Changes of B cell-activating factor and a proliferation-inducing ligand in serum of children with Hen（o）ch-Sch(o)nlein purpura nephritis / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the changes of B cell-activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in serum of children with Hen(o)ch-Sch(O)nlein purpura nephritis (HSPN),and to explore their role in the pathogenesis of children HSPN.Methods A total of 28 children with HSPN who were before treatment were selected in Department of Pediatrics Nephrology and Rheumatology,Shengjing Hospital of China Medical University from November 2017 to August 2018.Sixteen children with Hen(O)ch-Sch(O)nlein purpura were selected as HSP group,and 20 healthy children were selected as healthy control group.Followed the HSPN guideline to cure the patients for 6-8 weeks.The clinical data were collected.Serum levels of BAFF and APRIL were measured by adopting enzyme-linked immunosorbent assay (ELISA).Results (1) Changes of serum BAFF levelthe serum levels of BAFF in HSPN children were significantly lower than those in the HSP group and the healthy control group [HSPN group (0.652 ± 0.360) μg/L,HSP group (1.276 ± 0.459) μg/L,healthy control group (1.285 ± 0.299) μg/L,F =17.519,P =0.000].Moreover,the serum levels of BAFF in before treatment were significantly lower than those in after treatment [before treatment (0.652 ± 0.360) μg/L,after treatment (0.860 ± 0.262) μg/L,P ＜ 0.05).However,there were no significant di-fferences in the serum levels of BAFF between HSP group and healthy control group (P ＞ 0.05).(2)Changes of serum APRIL levelthe serum levels of APRIL in HSPN and HSP children were both significantly higher than those in healthy control group,but there were no marked differences between the 2 groups [HSPN group (2.285 ± 1.015) μg/L,HSP group (2.609 ± 1.264) μg/L,healthy control group (1.677 ±0.118) μg/L,F =3.647,P =0.016].There were no significant differences in the serum levels of APRIL between before treatment and after treatment [before treatment (2.285 ± 1.015) μg/L,after treatment (2.042 ± 0.695) μg/L,P ＞ 0.05].(3) Pearson correlation analysis results showed that the serum levels of BAFF were negatively correlated with 24 h urinary protein,urinary microalbumin,and urine red blood cell count (r =-0.587,-0.608,-0.515,all P ＜ 0.05).The serum levels of APRIL were positively correlated with serum IgA (r =0.588,P ＜ 0.05).Conclusions The level of serum BAFF decreased and APRIL increased in children with HSPN,which was related to the degree of renal involvement.It suggests that BAFF and APRIL may be related to the pathogenesis of HSPN in children.