The concentration of interleukin-17 in the blood and urine of patients with chronic glomerulonephritis with nephrotic syndrome

D. Chemodanova, A. Vinogradov, V. Сao, T. Krasnova, N. Chebotareva
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Abstract

BACKGROUND. In the mechanisms of immune inflammation in chronic glomerulonephritis (CGN), activation of T-cells plays an important role. The role of Th1 and Th2 cells in the pathogenesis of some forms of CGN has been well studied, while the activation of Th17 cells in CGN has been only evaluated in isolated studies. THE AIM: to evaluate the value of determining the level of IL-17 in urine and blood serum in chronic glomerulonephritis.PATIENTS AND METHODS. Adult patients with active CGN (N=40) were recruited aged from 18 to 75 years. Ten patients had focal segmental glomerulosclerosis, 6 had membranoproliferative glomerulonephritis, 15 had IgA nephropathy, and 9 had membranous nephropathy at histological examination. The control group included 10 healthy subjects. The IL-17A levels in the urine and blood serum were determined by enzyme-linked immunosorbent assay (ELISA). The IL17A levels in the urine were calculated as the ratio to urinary creatinine. The levels of IL-17 in urine and blood serum were compared with the indicators of proteinuria, albumin, creatinine, serum sodium, also the severity of hypertension, edema and daily sodium excretion.RESULTS. The results of our study showed a significantly higher concentration of IL-17 in urine in patients with a marked decrease in renal function. Also, the levels of IL-17 in urine directly correlated with serum sodium and inversely correlated with eGFR. We also found an association between increase levels of IL-17 in urine with arterial hypertension and the severity of edema. There were no significant correlations of IL-17 in blood serum and other laboratory indicators of nephritis activity.CONCLUSION. Patients with CGN have increase levels of IL-17 in the urine compared to healthy subjects. A more significant increase of IL-17 in urine is observed in patients with high clinical activity of HCG. IL-17A may participate in the mechanisms of sodium retention, the development of hypertension and edema in patients with nephrotic syndrome.
慢性肾小球肾炎伴肾病综合征患者血、尿白细胞介素-17的变化
背景。在慢性肾小球肾炎(CGN)的免疫炎症机制中,t细胞的激活起着重要的作用。Th1和Th2细胞在某些形式的CGN发病机制中的作用已经得到了很好的研究,而Th17细胞在CGN中的活化作用仅在孤立的研究中得到评估。目的:探讨IL-17在慢性肾小球肾炎患者尿和血清中的检测价值。患者和方法。招募年龄在18 - 75岁之间的成人活动性CGN患者(N=40)。局灶节段性肾小球硬化10例,膜性增生性肾小球肾炎6例,IgA肾病15例,组织学检查膜性肾病9例。对照组为10名健康受试者。采用酶联免疫吸附试验(ELISA)测定尿和血清中IL-17A水平。尿中IL17A水平计算为与尿肌酐的比值。将尿、血清IL-17水平与蛋白尿、白蛋白、肌酐、血清钠、高血压严重程度、水肿及日钠排泄量等指标进行比较。我们的研究结果显示,在肾功能明显下降的患者中,尿中IL-17浓度明显升高。此外,尿中IL-17水平与血清钠呈直接相关,与eGFR呈负相关。我们还发现尿中IL-17水平升高与动脉高血压和水肿严重程度之间存在关联。血清IL-17水平与肾炎活动度的其他实验室指标无显著相关性。与健康受试者相比,CGN患者尿液中IL-17水平升高。在HCG临床活性高的患者中,尿中IL-17的升高更为显著。IL-17A可能参与肾病综合征患者钠潴留、高血压和水肿的发生机制。
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