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| 过敏性紫癜患儿外周血VDBP VDR表达水平与Th17/Treg相关性研究 |
| Correlation between expression levels of VDBP and VDR in peripheral blood and Th17/Treg in children with henoch schonlein purpura |
| 投稿时间：2022-02-03 |
| DOI：10.3969/j.issn.1000-0399.2023.01.015 |
| 中文关键词: 过敏性紫癜 维生素D结合蛋白 维生素D受体 Th17/Treg |
| 英文关键词: Henoch-Schonlein purpura Vitamin D binding protein Vitamin D receptor Th17/Treg |
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| 中文摘要: |
| 目的 探讨维生素D结合蛋白(VDBP)、维生素D受体(VDR)在过敏性紫癜(HSP)患儿外周血中的水平变化及与Th17/Treg平衡的关系。方法 选取2019年12月至2020年12月南京医科大学附属儿童医院就诊并确诊的55例HSP患儿为HSP组,并以同期50例健康体检儿童为对照组。采用定量反转录-聚合酶链反应(qRT-PCR)法检测外周血中VDR mRNA水平,酶联免疫法检测VDBP水平,蛋白印迹法检测VDR蛋白的表达;流式细胞术检测Th17和Treg细胞比例;Pearson法分析VDBP与VDR表达的相关性以及二者与Th17/Treg的相关性;受试者工作特征曲线(ROC)评价血清VDBP和VDR水平对HSP发生的诊断价值。结果 与对照组比较,HSP组患儿外周血中VDBP表达水平明显下调,VDR表达水平上调,差异均有统计学意义(P＜0.05);HSP组患儿Th17、Th17/Treg均高于对照组,Treg均低于对照组(P＜0.05);VDBP与Treg呈正相关(r=0.358,P＜0.05),与Th17、Th17/Treg呈负相关(r=-0.436、 -0.606,P＜0.05);而VDR与Th17、Th17/Treg均呈正相关(r=0.433、0.696,P＜0.05),与Treg呈负相关(r=-0.385,P＜0.05);HSP患儿外周血中VDBP和VDR的呈负相关(r=-0.316,P＜0.05);ROC结果显示,VDR、VDBP水平预测过敏性紫癜患儿的曲线下面积(AUC)分别为0.732、0.933,对应的敏感度分别为67.27%、94.55%,特异度分别为80.00%、78.00%,二者联合预测过敏性紫癜患儿的AUC为0.946,灵敏感为85.45%,特异度为90.00%。结论 VDBP在HSP患儿外周血中明显低表达,VDR明显高表达,二者表达与Th17/Treg密切相关,联合检测VDR、VDBP有助于诊断HSP的发生。 |
| 英文摘要: |
| Objective To explore the changes in the levels of vitamin D binding protein (VDBP) and vitamin D receptor (VDR) in the peripheral blood of children with Henoch-Schonlein purpura (HSP) and their relationship with the balance of Th17/Treg. Methods A total of 55 children diagnosed with HSP in Children’s Hospital Affiliated to Nanjing Medical University from December 2019 to December 2020 were selected as the HSP group, and 50 healthy children in the same period were selected as the control group. Quantitative reverse transcription-polymerase chain reaction (QRT-PCR) was used to detect the level of VDR mRNA in peripheral blood, and enzyme-linked immunoassay was used to detect the level of VDBP. Western blotting was applied to detect the expression of VDR protein. Flow cytometry was used to detect the ratios of Th17 and Treg cells. Pearson method was used to analyze the correlation between VDBP and VDR expression and the correlation between the two and Th17/Treg. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of serum VDBP and VDR levels for the occurrence of HSP. Results Compared with the control group, the expression level of VDBP in the peripheral blood of children in the HSP group was significantly down-regulated, the expression level of VDR was up-regulated, and the difference was statistically significant (P<0.05). Th17 and Th17/Treg of children in HSP group were higher than those in control group, and Treg was lower than that in control group. VDBP was positively correlated with Treg (r=0.358, P<0.05), and negatively correlated with Th17 and Th17/Treg (r=-0.436, -0.606, P<0.05). VDR was positively correlated with Th17 and Th17/Treg (r=0.433, 0.696, P<0.05), and negatively correlated with Treg (r=-0.385, P<0.05). There was a significant negative correlation between VDBP and VDR in peripheral blood of children with HSP (r=-0.316, P<0.05). ROC results showed that the area under the curve (AUC) of VDR and VDBP levels predicting children with Henoch-Schonlein purpura was 0.732 and 0.933, respectively, and the corresponding sensitivity was 67.27% and 94.55%, and the specificity was 80.00% and 78.00%, respectively. The AUC of the combination of the two predicting children with Henoch-Schonlein purpura was 0.946, the sensitivity was 85.45%, and the specificity was 90.00%. Conclusions VDBP expression is significantly low in peripheral blood of children with HSP, and VDR expression is significantly high, which is closely related to Th17/Treg. The combined detection of VDR and VDBP contributes to the diagnosis of the occurrence of HSP, which has important clinical value. |
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