| Peer-Reviewed

Effect of TCM Combined with Western Medicine on CD19+ B Lymphocytes in Children with IgA Vasculitis with Nephritis

Received: 9 March 2022    Accepted: 25 March 2022    Published: 14 September 2022
Views:       Downloads:
Abstract

Introduction: Children with IgA vasculitis with nephritis (IgAVN) usually accepted TCM combined with western medicine therapy, but its effect on immune function is not clear, here is to analyze the change of peripheral blood CD19+ B lymphocytes in children with IgAVN after treatment of TCM combined with AECI or/and immunosuppressive agents. Methods: 46 children with IgAVN diagnosed from April 2016 to April 2017 were included and followed up in out-patient department till Dec 2021. All children with IgAVN were treated with TCM combined with ACEI or/and glucocorticoid steroids, with/without glucocorticoid-sparing agents. During treatment, urinary erythrocytes / urinary protein, peripheral blood CD (cluster of differentiation) of lymphocytes and serum immunoglobulins were tested before and after treatment. Results: All children with IgAVN except one were complete remission and no child progressed to CKD after 5-6 years follow-up. The counts of CD19+ B lymphocytes and CD19+ % in children with complete remission were significantly reduced after TCM combined with ACEI or/and glucocorticoid steroids with/without glucocorticoid-sparing agent (P < 0.01), the levels of serum IgA in children with complete remission and partial remission after 6 month combined therapy were significantly decreased (P < 0.01, P < 0.05), and IgM in partial remission children after 6 month combined therapy was significantly lower (P < 0.05). Conclusion: Peripheral blood CD19+ B lymphocytes in children with IgAVN decreased when it gained remission with treatment of TCM combined with ACEI or/and glucocorticoid steroids with/without glucocorticoid-sparing agent, suggesting that change of peripheral blood CD19+ B lymphocytes could be used to evaluate effect of therapy.

Published in International Journal of Pharmacy and Chemistry (Volume 8, Issue 4)
DOI 10.11648/j.ijpc.20220804.11
Page(s) 39-43
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

IgA Vasculitis with Nephritis, Traditional Chinese Medicine (TCM), CD19+ B Lymphocytes

