Expressions of Toll like receptor-2,-4 ,-6 in peripheral blood mononuclear cells and the association of serum IgG and IgM levels in children with idiopathic nephrotic syndrome / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate expressions of Toll-like receptor (TLR)-2,TLR-4 and TLR-6 in peripheral blood mononuclear cells (PBMC) and serum immunoglobulin G (IgG) and IgM levels in pediatric idiopathic nephrotic syndrome (INS).The correlation between Toll-like receptors (TLR-2,TLR-4 and TLR-6) and serum immunoglobulin levels (IgG and IgM) will be proven in the pathogenesis of childhood INS in active stage (AS) and remission stage (RS).Methods Forty-two INS patients (experimental group,32 boys,10 girls) and 29 healthy individuals (healthy control group,19 boys,10 girls) were enrolled in the present study from June,2017 to October,2018 in the First Affiliated Hospital of Xinxiang Medical University.There were no significant differences in gender (x2 =0.966,P =0.326) and age (t =-0.139,P =0.89) between 2 groups.TLR-2 mRNA,TLR-4 mRNA and TLR-6 mRNA expressions of PBMC were evaluated by using real-time PCR in both INS children with AS and RS and healthy children.The blood samples were drawn to detect by way of immunoturbidimetry serum immunoglobulin (IgG and IgM) levels in both INS children with AS and healthy children.The correlation between Toll-like receptors (TLR-2 mRNA,TLR-4 mRNA,TLR-6 mRNA) and serum immunoglobulin (IgG,IgM) levels were analyzed by using spearman correlation analysis.Results The expression levels of TLR-2 mRNA in INS children with AS,RS and healthy children were 1.85 ± 0.30,1.00 ± 0.23 and 0.85 ± 0.12,respectively,and the expression levels of TLR-4 mRNA were 1.24 ± 0.27,0.80 ± 0.23 and 0.68 ± 0.09,respectively,while the expression levels of TLR-6 mRNA were 1.35 ± 0.23,0.92 ± 0.19 and 0.79 ± 0.15,respectively,so the differences were statistically significant (F =198.453,67.013,82.405,all P ＜ 0.01).The serum IgG level(2.90 ± 0.89) g/L was lower in INS children with AS compared with the controls (9.21 ± 1.88) g/L.However,the serum IgM level (2.87 ± 0.96) g/L was higher in INS children with AS when compared with the controls(1.48 ± 0.30),and the differences were statistically significant(t =-16.810,8.701,all P ＜0.05).No significant correlation was noted between Toll-like receptors (TLR-2 mRNA,TLR-4 mRNA,TLR-6 mRNA) and serum immunoglobulin levels (IgG,IgM) (all P ＞ 0.05).Conclusions The results indicate that Toll-like receptors (TLR-2,TLR-4 and TLR-6) and immunoglobulin (IgG,IgM) might play a role in the pathogenesis of pediatric INS via distinct pathway.