rs6677604单核苷酸多态性与IgA肾病患者系膜C3沉积和预后的差异比较  

Comparisons of mesangial C3 deposition and prognosis in IgA nephropathy patients with different rs6677604 single nucleotide polymorphisms

作　　者：聂艳芳 余海峰 万晓晴 陈媛 Nie Yanfang;Yu Haifeng;Wan Xiaoqing;Chen Yuan(Department of Nephrology,Taizhou Central Hospital(Taizhou University Hospital),Taizhou 318000,Zhejiang Province,China)

机构地区：[1]台州市中心医院(台州学院附属医院)肾内科,台州318000

出　　处：《中国基层医药》2024年第11期1644-1649,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省台州市科技计划(1902ky36)。

摘　　要：目的比较rs6677604单核苷酸多态性(SNP)与免疫球蛋白A(IgA)肾病患者系膜C3沉积和预后的差异。方法采用回顾性巢式病例对照分析。收集台州市中心医院2018年7月至2021年7月收治的IgA肾病患者380例的临床资料,患者均检测rs6677604 SNP,从中选取AG基因型36例,GG基因型72例。比较两种基因型临床资料(IgA、C4和C3免疫沉积物评分,经皮肾活检术,间质纤维化/肾小管萎缩,系膜C3沉积)、组织和循环补体水平、CFHR基因拷贝数;定期随访2年,分析不同rs6677604 SNP患者的预后。结果rs6677604-AG基因型患者IgA、C4、C3免疫沉积物得分分别为(1.34±0.50)分、(1.47±0.31)分、(2.65±0.36)分,均低于rs6677604-GG基因型患者的(1.77±0.73)分、(2.17±0.33)分、(3.00±0.48)分(t=-3.17、-10.59、-3.86,均P<0.05),系膜C3沉积强度以2+居多,循环C3、C4和补体因子H(CFH)均高于rs6677604-GG基因型患者(t=7.90、9.87、2.27,均P<0.05),循环IgA和Gd-IgA1水平均低于rs6677604-GG基因型患者(t=-2.98、-2.08,均P<0.05)。rs6677604-AG基因型患者CFHR3基因均为1拷贝,CFHR1基因33例(91.67%)1拷贝,3例(8.33%)2拷贝;rs6677604-GG基因型患者CFHR3和CFHR1基因均为2拷贝。rs6677604-AG和rs6677604-GG基因型患者2年内复合终点差异无统计学意义(χ^(2)=0.19,P=0.656)。结论rs6677604 SNP与IgA肾病患者循环CFH水平和系膜C3沉积具有相关性,可能对IgA肾病中的补体激活具有调节作用。Objective To correlate rs6677604 single nucleotide polymorphism(SNP)with mesangial C3 deposition and prognosis among patients with IgA nephropathy.Methods A retrospective nested case-control study was conducted among 380 patients with IgA nephropathy who received treatment at Taizhou Central Hospital from July 2018 to July 2021.All patients were tested for rs6677604 SNP.Among them,36 AG genotypes and 72 GG genotypes were selected.The clinical data(IgA,C4,C3 deposit scores,percutaneous kidney biopsy,interstitial fibrosis/glomerular atrophy,mesangial C3 deposition),tissue and circulating complement levels,and CFHR gene copy numbers were compared between two genotypes.Regular follow-ups were conducted for 2 years to analyze the prognosis of patients with different rs6677604 genotypes.Results Patients with the rs6677604-AG genotype had scores of(1.34±0.50)points for IgA,(1.47±0.31)points for C4 deposit,and(2.65±0.36)points for C3 deposit,all of which were significantly lower than those in patients with rs6677604-GG genotype[(1.77±0.73)points,(2.17±0.33)points,(3.00±0.48)points,t=-3.17,-10.59,-3.86,all P<0.05].The deposition intensity of mesangial C3 was predominantly 2+.Circulating levels of C3,C4,and complement factor H were significantly higher in patients with rs6677604-AG genotype compared with patients with rs6677604-GG genotype(t=7.90,9.87,2.27,all P<0.05).Circulating levels of IgA and Gd-IgA1 were significantly lower in patients with rs6677604-AG genotype compared with those with rs6677604-GG genotype(t=-2.98,-2.08,both P<0.05).All patients with rs6677604-AG genotype had 1 copy of the CFHR3 gene,with 33 cases(91.67%)having 1 copy and 3 cases(8.33%)having 2 copies of the CFHR1 gene.Both CFHR3 and CFHR1 genes in patients with rs6677604-GG genotype were 2 copies.There was no statistically significant difference in composite endpoint between patients with rs6677604-AG and rs6677604-GG genotypes over the 2-year period(χ^(2)=0.19,P=0.656).Conclusion RS6677604 SNP is correlated with circulating complement fact

关 键 词：肾小球肾炎 IgA 补体因子H 多态性 单核苷酸 肾小球系膜 预后 

分 类 号：R692.31[医药卫生—泌尿科学]