References
[1] M. Piram, A. Mahr, Epidemiology of immunoglobulin A vasculitis (Henoch-Schonlein): current state of knowledge, Curr Opin Rheumatol. 25 (2013) 171-8, doi: 10.1097/BOR.0b013e32835d8e2a.
[2] J C Jennette, R J Falk, P A Bacon, et al., 2012 revised international chapel hill consensus conference nomenclature of vasculitides, Arthritis Rheum. 65 (2013) 1-11, doi: 10.1002/art.37715.
[3] Licia Peruzzi, Rosanna Coppo, IgA vasculitis nephritis in children and adults: one or different entities?, Pediatr Nephrol. 36 (2021) 2615-2625, doi: 10.1007/s00467-020-04818-7.
[4] S Hu, A Birg, M Hovaida, M W Gavin, D McCarthy, Avoiding "Rash" Conclusions: Challenge of IgA Vasculitis in Adults, Dig Dis Sci. 62 (2017) 874-878, doi: 10.1007/s10620-017-4505-2.
[5] Janet M M Gardner-Medwin, Pavla Dolezalova, Carole Cummins, Taunton R Southwood, Incidence of Henoch-Schönlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins, Lancet. 360 (2002) 1197-202, doi: 10.1016/S0140-6736(02)11279-7.
[6] Pillebout E, Verine J, Henoch-Schonlein purpura in the adult, Rev Med Interne. 35 (2014) 372-81, doi: 10.1016/j.revmed.2013.12.004.
[7] Yang J, Okpe A, Pathak A, In Every Man, There Is a Child: Henoch-Schonlein Purpura in an Adult With Liver Cirrhosis, Cureus. 13 (2021) e18270, doi: 10.7759/cureus.18270.
[8] Delbet JD, Parmentier C, Herbez Rea C, et al., Management of IgA Vasculitis with Nephritis, Paediatr Drugs. 23 (2021): 425-435, doi: 10.1007/s40272-021-00464-0.
[9] Marina Avramescu, Annie Lahoche, Julien Hogan, et al., To biopsy or not to biopsy: Henoch-Schönlein nephritis in children, a 5-year follow-up study, Pediatr Nephrol. 37 (2022): 147-152, doi: 10.1007/s00467-021-05086-9.
[10] Ozen S, Marks SD, Brogan P, et al., European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis-the SHARE initiative, Rheumatology (Oxford). 58 (2019): 1607-1616, doi: 10.1093.
[11] Reamy BV, Servey JT, Williams PM, Henoch-Schonlein Purpura (IgA Vasculitis): Rapid Evidence Review, Am Fam Physician. 102 (2020) 229-233.
[12] Dyga K, Szczepańska M, IgA vasculitis with nephritis in children, Adv Clin Exp Med. 29 (2020): 513-519, doi: 10.17219.
[13] Audemard-Verger A, Pillebout E, Guillevin L, et al., IgA vasculitis (Henoch-Shonlein purpura) in adults: Diagnostic and therapeutic aspects, Autoimmun Rev. 14 (2015): 579-85, doi: 10.1016/j.autrev.2015.02.003.
[14] Delbet JD, Geslain G, Auger M, et al., Histological prognostic factors in children with Henoch-Schonlein purpura nephritis, Pediatr Nephrol. 35 (2020): 313-320, doi: 10.1007/s00467-019-04363-y.
[15] Oni L, Sampath S, Childhood IgA Vasculitis (Henoch Schonlein Purpura)-Advances and Knowledge Gaps, Front Pediatr. 7 (2019) 257, doi: 10.3389 / fped. 2019. 00257.
[16] Leung AKC, Barankin B, Leong KF, Henoch-Schönlein Purpura in Children: An Updated Review, Curr Pediatr 16 (2020) 265-276, doi: 10.2174 / 1573396316666200508104708.
[17] Maritati F, Canzian A, Fenaroli P, Vaglio A, Adult-onset IgA vasculitis (Henoch-Schonlein): Update on therapy, Presse Med. 49 (2020) 104035, doi: 10.1016/j.lpm.2020.104035.
[18] Suzuki H, Yasutake J, Makita Y, et al., IgA nephropathy and IgA vasculitis with nephritis have a shared feature involving galactose-deficient IgA1-oriented pathogenesis, Kidney Int. 93 (2018) 700-705, doi: 10.1016/j.kint.2017.10.019.
[19] Su Q, Jiang L, Chai J, et al., Changes of Peripheral Blood Lymphocyte Subsets and Immune Function in Children with Henoch-Schonlein Purpura Nephritis, Iran J Immunol. 18 (2021): 221-225, doi: 10.22034/iji.2021.89742.1964.
[20] Yuling H, Ruijing X, Xiang J, et al., CD19+CD5+ B cells in primary IgA nephropathy, J Am Soc Nephrol. 19 (2008) 2130-9, doi: 10.1681/ASN.2007121303.
Cite This Article
  • APA Style

    Liu Jun-chao, Xu Hong, Shen Qian, Sun Li, Yu Jian, et al. (2022). Effect of TCM Combined with Western Medicine on CD19+ B Lymphocytes in Children with IgA Vasculitis with Nephritis. International Journal of Pharmacy and Chemistry, 8(4), 39-43. https://doi.org/10.11648/j.ijpc.20220804.11

    Copy | Download

    ACS Style

    Liu Jun-chao; Xu Hong; Shen Qian; Sun Li; Yu Jian, et al. Effect of TCM Combined with Western Medicine on CD19+ B Lymphocytes in Children with IgA Vasculitis with Nephritis. Int. J. Pharm. Chem. 2022, 8(4), 39-43. doi: 10.11648/j.ijpc.20220804.11

    Copy | Download

    AMA Style

    Liu Jun-chao, Xu Hong, Shen Qian, Sun Li, Yu Jian, et al. Effect of TCM Combined with Western Medicine on CD19+ B Lymphocytes in Children with IgA Vasculitis with Nephritis. Int J Pharm Chem. 2022;8(4):39-43. doi: 10.11648/j.ijpc.20220804.11

