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| Role of antinuclear antibodies in the pathogenesis of Henoch-Schonlein purpura in children |
| SHAO Hui-jiang, SHAO Xue-jun, JI Zheng-hua, JI Xue-qiang, XUE Jian, ZHU Yun-fen, MIAO Mei-hua |
| (Department of Laboratory Medicine, Children′s Hospital of Soochow University, Suzhou Jiangsu 215025, China) |
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Abstract Objective: To study the role of antinuclear antibodies(ANA) in the pathogenesis of Henoch-Schonlein purpura(HSP) in children. Methods: Clinical HSP children were reviewed and divided into purpura type, joint type, abdominal and nephritis HSP; meanwhile, blood samples were collected from healthy children receiving physical examination. The results of ANA titer and ANA profiles in HSP and all four subtypes were analyzed, as well as reciprocal relationship of immune function and the positivity of ANA, including the influence of humoral immunity(C3, C4, IgA, IgG, IgM) and cellular immunity(CD3+, CD3+CD4+, CD3+CD8+, CD3-CD19+, CD19+CD23+, CD3-CD16+CD56+ cells) caused by ANA, and the influence of ANA to the changes of humoral immunity and cellular immunity. Results: A total of 82 healthy controls and 436 children with HSP were collected. In HSP, 66(15.14%) were positive for ANA, including 17 cases of articular HSP, 25 cases of purpura type HSP, 13 cases of abdominal type HSP and 11 cases of nephritis; The titers of ANA lied between 1 ∶100-1 ∶320, and the positivity spectrum of specific ANA lied between the weak positive and positive.There was no statistically significant difference in the detection rate of ANA between different clinical subtypes of HSP(P=0.213). The quantity of IgA, IgG and IgM in HSP children with positivity of ANA were significantly higher than those in normal controls (P<0.01), and there was no significant difference in complement C3 and C4(P>0.05). For cellular immunity, CD3+, CD3+CD4+ and CD3-CD16+CD56+ cells were significantly decreased in this ANA positive HSP group(P<0.01, <0.01, 0.009 respectively), while CD3+CD8+, CD3-CD19+ and CD19+CD23+ cells were significantly increased(P=0.011,<0.01, <0.01 respectively). By divided HSP children into ANA positive and negative groups, there were no significant differences in the effects of autoantibody on humoral immunity and cellular immunity(P>0.05). Logistic regression analysis showed that indicators of humoral immunity and cellular immunity were not the key factors influencing the appearance of ANA. Conclusion: The positivity of ANA is not the key factor affecting the humoral immunity and cellular immunity of HSP children. The change of immune function in children with HSP is also not the essential factor affecting the appearance of ANA. The incidence of ANA with low titer or non-strong appearance in HSP children might be a phenomenon of non-specific antibodies caused by the autoimmune activation in HSP. ［Key words］HenochSchnlein purpura; children; antinuclear antibodies; humoral immunity; cellular immunity
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Received: 17 August 2017
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2017, Vol. 27 
