腹膜透析患者超滤衰竭相关外泌体来源miRNA的初步筛选  

Screening of exosomal-derived miRNA associated with ultrafiltration failure in peritoneal dialysis patients

作　　者：吴旭[1] 吴炜飞[1] 程志群[1] 范德墉[1] WU Xu;WU Weifei;CHENG Zhiqun;FAN Deyong(Department of Nephrology,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]湖州市中心医院肾内科,313000

出　　处：《浙江医学》2022年第7期702-706,712,I0004,共7页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2020RC035);湖州市科学技术局公益性应用研究项目(2019GYB52)。

摘　　要：目的初步筛选与腹膜透析患者超滤衰竭相关的外泌体来源miRNA。方法选取2000年1月至2019年11月在湖州市中心医院肾内科规律随诊的腹膜透析患者30例。其中15例患者腹膜平衡试验提示超滤衰竭,为观察组,另15例患者腹膜平衡试验提示无超滤衰竭,为对照组。观察并比较两组患者的一般资料与临床指标,并各随机抽取3例,采用高通量测序法分析腹膜透析流出液外泌体来源miRNA水平表达情况。结果两组患者性别、原发病、有无合并糖尿病或高血压及Hb、CRP、TC、血尿素氮、血肌酐、血尿酸、血清校正钙水平比较差异均无统计学意义(均P>0.05)。与对照组相比,观察组患者年龄大、透析龄长、首次透析时间早、腹膜透析相关性感染总次数多、腹膜转运特性为高转运比例高,血白蛋白、总尿素清除指数(Kt/V)及残余肾功能均偏低,血磷及血全段甲状旁腺激素(iPTH)均偏高,差异均有统计学意义(均P<0.05)。与对照组相比,观察组患者腹膜透析流出液外泌体中存在70个有明显表达差异的miRNA,其中hsa-miR-125a-3p_R-1、hsa-miR-1273c-p3和hsa-miR-132-3p等41个表达上调,hsa-miR-708-5p、hsa-miR-155-5p_R-1和bta-miR-2904-2-p5等29个表达下调,差异均有统计学意义(均P<0.05)。结论腹膜透析超滤衰竭患者的腹膜透析流出液外泌体存在多种miRNA表达的失调,miRNA可能参与腹膜超滤衰竭的发生。Objective To screen exosome-derived miRNA associated with ultrafiltration failure in peritoneal dialysis patients.Methods Thirty patients with peritoneal dialysis who were regularly followed up in the Department of Nephrology of Huzhou Central Hospital from January 2000 to November 2019 were enrolled in the study.Among them,15 patients had ultrafiltration failure indicated by peritoneal balance test(study group),and other 15 patients without ultrafiltration failure served as the control group.The general data and clinical indicators of the patients were observed and compared.The expression of exosome-derived miRNA in the peritoneal dialysis effluent was analyzed by high-throughput sequencing.Results There were no significant differences in gender,primary disease,diabetes mellitus or hypertension,Hb,CRP,TC,blood urea nitrogen,blood creatinine,blood uric acid and serum corrected calcium between 2 groups(all P>0.05).Compared with the control group,patients in the study group had older age,longer dialysis age,earlier first dialysis time,more total number of peritoneal dialysis-related infections,a higher proportion of peritoneal transport characteristics were high transport.The blood albumin,total urea clearance index(KT/V),estimated glomerular filtration rate(eGFR)of residual kidney were lower,and blood phosphorus and intact parathyroid hormone(iPTH)were higher in the study group(all P<0.05).Compared with the control group,there were 70 exosome-derived miRNAs with significantly different expressions in the study group,among which 41 miRNAs were up-regulated,including hsa-miR-125a-3p_R-1,hsa-miR-1273c-p3 and hsa-miR-132-3p,and 29 were down-regulated,including hsa-miR-708-5p,hsa-miR-155-5p_R-1 and bta-miR-2904-2-p5(all P<0.05).Conclusion There are multiple abnormally expressed miRNAs in the exosomes of peritoneal dialysis effluent in peritoneal dialysis patients with ultrafiltration failure,suggesting that miRNA might be involved in the occurrence of peritoneal ultrafiltration failure.

关 键 词：腹膜透析 超滤衰竭 外泌体 MIRNA 

分 类 号：R692.5[医药卫生—泌尿科学]