Abstract
Objective: To investigate the variation and effect of
peripheral Th17 and regulatory T (Treg) cells upon the clinical
prognosis of #idiopathic membranous nephropathy (IMN) patients after
cyclosporin A (CsA) treatment.
Methods: Twenty-four IMN patients with 24-hour urinary protein
level ≧4g were recruited. According to 24-hour urinary protein levels,
all patients were assigned into the high-and middle-risk groups. All
enrolled patients received standardized treatment of #prednisolone acetate in combination with CsA. The Treg and Th17 frequencies were
measured by flow cytometry. Serum cytokines were detected by
enzyme-linked #immunosorbent assay. Serum albumin and 24-hour urinary
protein were measured by fully automatic biochemical analyzer.
Results: Compared with the healthy controls, Th17%, levels of
IL-17 and TNF-α were up-regulated, whereas Treg% and TGF-β level were
down-regulated in the peripheral blood of IMN patients. This imbalance
was more pronounced in the high-risk group compared with middle-risk
groups. The 24-hour urinary protein level was positively correlated with
Th17% and Th17/Treg ratio, whereas negatively correlated with Treg%.
After 6-month treatment, Peripheral Th17 frequency, IL-17 and TNF-α
level decreased, whereas Treg frequency and TGF-β level increased in the
effective group (all P<0.05). No significant changes were found in
the ineffective group. Conclusion: IMN patients present with peripheral
Th17/ Treg imbalance, which is correlated with the severity of IMN. CsA
treatment is an effective approach to improve #peripheral Th17/Treg imbalance in IMN patients, which is associated with the clinical
efficacy of CsA treatment. Monitoring the variations in peripheral
frequency of Treg and Th17 is of significance for evaluation of the
severity of IMN and clinical efficacy.
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