Clin Nephrol. 2021 Sep;96(3):155-164. doi: 10.5414/CN110333.
To investigate the changes in Treg and Th17 cells and explore the significance of Treg/Th17 balance in adult primary membranous nephropathy (PMN) patients.
A total of 60 PMN patients and 50 healthy adults from June 2013 to October 2016 were enrolled in this study. The levels of Treg, Th17, and related cytokines were assessed. Pearson correlation was used for conducting correlation analysis.
There was a significant increase in Th17 frequencies and IL-17 (Th17-related cytokines) in the peripheral blood mononuclear cells (PBMCs), as well as a significant decrease in Treg frequencies and IL-10 (Treg-related cytokines). The IL-17 concentrations in the peripheral blood of PMN patients were positively correlated with urinary protein, while IL-10 levels were negatively correlated with urinary protein. Protein expression of Treg transcription factor (Foxp3) was significantly low in the renal tissues of PMN patients, while the expression of IL-17 was much higher. Th17/Treg imbalance was reversed to normal after effective treatment with tacrolimus in 15 PMN patients.
These results suggested the existence of Treg/Th17 imbalance in PMN patients, showing the importance of Treg/Th17 imbalance in PMN pathogenesis.
研究调节性 T 细胞（Treg）和辅助性 T 细胞 17（Th17）细胞的变化，探讨 Treg/Th17 平衡在成人原发性膜性肾病（PMN）患者中的意义。
选取 2013 年 6 月至 2016 年 10 月期间的 60 例 PMN 患者和 50 例健康成年人，评估 Treg、Th17 及相关细胞因子水平。采用 Pearson 相关性分析进行相关性分析。
PMN 患者外周血单个核细胞（PBMC）中 Th17 频率和白细胞介素 17（IL-17，Th17 相关细胞因子）显著增加，Treg 频率和白细胞介素 10（IL-10，Treg 相关细胞因子）显著降低。PMN 患者外周血中 IL-17 浓度与尿蛋白呈正相关，而 IL-10 水平与尿蛋白呈负相关。PMN 患者肾组织中 Treg 转录因子（Foxp3）的蛋白表达明显降低，而 IL-17 的表达则明显升高。在 15 例接受他克莫司有效治疗的 PMN 患者中，Th17/Treg 失衡得到逆转。
这些结果提示 PMN 患者存在 Treg/Th17 失衡，表明 Treg/Th17 失衡在 PMN 发病机制中的重要性。
