Wang Gang, Lai Fernand Mac-Moune, Tam Lai-Shan, Li Kwok-Ming, Lai Ka-Bik, Chow Kai-Ming, Li Kam-Tao Philip, Szeto Cheuk-Chun
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
J Rheumatol. 2007 Dec;34(12):2358-64. Epub 2007 Nov 1.
To examine urinary expression of podocyte-associated molecules in patients with lupus nephritis (LN).
We studied 32 patients with active LN (Active group) and 17 patients with inactive lupus (Silent group). Messenger RNA expression of nephrin, podocin, and synaptopodin in urinary sediment was quantified by real-time polymerase chain reaction and compared to other clinical measures.
The urinary concentrations of nephrin, podocin, and synaptopodin were significantly higher in the Active than the Silent group (p < 0.05 for all comparisons). There was no relation between urinary gene expression and the histological class of LN, but urinary nephrin expression correlated with proteinuria (r = 0.480, p < 0.01) and the score of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI; r = 0.578, p < 0.01). Urinary podocin expression also correlated with SLEDAI score (r = 0.389, p = 0.006). After initiation of immunosuppressive treatment, all patients were followed for an average of 13.7 +/- 2.4 months. The decline of the glomerular filtration rate (GFR) correlated with urinary expression of podocin (r = 0.406, p = 0.005) and synaptopodin (r = 0.337, p = 0.021). In a multiple linear regression model, urinary podocin expression and baseline GFR were independent predictors of GFR decline.
The concentration of podocyte-associated molecules in urinary sediment correlated with lupus activity and GFR decline. The clinical utility of quantifying urinary expression of podocyte-associated molecules for risk stratification of patients with LN deserves further study.
检测狼疮性肾炎（LN）患者尿中足细胞相关分子的表达情况。
我们研究了32例活动性LN患者（活动组）和17例非活动性狼疮患者（静止组）。通过实时聚合酶链反应对尿沉渣中nephrin、podocin和synaptopodin的信使核糖核酸表达进行定量，并与其他临床指标进行比较。
活动组尿中nephrin、podocin和synaptopodin的浓度显著高于静止组（所有比较p<0.05）。尿基因表达与LN的组织学类型无关，但尿nephrin表达与蛋白尿相关（r=0.480，p<0.01）以及系统性红斑狼疮疾病活动指数（SLEDAI）评分相关（r=0.578，p<0.01）。尿podocin表达也与SLEDAI评分相关（r=0.389，p=0.006）。开始免疫抑制治疗后，所有患者平均随访13.7±2.4个月。肾小球滤过率（GFR）的下降与尿podocin表达（r=0.406，p=0.005）和synaptopodin表达（r=0.337，p=0.021）相关。在多元线性回归模型中，尿podocin表达和基线GFR是GFR下降的独立预测因素。
尿沉渣中足细胞相关分子的浓度与狼疮活动和GFR下降相关。定量检测LN患者尿中足细胞相关分子表达以进行风险分层的临床实用性值得进一步研究。
