 normal controls (mean age 10.1+/-3.5 years).
sCD30 levels were higher in the 30 children with CRF than in the 10 controls (179.8+/-79.4 vs 11.3+/-10.9 U/ml, P<0.001) exhibiting an inverse correlation with glomerular filtration rate (GFR) (r=-0.7860, P<0.001). In 11 children with CRF, after 19.9+/-16.7 months of rhGH treatment, a decrease of sCD30 plasma level (170+/-50 vs 134+/-49 U/ml, P<0.01) was observed. The five children with primary GH deficiency had higher sCD30 plasma level than controls (mean 147+/-105 vs 11+/-10 U/ml, P<0.004) and sCD30 plasma levels decreased to 95.2+/-109.6 U/ml after rhGH treatment.
The finding that rhGH treatment decreased sCD30 plasma levels in children with CRF, and that children with primary GH deficiency had higher sCD30 plasma levels than controls, suggest that GH may regulate CD30 expression and possibly the balance of Th1/Th2. Whether the uraemia-induced increase in sCD30 is due to decreased renal excretion, to overproduction or both, remains to be determined.
先前的研究表明,体内Th2淋巴细胞活化与可溶性CD30(sCD30)血浆水平升高有关。由于多种激素(脱氢表雄酮、糖皮质激素、孕酮)可调节Th1/Th2平衡,且生长激素(GH)可增强淋巴细胞功能,我们测定了因慢性肾衰竭(CRF)或孤立性生长激素缺乏导致生长发育迟缓的儿童在重组人生长激素(rhGH)治疗前后的sCD30血浆水平,以评估rhGH治疗对Th1/Th2平衡的潜在影响。
采用酶联免疫吸附测定法(ELISA)测定30例CRF患儿(平均年龄10.7±3.7岁)、5例孤立性生长激素缺乏患儿(平均年龄11.4±2.6岁)和10例正常对照儿童(平均年龄10.1±3.5岁)的sCD30血浆水平。
30例CRF患儿的sCD30水平高于10例对照儿童(179.8±79.4 vs 11.3±10.9 U/ml,P<0.001),且与肾小球滤过率(GFR)呈负相关(r=-0.7860,P<0.001)。11例CRF患儿在rhGH治疗19.9±16.7个月后,sCD30血浆水平下降(170±50 vs 134±49 U/ml,P<0.01)。5例原发性生长激素缺乏患儿的sCD30血浆水平高于对照儿童(平均147±105 vs 11±10 U/ml,P<0.004),rhGH治疗后sCD30血浆水平降至95.2±109.6 U/ml。
rhGH治疗可降低CRF患儿的sCD30血浆水平,且原发性生长激素缺乏患儿的sCD30血浆水平高于对照儿童,这表明GH可能调节CD30表达,进而可能调节Th1/Th2平衡。尿毒症导致的sCD30升高是由于肾脏排泄减少、产生过多还是两者兼有,仍有待确定。