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联合检测 IL-1ra、TNF-R I、TNF-R II 和 RANTES 在原发性肾小球肾炎患者中的预测价值。

Predictive value of conjointly examined IL-1ra, TNF-R I, TNF-R II, and RANTES in patients with primary glomerulonephritis.

机构信息

Department of Kidney Transplantation, Medical University of Łódź, Łódź, Poland.

出版信息

J Korean Med Sci. 2013 Feb;28(2):261-7. doi: 10.3346/jkms.2013.28.2.261. Epub 2013 Jan 29.

Abstract

Interleukin-1 receptor antagonist (IL-1ra), tumor necrosis factor soluble receptors (sTNF-R) type I and II, and regulated upon activation, normal T-cell expressed and secreted (RANTES) play an important role in the modulation of primary glomerulonephritis (GN) course. The aim of the study was to assess whether pre-treatment measurements of IL-1ra, sTNF-R, and RANTES assessed conjointly may be useful as predicting factors in patients with GN. In 84 patients (45 males and 39 female) serum concentration (pg/mL) and urinary excretion (pg/mgCr) of cytokines were measured. After 12 months of therapy with steroids and cyclophosphamide the patients were divided into two subgroups: Responders (R) and Non-Responders (NR) according to the treatment results. The urinary IL-1ra, TNF-RI and RII were significantly higher in R than NR (1,732 vs 646 with P < 0.001, 13.1 vs 6.3 with P = 0.005, and 33.6 vs 14.4 with P = 0.012). The urinary RANTES excretion was increased in NR (79.6 vs 28.5; P < 0.001). The multivariable analysis showed that if conjointly assessed, only urinary IL-1ra, TNF-R I and R II, RANTES with 85% probability pointed the feature remission (R). In conclusion, the urinary excretion of IL-1ra, TNF-R I and R II, and RANTES examined conjointly are effective in predicting favorable response to immunosuppressive treatment in patients with GN.

摘要

白细胞介素-1 受体拮抗剂(IL-1ra)、肿瘤坏死因子可溶性受体(sTNF-R)I 型和 II 型以及激活后正常 T 细胞表达和分泌的调节物(RANTES)在调节原发性肾小球肾炎(GN)病程中发挥重要作用。本研究旨在评估联合评估 IL-1ra、sTNF-R 和 RANTES 的预处理测量值是否可作为 GN 患者的预测因子。在 84 名患者(45 名男性和 39 名女性)中测量了细胞因子的血清浓度(pg/mL)和尿排泄量(pg/mgCr)。经过 12 个月的类固醇和环磷酰胺治疗后,根据治疗结果将患者分为两组:反应者(R)和非反应者(NR)。R 组的尿 IL-1ra、TNF-RI 和 RII 明显高于 NR 组(1732 与 646,P < 0.001;13.1 与 6.3,P = 0.005;33.6 与 14.4,P = 0.012)。NR 组的尿 RANTES 排泄增加(79.6 与 28.5;P < 0.001)。多变量分析表明,如果联合评估,只有尿 IL-1ra、TNF-R I 和 R II、RANTES 有 85%的可能性指出缓解特征(R)。总之,联合检查的尿 IL-1ra、TNF-R I 和 R II 以及 RANTES 的排泄可有效预测 GN 患者对免疫抑制治疗的良好反应。

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