miR-29a在IgA肾病诊疗中的意义  

Significance of miR-29a in the Diagnosis and Treatment of IgA Nephropathy

作　　者：张倩倩[1] 贾真 韦建新[1] 周淑华[1] ZHANG Qian-qian;JIA Zhen;WEI Jian-xin;ZHOU Shu-hua(Department of Nephrology,Dezhou People's Hospital,Dezhou Shandong 253023,China)

机构地区：[1]德州市人民医院肾内科,山东德州253000

出　　处：《德州学院学报》2020年第2期54-58,64,共6页Journal of Dezhou University

基　　金：山东省医药卫生科技发展计划项目(2017WS538).

摘　　要：背景:IgA肾病发病率高,目前缺乏无创生物标志物对其诊疗进行评估,miRNAs可从尿、血清、血浆和肾组织中检测.大多数miRNAs可以通过实时定量聚合酶链反应(RT-PCR)和微阵列技术进行检测.国内外研究尿中的一些miRNA可作为诊断和评估IgAN的新型生物标志物.目的:该研究旨在分析IgA肾病患者尿、血清、肾脏组织中miR-29a的表达,阐明miR-29a在IgA肾病诊疗中的意义.方法:33例经活检确诊为IgAN的患者被纳入IgAN组.选取47例小剂量糖皮质激素联合MMF治疗3个月的原发性IgAN患者为治疗组.取15例健康志愿者的血清、尿样作为正常对照组,取15例肾癌患者的肾切除标本作为正常肾脏对照组.采用RT-PCR方法检测比较三组间样本的miR-29a水平,探讨miR-29a在IgAN诊断治疗中的意义.结果与结论:与对照组相比,IgAN患者尿、血清、肾脏组织中miR-29a表达降低(p<0.05).IgAN组尿和血清miR-29a的表达与蛋白尿(r=-0.322,P<0.05;r=-0.356,P<0.05),及肾小球硬化(r=-0.427,P<0.05);(r=-0.517;P<0.05)呈负相关.IgAN组尿中miR-29a的表达与肾小球的表达呈正相关,滤过率(EGFR)(r=0.328,P<0.05)与舒张压呈负相关(r=-0.421 P<0.05);血清和肾内miR-29a表达与尿miR-29a的表达呈正相关(r=0.713,P<0.05;r=0.322,P<0.05).与IgAN组比较,治疗组血清和肾内miR-29a表达明显高于IgAN组,差异具有统计学意义(P<0.05).尿和血清miR-29a水平与IgAN病情进展密切相关.小剂量糖皮质激素联合MMF治疗后可上调IgAN患者血清和尿中miR-29a的水平.血清和尿miR-29a可能作为反映评估IgAN治疗效应的生物标志物.Background:IgA nephropathy(IgAN)is the most prevalent form of chronic glomerulonephritis in the world.At present,there is a lack of non-invasive biomarkers to evaluate the diagnosis and treatment of IgAN.MicroRNAs can be detected in urine,serum,plasma and kidney tissues.Most microRNAs can be detected by realtime quantitative polymerase chain reaction(RT-PCR)and microarray technology.the potential of some miRNAs in urine as novel biomarkers for diagnosis and monitoring of IgAN has been documented.Objectlve This study was designed to analyse the urinary,serum and renal expression of miR-29 a of patients diagnosed with IgAN,aiming to elucidate the significance of miR-29 a in the diagnosis and treatment of IgA nephropathy.Methods:Thirty-three patients diagnosed with IgAN by biopsy were assigned in the IgAN group.Serum and urine sampling was collected from 15 healthy volunteers as healthy control group,normal renal tissue from the nephrectomy specimen of 15 patients with renal cell carcinoma in the control group.Forty-seven primary IgAN patients treated with low dose glucocorticoid combined with MMF for 3 months were assigned in the treatment group.RT-PCR was performed to compare miR-29 a level between three groups and explore the effect of MMF on expression level of urinary and serum miR-29 a.Results and conclusion:Compared with control group,the urinary,serum and renal expression of miR-29 a in IgAN group were decreased(P<0.05).Urinary and serum expression of miR-29 a inversely correlated with proteinuria(r=-0.322,P<0.05;r=-0.356,P<0.05),and glomerulosclerosis(r=-0.427,P<0.05;r=-0.517,P<0.05)in IgAN group.Urinary expression of miR-29 a positively correlated with evaluated Glomerular Filtration Rate(eGFR)(r=0.328,P<0.05),inversely correlated with diastolic blood pressure(r=-0.421,P<0.05)in the IgAN group.Serum and intra-renal expression of miR-29 a was positively correlated with urinary expression of miR-29 a(r=0.713,P<0.05;r=0.322,P<0.05).The serum and urinary levels of miR-29 a in the treatment group were significa

关 键 词：miR-29a IGA肾病 吗替麦考酚酯 糖皮质激素 肾脏纤维化 

分 类 号：R277.5[医药卫生—中医学]