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目的探讨环孢素Ａ（ｃｙｃｌｏｓｐｏｒｉｎＡ，ＣｓＡ）治疗前后对肾病患儿的环孢素亲和素ｃｙｃｌｏｐｈｉｌｉｎ（ＣｙＰ）ｍＲＮＡ表达的影响，ＣｓＡ与ＣｙＰ基因表达之间的关系及临床意义。方法通过逆转录聚合酶链反应（ＲＴ－ＰＣＲ）测定肾病患儿经ＣｓＡ治疗前后血白细胞中ＣｙＰｍＲＮＡ的表达，并以正常儿童作对照及应用荧光偏振免疫法测定ＣｓＡ的浓度。结果表明肾病患儿经ＣｓＡ治疗前血白细胞中ＣｙＰｍＲＮＡ基因表达明显高于ＣｓＡ治疗后及对照组，而ＣｓＡ血浓度与ＣｙＰｍＲＮＡ表达成负相关。结论ＣｓＡ治疗前肾病患儿血白细胞中ＣｙＰｍＲＮＡ高水平的表达，应用ＣｓＡ后与ＣｙＰ形成ＣｓＡ－ＣｙＰ免疫复合物，反馈性的ＣｙＰ表达水平下降，而ＣｓＡ血浓度与ＣｙＰ表达成负相关。说明低浓度的ＣｓＡ与高水平表达的ＣｙＰ对肾病不能起到治疗作用，而合适浓度ＣｓＡ（１００～２００μｇ／Ｌ）与低水平ＣｙＰ表达有助于肾病的缓解。
Objective To investigate the effect of cyclosporin A (CsA) on cyclosporin cyclophilin (CyP) mRNA expression in children with nephropathy and the relationship between CsA and CyP gene expression and its clinical significance. Methods The expression of CyP mRNA in white blood cells of children with nephropathy was measured by reverse transcriptase-polymerase chain reaction (RT-PCR) before and after CsA treatment. The normal children were used as controls and the concentration of CsA was determined by fluorescence polarization immunoassay. The results showed that the expression of CyPmRNA in leukocytes before CsA treatment was significantly higher in children with nephropathy than in CsA treatment and control group, while the concentration of CsA in blood was negatively correlated with the expression of CyP mRNA. Conclusions CsA can improve the expression of CyPmRNA in blood leucocytes in children with nephrotic syndrome. CsA-CyP immunosuppressive complex with CyP is formed after CsA treatment, and the level of CyP expression is decreased. CsA concentration is negatively correlated with CyP expression. These results indicated that low concentration of CsA and high level of CyP could not play a therapeutic role in nephropathy. Appropriate concentrations of CsA (100 ~ 200μg / L) and low level of CyP could contribute to the remission of nephropathy.