    Copy | Download

  • @article{10.11648/j.ijpc.20220804.11,
      author = {Liu Jun-chao and Xu Hong and Shen Qian and Sun Li and Yu Jian and Liu Hai-mei and Li Guo-min},
      title = {Effect of TCM Combined with Western Medicine on CD19+ B Lymphocytes in Children with IgA Vasculitis with Nephritis},
      journal = {International Journal of Pharmacy and Chemistry},
      volume = {8},
      number = {4},
      pages = {39-43},
      doi = {10.11648/j.ijpc.20220804.11},
      url = {https://doi.org/10.11648/j.ijpc.20220804.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijpc.20220804.11},
      abstract = {Introduction: Children with IgA vasculitis with nephritis (IgAVN) usually accepted TCM combined with western medicine therapy, but its effect on immune function is not clear, here is to analyze the change of peripheral blood CD19+ B lymphocytes in children with IgAVN after treatment of TCM combined with AECI or/and immunosuppressive agents. Methods: 46 children with IgAVN diagnosed from April 2016 to April 2017 were included and followed up in out-patient department till Dec 2021. All children with IgAVN were treated with TCM combined with ACEI or/and glucocorticoid steroids, with/without glucocorticoid-sparing agents. During treatment, urinary erythrocytes / urinary protein, peripheral blood CD (cluster of differentiation) of lymphocytes and serum immunoglobulins were tested before and after treatment. Results: All children with IgAVN except one were complete remission and no child progressed to CKD after 5-6 years follow-up. The counts of CD19+ B lymphocytes and CD19+ % in children with complete remission were significantly reduced after TCM combined with ACEI or/and glucocorticoid steroids with/without glucocorticoid-sparing agent (P < 0.01), the levels of serum IgA in children with complete remission and partial remission after 6 month combined therapy were significantly decreased (P < 0.01, P < 0.05), and IgM in partial remission children after 6 month combined therapy was significantly lower (P < 0.05). Conclusion: Peripheral blood CD19+ B lymphocytes in children with IgAVN decreased when it gained remission with treatment of TCM combined with ACEI or/and glucocorticoid steroids with/without glucocorticoid-sparing agent, suggesting that change of peripheral blood CD19+ B lymphocytes could be used to evaluate effect of therapy.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Effect of TCM Combined with Western Medicine on CD19+ B Lymphocytes in Children with IgA Vasculitis with Nephritis
    AU  - Liu Jun-chao
    AU  - Xu Hong
    AU  - Shen Qian
    AU  - Sun Li
    AU  - Yu Jian
    AU  - Liu Hai-mei
    AU  - Li Guo-min
    Y1  - 2022/09/14
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijpc.20220804.11
    DO  - 10.11648/j.ijpc.20220804.11
    T2  - International Journal of Pharmacy and Chemistry
    JF  - International Journal of Pharmacy and Chemistry
    JO  - International Journal of Pharmacy and Chemistry
    SP  - 39
    EP  - 43
    PB  - Science Publishing Group
    SN  - 2575-5749
    UR  - https://doi.org/10.11648/j.ijpc.20220804.11
    AB  - Introduction: Children with IgA vasculitis with nephritis (IgAVN) usually accepted TCM combined with western medicine therapy, but its effect on immune function is not clear, here is to analyze the change of peripheral blood CD19+ B lymphocytes in children with IgAVN after treatment of TCM combined with AECI or/and immunosuppressive agents. Methods: 46 children with IgAVN diagnosed from April 2016 to April 2017 were included and followed up in out-patient department till Dec 2021. All children with IgAVN were treated with TCM combined with ACEI or/and glucocorticoid steroids, with/without glucocorticoid-sparing agents. During treatment, urinary erythrocytes / urinary protein, peripheral blood CD (cluster of differentiation) of lymphocytes and serum immunoglobulins were tested before and after treatment. Results: All children with IgAVN except one were complete remission and no child progressed to CKD after 5-6 years follow-up. The counts of CD19+ B lymphocytes and CD19+ % in children with complete remission were significantly reduced after TCM combined with ACEI or/and glucocorticoid steroids with/without glucocorticoid-sparing agent (P < 0.01), the levels of serum IgA in children with complete remission and partial remission after 6 month combined therapy were significantly decreased (P < 0.01, P < 0.05), and IgM in partial remission children after 6 month combined therapy was significantly lower (P < 0.05). Conclusion: Peripheral blood CD19+ B lymphocytes in children with IgAVN decreased when it gained remission with treatment of TCM combined with ACEI or/and glucocorticoid steroids with/without glucocorticoid-sparing agent, suggesting that change of peripheral blood CD19+ B lymphocytes could be used to evaluate effect of therapy.
    VL  - 8
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Department of Traditional Chinese Medicine, Children’s Hospital of Fudan University, Shanghai, China

  • Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China

  • Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China

  • Department of Rheumatology, Children’s Hospital of Fudan University, Shanghai, China

  • Department of Traditional Chinese Medicine, Children’s Hospital of Fudan University, Shanghai, China

  • Department of Rheumatology, Children’s Hospital of Fudan University, Shanghai, China

  • Department of Rheumatology, Children’s Hospital of Fudan University, Shanghai, China

  • Sections