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目的探讨环磷酰胺(CTX)对肾病综合征(NS)患儿P-糖蛋白170(P-gp170)表达的影响。方法以流式细胞术检测频繁复发NS患儿(33例,研究组)CTX治疗前后外周血CD3淋巴细胞P-gp170表达,反相高效液相色谱法检测血清CTX浓度。对照组为14例糖皮质激素(GC)敏感非依赖NS患儿。结果研究组治疗前CD3/P-gp170表达为(8.25±2.03)%,明显高于治疗后3个月的(2.92±1.94)%(P<0.01);治疗后CD3/P-gp170表达与血清CTX浓度呈负相关(P<0.05)。结论下调外周血淋巴细胞P-gp170的表达可能为CTX逆转NS患儿GC耐药的机制之一。CTX可通过抑制P-gp170表达而节约GC用量。
Objective To investigate the effect of cyclophosphamide (CTX) on the expression of P-glycoprotein 170 (P-gp170) in children with nephrotic syndrome (NS). Methods Flow cytometry was used to detect the expression of P-gp170 in CD3 lymphocytes in peripheral blood of patients with frequent recurrence of NS (33 cases, study group) before and after CTX treatment. The concentration of CTX in serum was detected by reverse-phase high performance liquid chromatography. The control group was 14 patients with glucocorticoid (GC) sensitive non-dependent NS. Results The expression of CD3 / P-gp170 in study group before treatment was (8.25 ± 2.03)%, which was significantly higher than that (2.92 ± 1.94)% at 3 months after treatment (P <0.01) CTX concentration was negatively correlated (P <0.05). Conclusion Down-regulation of P-gp170 expression in peripheral blood lymphocytes may be one of the mechanisms of CTX reversal of GC resistance in children with NS. CTX can save GC dosage by inhibiting P-gp170 expression.