Increased transforming growth factor-beta (TGF-beta)-secreting T cells andIgA anti-cardiolipin antibody levels during acute stage of childhood Henoch-Schonlein purpura

Henoch-Schonlein purpura (HSP) is a small vessel vasculitis characterized b y increased serum IgA and IgA-dominant immune complex deposition in lesions . The involvement of IgA implies a probable role for TGF-beta, a major fact or in IgA production, in the pathogenesis of HSP. Among IgA antibodies, ser um IgA anti-cardiolipin antibodies (aCL) have been found in many diseases, including vasculitis. In addition to the clinical presentations and laborat ory parameters, we further investigated the roles of IgA aCL and TGF-beta i n childhood HSP. Twenty-six Chinese children with the diagnosis of HSP were enrolled. Blood samples from these patients were collected at both acute a nd convalescent stages. Intracellular staining of lymphocytes was performed to enumerate type 1 (interferon-gamma-secreting), type 2 (IL-4-secreting), and type 3 (TGF-beta -secreting) helper T cells. Serum levels of TGF-beta were detected by ELISA. Serum IgA aCL of 21 of 26 patients at the acute sta ge, 11 of them at the convalescent stage, were measured by ELISA. The data showed that IgA aCL serum levels were significantly elevated in patients co mpared with healthy controls (P < 0.001), and those patients at the convale scent stage (P < 0.001). In addition, TGF-beta -secreting T cells were sign ificantly elevated during the acute stage, and decreased at the convalescen t stage. Although more studies are needed, the high prevalence of IgA aCL a nd increased TGF-beta -secreting T cells in children with acute HSP reveale d some points which should permit a better understanding of the pathogenesi s of HSP.