Balance of regulation of Th17/Treg in children with Henoch-Schönlein purpura nephritis using Huaiqihuang

Abstract

Objective To observe the levels of Th17 and associated cytokine IL-17 and Treg in peripheral blood in children with Henoch-Schonlein purpura nephritis(HSPN), and to explore the balance of regulation of Th17/Treg and the function of improvement of clinical symptoms in children with HSPN by using Huaiqihuang. Methods The objects were divided into 3 groups: healthy control group(n=11), Henoch-Schonlein purpura(HSP) group(n=10) and HSPN group(n=30). Healthy children were measured for the level of IL-17 by enzyme-linked immunosorbent assay(ELISA) and the circulating frequencies of Th17 and CD4+ CD25+ Treg cells by flow cytometry(FCM). HSP group and HSPN group were measured for the levels of IL-17, Th17 cells and Treg cells when illness had acute attack and had not used any drugs.Furthermore, HSPN group was measured for 24-hour urine proteins and urinary sediment red blood cells(RBCs). Patients in HSPN group with the pathological grading Ⅱ were divided into conventional therapy group(n=10) and Huaiqihuang group(n=10) randomly.Patients in HSPN group with the pathological grading Ⅲa were divided into Prednisone group(n=5) and Prednisone+ Huaiqihuang group(n=5) randomly.Conventional therapy group was treated with oral Fosinopril and Dipyridamole.Huaiqihuang group was treated with conventional therapy and oral Huaiqihuang particles.Prednisone group was treated with conventional therapy and oral Prednisone.Prednisone+ Huaiqihuang group was treated with conventional therapy, Prednisone and Huaiqihuang particles.After 2 months of treatments, the levels of IL-17, Th17 cells, Treg cells, 24-hour urine proteins and urinary sediment RBCs were mea-sured. Results The circulating frequencies of Th17 cells and IL-17 in HSP group and HSPN group were higher than those in healthy control group(all P 0.05). Th17 cells, IL-17 levels and urinary sediment RBCs in conventional therapy group after treatment were lower than before, while Treg cells were higher than before, but there was no significant difference(all P>0.05). Twenty-four hour urine proteins were lower after treatment than before(P 0.05). Conclusions Th17 cells and associated cytokine IL-17 levels increase in peripheral blood of children with HSPN, while Treg cells decrease in HSPN.Huaiqihuang can decrease Th17 cells and IL-17 level, and increase Treg cells.Furthermore, it can decrease hematuria and proteinuria. Key words: Henoch-Schonlein purpura nephritis; Th17; Treg; Huaiqihuang