Is the Change of Cytokines Related to Renal Damage in Children with IgA Vasculitis？

Abstract

BackgroundThe long-term prognosis of IgA vasculitis (IgAV) depends on thedegreeof renal damage. Studies on the pathogenesis of renal injury in IgAV have found that cytokines play an important role in mediating and driving the process of renal damage.ObjectiveTo investigate the significance and value of cytokine in the process of renal damage in IgAV by exploring the changes of serum cytokine level in children with IgAV renal damage.Methods194 IgAV children hospitalized in the Department of Pediatric, Shengjing Hospital of China Medical University from January 2018 to June 2020 were selected as research subjects. They were divided into IgAV group (n=97) and IgAV renal damage group (n=97) according to the presence or absence of renal damage, and 60 healthy children who underwent physical examination in the pediatric health department of our hospital during the same period were selected as the control group. The cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, IFN-γ, and TNF-α) , absolute lymphocyte count, immunoglobulin A, and immunoglobulin E were collected from the children. Multivariate Logistic regression was used to analyze the factors influencing IgAV renal damage, and the receiver operating curve (ROC) of the diagnostic value of cytokines on the characteristics of IgAV renal damage was drawn.ResultsThe IL-2 level in the lgAV group were higher than those in the lgAV renal damage group and the control group, and the IL-2 level in the lgAV renal damage group was higher than that in the control group (P<0.05) ; IL-17 level in the lgAV renal damage group were higher than those in the lgAV group and the control group, and IL-17 level in the lgAV group was higher than that in the control group (P<0.05) ; IL-6, IL-10, and TNF -α level were higher in the lgAV renal damage group than those in the lgAV renal damage group and the control group (P<0.05) ; IFN-γ level were higher in the lgAV renal damage group and the control group than that in the lgAV group (P<0.05) . Multivariate Logistic regression analysis showed that IL-2, IL-17, IFN-γ, and TNF-α were influencing factors in developing IgAV renal damage (P<0.05) . The AUC of IL-12 for predicting IgAV renal damage was 0.589, with a sensitivity of 38.0% and specificity of 47.0%. The AUC of IL-17 for predicting IgAV renal damage was 0.621, with a sensitivity of 47.4% and specificity of 77.3%. The AUC of IFN-γ for predicting IgAV renal damage was 0.688, with a sensitivity of 75.0% and specificity of 55.7%. The AUC of TNF-α for predicting IgAV renal damage was 0.614, with a sensitivity of 42.0% and specificity of 37.0%. The AUC of IL-17 and IFN-γ combined for predicting IgAV renal damage was 0.710, with a sensitivity of 71.1% and specificity of 66.0%.ConclusionSerum cytokines IL-17 and IFN-γ are closely associated with the development of renal damage in IgA vasculitisrenal damage, early detection of both levels and dynamic monitoring of their changes can serve as an early warning for early detection of renal involvement and adjustment of treatment plans.

Keywords

• |purpura, schoenlein-henoch|iga vasculitis|iga vasculitis renal damage|cytokines|child|forecasting