通讯作者: 赵宇, 345680508@qq.com

DOI：10.12201/bmr.202601.00065

Research of correlation between MDSC, sPD-1 and the activity of primary membranous nephropathyPAN Linlin; NIE Zhenyu；ZHAO Yu; BAO Beiyan

• 摘要：目的 本文拟探究外周血骨髓源性抑制细胞（myeloid-derived suppressor cells，MDSC）、辅助性T细胞17（T helper cell 17，Th17）、血清白介素-17A（interleukin 17A，IL-17A）和可溶性程序死亡分子（soluble programmed death-1，sPD-1）在原发性膜性肾病（primary membranous nephropathy，PMN）患者中的表达以及与PMN疾病活动度的相关性。方法 收集2021年9月至2022年11月在宁波市泌尿肾病医院肾内科就诊且经肾活检病理诊断为MN的患者资料，其中肾病综合征患者30例，非肾病综合征患者30例，并选取同期我院体检的健康对照组30例。本研究采用细胞流式术测定外周血MDSC和Th17比例以及采用酶联免疫吸附测定法（enzyme linked immunosorbent assay，ELISA）检测IL-17A、sPD-1、抗M型磷脂酶A2受体（phospholipase A2 receptor，PLA2R）抗体和抗I型血小板反应蛋白7A域（thrombospondin type-1 domain-containing 7A，THSD7A）抗体水平。本研究采用Spearman相关分析检验外周血MDSC、Th17、IL-17A和sPD-1与PMN疾病活动度的相关性。结果 1、膜性肾病组外周血MDSC比例（P<0.001）、Th17比例（P<0.05）、血清IL-17A（P<0.01）和sPD-1（P<0.01）水平均显著高于健康对照组；2、外周血MDSC（r=0.514，P<0.001）、Th17（r=0.522，P<0.001）、IL-17A（r=0.598，P<0.001）和sPD-1（r=0.302，P<0.05）与尿微量白蛋白/尿肌酐呈正相关；外周血MDSC（r=0.376，P=0.003）、Th17（r=0.560，P<0.001）和IL-17A（r=0.415，P<0.01）水平与抗PLA2R抗体水平呈正相关；外周血MDSC（r=-0.439，P<0.001）、Th17（r=-0.603，P<0.001）、IL-17A（r=-0.639，P<0.001）和sPD-1（r=-0.226，P<0.05）与血白蛋白水平呈负相关。结论 1、与健康对照组相比，PMN患者外周血MDSC、Th17细胞比例增加，血清IL-17A和sPD-1表达水平高；2、外周血MDSC和Th17比例，血清IL-17A和sPD-1水平与PMN疾病活动度呈正相关，提示MDSC、Th17、IL-17A和sPD-1可能参与PMN的发病机制。

   

  Abstract: Objective This study intends to explore the expression of peripheral blood myeloid-derived suppressor cells (MDSC), T helper cell 17 (Th17), interleukin 17A (IL-17A) and soluble programmed death-1 (sPD-1) in patients with primary membranous nephropathy (PMN), as well as their correlations with the disease activity of PMN. Methods This study collected the clinical data of 60 patients (30 with nephrotic syndrome, 30 with non-nephrotic syndrome) diagnosed as membranous nephropathy by renal biopsy in the Nephrology Department of Ningbo Urology and Nephropathy Hospital from September 2021 to November 2022. Additionally, 30 healthy individuals who visited the hospital for routine physical examination during the same period of time were placed as controls. We determined the proportion of peripheral blood MDSC and Th17 by flow cytometry and the level of IL-17A, sPD-1, anti-phospholipase A2 receptor (PLA2R) antibody and anti-thrombospondin type-1 domain-containing 7A(THSD7A) antibody by enzyme linked immunosorbent assay (ELISA) Kit. The correlation of MDSC, Th17, IL-17A , sPD-1 and the activity of PMN was performed using Spearman correlation. Results 1. The proportion of MDSC in peripheral blood was significantly higher in the PMN group in comparison with the healthy control group (P<0.001). The proportion of Th17 in peripheral blood was higher in the PMN group in comparison with the healthy control group (P<0.05). There were significant differences in serum IL-17A and sPD-1 levels between the PMN group and healthy control group (P<0.01). 2. The proportions of peripheral blood MDSC (r=0.514, P<0.001), Th17 (r=0.522, P<0.001), and the levels of IL-17A (r=0.598, P<0.001), sPD-1 (r=0.302, P<0.05) were positively correlated with microalbumin/creatinine. The proportions of peripheral blood MDSC (r=0.376, P<0.01), Th17 (r=0.560, P<0.001), and the level of IL-17A (r=0.415, P<0.01) were positively correlated with anti-PLA2R antibody. The proportions of peripheral blood MDSC (r=-0.439, P<0.001), Th17 (r=-0.603, P<0.001), and the level of IL-17A (r=-0.639, P<0.001), sPD-1 (r=-0.226, P<0.05) were negatively correlated with blood albumin. 4. Univariate logistic regression analysis found estimated glomerular filtration rate (eGFR) (P<0.05), microalbumin/creatinine (P<0.05) and blood albumin (P<0.05) were the factors of clinical remission. Conclusions 1. Peripheral blood the proportion of MDSC and Th17, the level of IL-17A, sPD-1 were higher in PMN patients in comparison with the healthy control group. 2. The proportions of peripheral blood MDSC, Th17, and the levels of IL-17A, sPD-1 were positively correlated with the activity of PMN which indicated MDSC, Th17, IL-17A and sPD-1 may be involved in the pathogenesis of PMN.

  提交时间：2026-01-24

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• 序号	提交日期	编号	操作
  1	2025-10-16	10.12201/bmr.202601.00065V1	下载

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